I’ve mentioned a few times in past blog posts that cash-only medical practices can be a great option for both the uninsured and insured with a high deductible patient, and specifically discussed the benefits of what are called direct primary care practices. Generally, these are practices that charge a monthly fee to all of their patients, and then offer generous access for patients including in some cases an unlimited number of visits.
This is a very helpful model to those patients who expect to need to see a doctor more than just a few times a year. For others however, particularly young self-pay patients who are relatively healthy and don’t expect to need to see a doctor more than once or twice a year unless there’s a serious injury, paying $50 or more a month for unlimited access to a doctor can be a waste of money. So, what’s the alternative for someone who doesn’t need to see the doctor very often?
One option may be another type of cash-only doctor who simply accepts all patients on a self-pay basis without asking them to enroll in their practice ahead of time. Several thousand doctors across the country have adopted this style of practice over the past decade. The Bangor Daily News reported several months ago on one Maine doctor who embraced cash-only primary care medicine earlier this year (“South Portland Doctor Stops Accepting Insurance, Posts Prices Online,” May 27, 2013):
“Dr. Michael Ciampi took a step this spring that many of his fellow physicians would describe as radical.
The family physician stopped accepting all forms of health insurance. In early 2013, Ciampi sent a letter to his patients informing them that he would no longer accept any kind of health coverage, both private and government-sponsored. Given that he was now asking patients to pay for his services out of pocket, he posted his prices on the practice’s website.
… the decision to do away with insurance allows Ciampi to practice medicine the way he sees fit, he said. Insurance companies no longer dictate how much he charges. He can offer discounts to patients struggling with their medical bills. He can make house calls.
“I’m freed up to do what I think is right for the patients,” Ciampi said. “If I’m providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense.”
“…I’ve been able to cut my prices in half because my overhead will be so much less,” he said.
Before, Ciampi charged $160 for an office visit with an existing patient facing one or more complicated health problems. Now, he charges $75.
Patients with an earache or strep throat can spend $300 at their local hospital emergency room, or promptly get an appointment at his office and pay $50, he said.
The reason doctors like Dr. Ciampi are able to offer prices that are even better than what insurers often pay is simple – without the bureaucratic and administrative expense of having to file insurance claims and wait to get paid, there is fairly little overhead compared to traditional medical offices.
These types of practices have been growing for over a decade, particularly in Washington State due to the efforts of Dr. Vern Cherewatenko, who founded the SimpleCare network several years ago as a way for patients to find doctors who only accept cash, or who at least give self-pay patients their best price.
These types of practices seem ideal for self-pay patients who don’t expect to need to see a doctor on a frequent basis or at least don’t want to pay a monthly subscription fee such as those charged by direct primary care practices. In addition to the SimpleCare web site, you can find doctors who are cash-only or at least cash-friendly at the web site of the Association of American Physicians & Surgeons.
For self-pay patients who need primary care provided by a medical doctor, finding a nearby cash-only practice is likely to be the right move.