Fed Up With Obamacare, Doctors Increasingly Prefer Cash For Care

Forbes ^ | April 2, 2013 | Sally Pipes

[grundle]

Patients should welcome this development. Not only does the move toward direct payment have the potential to reduce health costs — it could also yield higher-quality care.

Even before Obamacare, direct-pay practices were growing in popularity. According to the Center for Studying Health System Change, direct-payment practices increased from 9.2 percent of the market in 2001 to 12.4 percent by 2008.

Nearly 7 percent of doctors say they are planning to change to some form of direct-pay care in the next three years, according to a survey of 13,000 doctors done for the Physicians Foundation. The consulting firm Accenture projects that one in three doctors in independent practice will adopt “subscription-based care models.”

One direct payment model that’s growing in popularity is “concierge” care, whereby doctors charge a monthly or annual fee for care — and bypass the administrative headaches associated with insurance and government programs altogether. The American Academy of Private Physicians — which represents cash-only doctors — estimates that the number of concierge doctors has shot up 30 percent in just the last year.

Examples of these practices abound.

Qliance, for instance, offers primary and preventive care for less than $90 a month in several cities in Washington state. In January, the company raised $8.6 million to expand beyond its home state.

One Medical in San Francisco charges patients between $150 and $200 a year for same-day appointments, online prescriptions, and email access to doctors. And in Portland, Oregon, patients at the Multnomah Family Care Center can pay a one-time enrollment fee and then monthly membership and provider fees that average less than $60 a month for preventative care. Others include Atlas MD, MedLion, Simple Care, and Paladina Health.

[2ndDivisionVet]

Six months from now this will be illegal.

[Secret Agent Man]

now this could be reform i could get behind.

obamacare causes doctors to drop insurance and govt exchanges altogether and go back to cash. more care at lower costs. like it used to be.

[Jyotishi]

Cash for medical care — how very third-world!

[Jet Jaguar]

Bump

[JRandomFreeper]

They were very receptive to cash at the upscale hospital I had to recently visit. Not that my kid isn't going to dispute some of the billing, that's her job, but cash is king. They knocked almost 1 kilobuck off the bill before she even asked..

/johnny

[Squantos]

Not sure why the HMO thing grew as we used to just pay as we went and had only hospitalization insurance vs every cough and boo boo bandaid runs to the doc.....

.....albeit we have employer provided medical now I plan a pay as we go plan with only hospitalization / cancer plan insurance for retirement.

Frugal conservative I am I am ....

[dadfly]

go doctors! cut out the middleman government.

[dubyajam]

Many docs in my area doing this now

[Jacquerie]

I’d wager not one in ten Americans understand that government is the reason for outrageous medical costs.

[JoeProBono]

[old and tired]

Three I years ago I had my prostate out. Before having it done, I looked around for the best surgeons. Two nearby - one if Baltimore and one in Philadelphia. Neither one would take insurance. 10k cash, visa and MC accepted. I stayed overnight in the hospital, which my insurance did cover. My insurance pays 50% non network, which came to a whopping $600. Turns out 50% is 50% of what the insurer would have paid an in-network doc which would have been $1200.

I know several doctors who are no longer accepting Medicare patients.

[jsanders2001]

> Six months from now this will be illegal.

Just like Obamacare should be ...illegal. Well good luck enforcing it Feds. You’re doing your best to turn us all into outlaws, Obie. Watch out what you wish for.

[Rocky]

New organization: Doctors Without Moochers

[listenhillary]

Not easy to track down but from what I’ve seen, an average office visit cost $5.00 in 1950. Adjust for inflation and that $5.00 becomes about $48.00 in 2013.

What are people paying now for a routine office visit to a family doctor?

[old and tired]

The thing is, a decent doc deserves every penny. However, now that we have these CVS minute clinics to go to when we get an ear infection, we’re just not going to need as many doctors. A majority of routine health problems can be handled just fine by a nurse practitioner or physician’s assistant. My grandson is going to a dermatologist for teenage acne and he’s seeing a nurse practitioner who’s cleared his skin right up.

[jsanders2001]

The irresponsible Obama supporters that don’t pay their medical bills ( or most other bills for that matter) and Insurance company policies both contributed to the problem too IMO (developed through talking to many healthcare providers in the past.) Allegedly, the non-payment rate was so high they had to overbilll the “paying” patients to make up the difference; almost the same result as socialized medicine if you think about it. I think the medical industry just went a little too overboard with it and the domino effect applied and it caused the price of medical care to rise exponentially.

[old and tired]

$50 is what one of the doctors I know who dropped Medicare patients charges for an office visit. A lot of his patients have stayed with him. They go to the Quest Lab to have their bloodwork done and that’s still covered by insurance.

[JoeProBono]

[old and tired]

The irresponsible Obama supporters that don’t pay their medical bills ( or most other bills for that matter) and Insurance company policies both contributed to the problem too

I know this is going to sound very lib of me, but I really think insurance companies and hospitals(along with the government) bear a huge responsibility for the mess we're in. My daughter and son in law have had Blue Cross and Blue Shield of SC for the last several years. My son in law (who is a top notch high billing corporate attorney) tells me the billing and reimbursement is such a mess that the majority of medical situations have errors either in the billing or reimbursement. My daughter no longer pays the medical bills that come in.

A couple of times a year, my son in law sits down, assembles all the medical bills and insurance statements, and then contacts the hospitals, doctors and BC/BS to get things all squared away. Not every bill is wrong, obviously, but enough of them are that it makes the most sense to ignore all of them until all facts are in. And the least stressful course of action is to rountinely ignore all medical bills until my son in law has a day to spend on them. For that to be their least stressful course of action, it's obvious we have a screwed up system.