Noose – Arkansas Physishuns Adopt Patient-Drif' Models | Arkansas Record | Editorials

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T' acoupla models gunyun' groun n' t'state alloe docters ta practiss n' a mer personal a'settin, treatin few'r patyints, offerin long'r appointmants, an' communicatyun' wiff patyints via text an' cell phone aft'r hours.

Arkansas has laws at a'loose docters an' patyints n' DPC an' concierge medasin practices frum oneryus regulatyuns und'r t'state insurance code.

Avoidyun' Insurance System

Matt Glans, a seenyer policy analeest fer T' Heertlan' Institute, which publishes Heelth Keer Noose, sez thar is a big differance tween t'concierge an' direck primree keer models.

“Wile direck primree keer is ofte compard ta concierge medasin, thay air nairy t'same,” Glans sed. “T' true value o'direck primree keer is its avoidance o't' insurance system altogeth'r. Und'r un insurance-baset payment system, primree keer docters face myriad regulatyuns an' a sloe an' costlee reimbursement system an' overheed at a'ken ett up ta 60 persent o'a typickull primree keer practiss’s revenue. Und'r a concierge model, patyints pay docters $1,500 ta $5,000 p'r year fer continuyus access, an' t'docters typicallee bill patyints’ insurers n' addishun ta chargyun' t'patient un access fee.”

Innovatif' an' Ol'-Skool

Dr. Allun McKenzie, M.D., a practicin physiciun since 2006, wurked fer Baptist Heelth, Arkansas’ largest hospital system, fer mer thun a decade befor affiliatyun' wiff MD-VIP, a concierge-style heelth keer group, las year. He sez he sees fur few'r patyints since adoptyun' t'concierge model, which he sez is bett'r fer patyints.

“I cummenced practiss [fer Baptist Heelth] n' 2006,” McKenzie sed. “Aft'r a duzen yeers, I had ov'r 2,700 patyints, seein about 30 patyints a day. Folk wuz bein turnt away ta walk-n' clinics an' ERs. I felt like I didn’t knoe my patyints well innymore, an' thay didn’t have access ta me. It wuz embarrassyun' an' nairy good fer patyints. Nawh, un avridge, I see eiite patyints a day.”

MD-VIP physishuns air limitid ta 600 patyints, McKenzie sez. Thay wurk wiff insuret patyints but rekwire un annual fee n' addishun. Adult patyints pay $1,650 p'r year, which McKenzie sez helps offset costs fer each patient’s comprehensif' annual wellness exam, a'lettin t'practiss ta remane small.

“Wile it’s progressif', it’s also ol'-skool,” McKenzie sed. “It’s bee a rilly neat eggsperients. [Patyints] git a slew bett'r prevantif' servus an' tenchun. My annual fee a'ken be paid out o'a heelth savins account er flex spendin account. Youngns o'patyints come along a'loose until thay air 26.”

Less Regulashun, Bureeucracy

Glans sez t'monthlee fee associatid wiff direck-payment heelth keer optyuns a'ken hep decreese t'regulatery burde un providers.

“T' guarantee o'a set monthlee fee removes t'layers o'regulashun an' bureeucracy creetid by t'radityunal insurance system,” Glans sez. “It also allows physishuns ta see few'r patyints an' focus mer un each patient. Routine tests an' procedures air includet n' mos DPC plans, an' low'r membership fees air ofte charget fer programs at do nairy provide these dishnull services.”

‘Wait Time Is Negligibull’

Dr. Joel Fankhaus'r, M.D., practices at Direck Keer Clinic o'Nerthwest Arkansas, n' Rogers, Arkansas. Fankhaus'r sez t'clinic offers minny a o't' same services as tradityunal docter’s practices wile cuttin out t'insurance cumpnys altogeth'r. Fankhaus'r sez individuals air generly charget $40 p'r month, wiff a maximum amount o'$80, an' famblies pay $160. His'n practiss limits physishuns ta no mer thun 800 patyints.

“We designet air practiss n' such a way such at folk have a monthlee fee an' thay a'ken be see as minny a times as thay want ta,” Fankhaus'r sed. “We a'ken do t'same procedures as inny primree keer offus, an' air appointmants air 30 ta 60 minnuts apart, so if'n it’s sumthin complicatid we a'ken easilee skejule y'all fer un hour, eve t'end o'a day un a Frydee if'n it is urgent er pressyun' enough. Wait time is negligibull.”

Wen wurkin n' a tradityunal offus, Fankhaus'r felt trappet by t'numbers, he sez.

“[Thar wuz] mer an' mer folk un air skejule, so thay’d end up goin ta urgent cares er uther docters er thay’d have six minnuts n' my offus,” Fankhaus'r sed. “I could nev'r catch up, an' folk felt thay didn’t have t'ime ta discuss inny ackshul seriyus medicull problems. At’s whut we as docters don’t like about t'way t'heelth keer system wurks.”

‘Nairy un Insurance Cumpny’

Fankhaus'r sez t'new heelth keer models air meetin t'needs o't' a'rizin numb'r o'folk who feel rung by t'cost o'insurance.

“Insurance is nairy afferdabull er nairy offerd by employers innymore,” Fankhaus'r sed. “If'n y'all pay 100 persent o'a high deductibull [plun] , all y'all’re gittin is a poerlee negotiatid group rate. Folk air a'havin ta make decisyuns un wuther ta go ta a docter er nairy, an' thishere is nairy baset un concerns, but ‘A'ken I afferd it at thishere moment?’”

McKenzie sez patyints must also explere tradityunal heelth insurance plans ta obtane necessree coverage fer hospitalizashun an' specializet keer an' procedures.

“Thar have ta be differnt optyuns fer folk,” McKenzie sed. “Y'all a'ken’t provide unlimitid keer without a cap.”

“We tell folk un t'frunt end, we air nairy un insurance cumpny,” Fankhaus'r sed. “We air nairy encouragyun' y'all ta nairy have insurance. If'n y'all have at opshun availabull ta y'all, y'all should look into a'havin insurance n' case y'all have a $100,000 hospital bill.”

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