The other day I was going through the comments that had been submitted recently in response to various blog posts. This is actually one of the more enjoyable parts of maintaining this web site, because I often get to find out how people are finding affordable care options as self-pay patients, or respond to questions or comments they have. I also get to wade through a lot of spam (although if I ever need a mail-order-bride from Russia, I now know there are sites I can turn to).
Reviewing the comments that had been left on one of my recent posts about cash-only and cash-friendly doctors, I found one by Dr. Efrain Arroyave, a retired doctor in the Miami region. Dr. Arroyave in recent years has been very active in the self-pay healthcare world, helping to launch companies catering to self-pay patients like econoLABS, NextImage Direct, and opening in September, SelfPayMD, a chain of primary care practices in the Miami area that are cash-only.
I thought Dr. Arroyave’s comments were pretty interesting, and I thought they deserved a wider audience than whomever might stumble across them on that blog post. So, with his permission, I’ve re-posted his comments here as a stand-alone guest piece. It reads a little different than most pieces, because it was written in part to explain the ‘business case’ for SelfPayMd (or at least that’s how it reads to me), but it’s still a very informative commentary and I hope you all get as much out of his comments as I did!
Regardless of ObamaCare, “Self-Pay” Primary Care Practice Models Will Thrive!
Even before ObamaCare, as a direct result of diminishing reimbursements and rising overhead costs, many Primary Care Physicians (PCPs) retired early, abandoned their practice or joined primary care groups to share overhead. Some refused to accept government or private insurance, opting to change their insurance-based practice to a “direct-pay” business model (self-pay). Currently in the USA, direct-pay accounts for 4%-6% of primary care medical practices – and growing. Even in England, where they have had socialized medicine for several decades, it is growing at 5% per year.
Stressed Primary Care Physicians
Today PCPs typically get paid about 20% – 25% of their billed amount, while shouldering labor-intensive collections effort. Thus, by not accepting any form of health insurance, we eliminate unnecessary employees, which allows for a lower overhead, which in turn allows us [SelfPayMD] to charge only $75 per visit. Continue reading