Affordable Care Act Information
The Affordable Care Act puts consumers back in charge of their health care. As consumers research and select insurance carriers/plans, there are many factors to consider:
How much medical attention does the patient need on average each year?
Is the patient under the regular care of a specialist?
How high of a monthly premium can the patient afford?
What is a reasonable amount for the patient’s deductible?
How realistic is it that the patient will reach their deductible through routine medical expenses incurred over a year’s time?
However, many still feel frustrated by the amount that must be paid into a health insurance plan, knowing that the claims may recover only a fraction of the premium dollars spent.
A new strategy to paying for medical coverage and care is spreading. Combining a high-deductible and low-premium policy with payment at a direct primary care practice (i.e. monthly membership fee at a Concierge practice) can reduce overall medical spending.
Maintaining a high-deductible plan keeps patients compliant with the federal regulations of the Affordable Care Act, and it will cover patients in catastrophic or emergency medical situations.
Increasing the health insurance deductible will save money in the long run because of the lower healthcare policy premium, but how will that kind of plan be beneficial when patients need minor medical attention? With a high deductible plan, the patient will still have to pay out of pocket for services rendered if they have have not yet met their deductible. These kind of services can include x-rays, bone density checks, routine doctor’s visits, and other medical attention that may be needed on the day to day basis.
This is where DCP and Concierge practices can benefit you.
Direct Primary Care practices collect direct payment for services from patients at office visits. Direct pay allows doctors to charge significantly reduced, reasonable rates for medical services. The direct pay option allows patients to pay reduced costs for services from a quality medical center, all the while still receiving adequate time and attention from the doctor as well as spending a reduced price for such quality services. This kind of reduced price may be received by patients from practices where the doctor may see the patient for 1/10th of the time spent there in total.
Concierge Care practices collect a periodic “membership fee” from patients. The fee schedule is set based on projected care needs, and covers basic checkups and other minor to moderate medical issues. Members enjoy peace of mind that they will be seen and treated by a doctor whenever they need medical care, and that the additional expenses for needed tests (see below) will be a fraction of what would normally be charged at doctor’s practices who may see patients for less time and with less attention.
These two approaches allow patients who would pay additional out of pocket costs due to a high deductible, to pay a reduced cost for the same services but receiving those of a higher quality.
This approach allows doctors who can spend more time assessing the condition of each patient. And a longer, more focused assessment of a patient’s condition can result in more accurate diagnoses and, ultimately, a better treatment plan. When doctors are able to take the time to listen to and care for their patients, the relationship becomes one of trust and respect, replacing the skepticism and frustration that so many patients feel under the current care model where they may only see the doctor for 1/10th of the time they are in the hospital or practice.