LANSING, Mich. — With health care costs on the rise a growing number of Americans are throwing out the old way of seeing a doctor. They're turning to a membership model instead.a monthly or annual fee gets you direct access to a doctor – no insurance needed. As Ash-Har Quraishi found, it’s a model that some say cuts their medical costs.
“I was just miserable.” Twenty years into her career bogged down by red-tape, too many patients and long days. “The joy of medicine is gone and then you're just doing paperwork.” Dr. Shaila Pai-Verma was looking for a better way to practice medicine.
So, a year ago she started a new primary care practice – with a new business model. Dr. Shaila Pai-Verma is a direct primary care physician and she shared “the patient basically has a direct contract with the physician and they take insurance companies out of it.”
Patients pay a flat monthly or yearly fee. in exchange they receive a broad range of primary care services and quick, unlimited access to their doctor via in-person office visits, phone or by text. “Everyone wants everything immediate right. and so, i think this is it is this is it. you know it's good especially in this time for people to have access.”
Membership fees range from about $125 to $200 per month on average – about $250 dollars less than having typical health insurance. Most patients still carry catastrophic coverage for emergency treatments and hospitalizations but that insurance is usually only 50-100 a month meaning patients still save money.
For Bonnie Micceli and her family it was all about access. “With this it's just so much easier to just know that I can contact directly here within a few hours for any issues that I'm having. ”In late September a bipartisan proposal was introduced in Congress that would expand access to the model and allow people to use their health savings account for direct primary care. https://www.govinfo.gov/content/pkg/bills-116hr8417ih/pdf/bills-116hr8417ih.pdfhttps://crenshaw.house.gov/news/documentsingle.aspx?documentid=379.
Some critics say the model could worsen the shortage of primary care physicians that’s already driven by burnout - because they see fewer patients than in traditional practices, but according to a recent study DPC members had 25% lower hospital admissions and the cost of ER claims was reduced by 54%. https://www.soa.org/globalassets/assets/files/resources/research-report/2020/direct-primary-care-eval-model.pdf.
Dr. Shaila Pai-Verma explained “There's less ER visits and you know better health care for the patient.” While there is still debate, for a growing number of Americans it’s becoming a simplified health insurance alternative. Bonnie Micheli shared “honestly, it’s just so nice to know what I'm paying every month or if you do the annual what you're getting for that money and you know exactly who to go to when you have a problem.”
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