Wisconsin direct primary care practice closing, but more opening nationally

At the end of October, I wrote a blog post titled “More cash-only doctors offering services to self-pay patients,” featuring Dr. Will Schupp of Wisconsin and Dr. Kevin Wacasey of Texas. Schupp had opened a direct primary care practice in which patients paid a low monthly fee for nearly unlimited access to primary care, while Wacasey had opened a more traditional cash-only practice that charged patients when they came to see him.

Unfortunately I’ve recently found out that Dr. Schupp’s practice will be closing. My friends over at AtlasMD.com report the following:

We’re disheartened to share the news that Dr. Schupp closed his Madison, WI-direct primary care facility last month. He told the DPC Journal Editor, Michael Tetreault, “I wanted to try something different [entrepreneurial] and had over 100 patients were interested in the first two-months of startup. I was able to cover expenses with just 40 patients.” 

Ouch. It’s incredible to hear that Dr. Schupp managed to break even with just 40 patients enrolled. Schupp continued to tell Tetreault, though, that several factors determined his decision to discontinue operation… one of which included the uncertainty of prospective patients related to the Affordable Care Act.

“The Affordable Care Act marketplace presented a lot of problems for my practice,” he wrote. “This is ironic, since a more transparent marketplace would be beneficial for me, but I did not foresee a broken website, a government shutdown and more expensive insurance for many of my patients. The new signups to the practice nearly stopped during the month of October, and people on the waiting list understandably wanted to remain there until the marketplace was functioning.”

The Capital Times reports that Dr. Schupp’s practice “flatlined” after 6 months of operation. However, Dr. Schupp added that it was a rewarding endeavor that he really enjoyed…

Very disappointing obviously, especially for self-pay patients in the Madison, Wisconsin area who might be looking for an option. But despite this setback for one direct primary care practice, there continues to be a growing number of practices leaving the third-party payer system and instead offering care to patients who pay them directly.

Just a quick google search using the term ‘direct primary care practice opening’ for the past month yields numerous new practices opening their doors to self-pay patients. Here’s a sampling:

Primary Care Practice to Open In January

Boulder County Business Record, December 13, 2013

BOULDER – Foundation Health LLC, a new direct primary-care practice, is scheduled to open in downtown Boulder in late January.

Direct primary-care practices offer ongoing health care for a monthly fee without going through an insurance company.

A group of six local partners is going in on the business…

Foundation Health’s partners are billing the business as a complement to health insurance. For $150 per month, Foundation Health customers gain unlimited access and office visits at Foundation Health with no co-pays or co-insurance. The office will offer extended hours and generally provides that patients can get in to see their physician within 24 hours. Providers are also available 24 hours per day via phone and text messaging.

The idea is to create easier access to a primary-care physician while also helping bridge the gap in coverage that often comes with higher deductible insurance plans. At a time when health-insurance costs are increasing significantly, Ginnie Meyers said the Foundation Health model provides a way for consumers to opt for a higher deductible health-care plan, add on the Foundation Health subscription to cover office visits, and still save money on monthly premiums…


Howell clinic rolls out new model for primary care

LivingstonDaily.com, December 28, 2013

A Livingston County medical clinic is hoping to change the way patients view — and pay for — primary care.

BlueSky Health recently launched its direct primary care model known as BlueSky Direct, which essentially eliminates the insurance middleman. For a flat, out-of-pocket fee of $30 per month, patients have access to diagnoses, disease management, preventive care and limited procedures performed at its clinic…

BlueSky Direct is not an insurance plan, and patients still need health insurance to cover medical care beyond primary care. The cost of BlueSky Direct cannot be applied to a patient’s insurance deductible, but switching to BlueSky Direct combined with a high-deductible health insurance plan can save a patient 10 percent to 40 percent on health-care costs per year, according to its website.


MedLion to offer direct doctor access for monthly fee

Sacramento Business Journal, December 12, 2013

MedLion, a fast-growing company that sells access to a primary care doctor for $69 a month, will open a Roseville office early next year.

The Nevada-based company offers an affordable alternative to concierge practices that charge a hefty flat fee for personal access to a doctor 24/7. Office visits are $10…

MedLion memberships will be available in an independent medical practice operated by Dr. Shahzad Anwar, a board-certified primary care doctor…

“My motivation? To provide patients with quality care in a setting in which they and the provider have control over how care is delivered,” Anwar said.

The practice will offer access to medication, lab tests, imaging and other services, some at reduced rates. A price list keeps costs transparent, Anwar said.

I don’t believe I’ve written about MedLion yet, which is a major oversite on my part! MedLion is promoting direct primary care practices throughout the country, adopting what might be considered a franchise model. The Sacramento Business Journal article cited above gives a little bit of information on this innovative and growing company:

MedLion has 16 location in five states. The company is funded by founder Samir Qamar, a former house doctor for Pebble Beach resorts that serve the wealthy.

The company is not the only one trying this approach. There are at least two national competitors: Qliance and Iora Health.

According to MedLion’s web site, they currently have locations in Arizona, California, Nevada, Pennsylvania, and Alabama, with locations in Florida, Georgia, Louisiana, North Carolina, Ohio, Oregon, South Carolina, Texas, Utah, Washington, and Wisconsin scheduled to open in 2014. Everything I’ve read suggests that MedLion is rapidly expanding, bringing direct primary care practices to communities around the country.

So while it’s sad that Dr. Schupp’s efforts to establish a direct primary care practice in Wisconsin weren’t successful, the good news is that this model of providing affordable primary care to self-pay patients is growing, benefiting both the patient and the doctor. The new year promises to bring many changes in health care, and it looks like those changes will include more options for self-pay patients.

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