Contents tagged with direct primary care
By Kissi Blackwell, MD
Recent events have shed light on the existing difficulties facing family physicians and have revealed the fragility of the current healthcare system. The SARS-CoV-2 pandemic has devastated our health care delivery process, and many family physicians are facing the difficult decision to close their doors or contend with salary reductions due to sharply decreased face-to-face visits. Now, more than ever, patients are valuing visits that can take place outside of the exam room, and, unfortunately, reimbursement has been severely lacking for virtual visits for traditional fee-for-service practices.
In the midst of all this uncertainty, there has been an inherent need to shift the way we approach primary care delivery and payment. In a time where we stand to lose thousands of primary care physicians to financial difficulties or retirement forced upon them by the current situation, we owe it to our profession to find a better way.more
By Jonathan Nelson
Direct primary care practices are cropping up across the country as physicians grow more frustrated by administrative burdens inherent in a fee-for-service third-party insurance market. But some regulatory obstacles block many people from joining DPC practices. The Direct Primary Care Coalition — of which TAFP is a steering committee member — has called on physicians to ask their representatives in Washington D.C. to sign on to federal legislation that would remove those obstacles.
In DPC practices, physicians charge patients a monthly, quarterly, or annual fee — like a retainer or membership fee — that covers a broad set of primary care services and patients typically enjoy greatly enhanced access to their physician. IRS rules interpret these DPC payments to be like paying premiums for health insurance rather than just a different way to purchase a set of services. Even though Texas and 17 other states have passed laws defining DPC arrangements to be outside of state insurance regulation, the IRS interpretation bars individuals with health savings accounts paired with high-deductible health plans from using their HSA funds to pay DPC fees.more
Emily Briggs, MD, MPH, opened her own full scope practice in New Braunfels, Texas, which also highlights full scope obstetrics. She recently joined a physician-led Accountable Care Organization … more
Member of the Month: Anthony Lyssy, DO
Direct primary care doc helps patients focus on prevention
After completing medical school at UNTHSC in Fort Worth and completing a … more
By Dale Ragle, MD
TAFP President, 2014-2015
On April 16, 2015, President Obama signed the Medicare Access and CHIP Reauthorization Act of 2015, which phases out Medicare’s flawed sustainable growth rate payment formula over the next 10 years. The so-called “doc fix” enjoyed bipartisan and bicameral support in Congress, a rare phenomenon these days, as well as support from most major medical organizations, including AAFP and the American Medical Association. In spite of broad support, the bill took more than a year of tweaking and survived innumerable negotiations between both political parties and the White House, a testament to the adage that “the devil is in the details.”
The SGR formula tied Medicare expenditures to the gross domestic product. Since demand and utilization of health care services do not rise and fall directly with the ebbs and flows of the general economy, the SGR often threatened to cut physician fees year after year. Perennially, Congress passed special legislation to delay the fee cuts, often only finding they have to repeat the action in the following year.more
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Back to the future with direct primary careRemember a time when you could treat your patients … more
By Dale Ragle, MD
TAFP President, 2014-2015
Greetings colleagues. Do you remember a time when you could take care of your patients without any of the hassle and expense associated with billing insurance companies? When you could spend as much time with your patient as needed? When you simply received payment from your patients instead of some third-party payer?
Many physicians practicing today have only heard stories of those days, but a growing number are rediscovering them by stepping off the insurance treadmill and contracting directly with their patients. Direct primary care is an innovative model for delivering and purchasing health care services that gives physicians and their patients an alternative to the third party, fee-for-service system. For a flat monthly fee, patients have unlimited access to their doctor—in person and by phone or e-mail—for a full range of comprehensive primary care services including acute and urgent care, regular checkups, preventive care, chronic disease management, and care coordination.more
By Tom Banning
Yogi Berra famously said I hate making predictions, especially about the future. It’s particularly painful when those predictions come true as was the case for many of the predictions TAFP made at the outset of the 84th Texas Legislature on how health care issues would fare this session.
Playing to their primary voters, the House and Senate focused attention almost solely on tax cuts, border security, transportation, when and where you can carry a gun, and a host of other mostly inconsequential partisan ideas.more
The clock is winding down on the Texas Legislature
With less than a week left in the 84th Texas Legislature, many bills TAFP has been tracking have passed the House and the Senate … more