Healthcare is more complicated than ever before.
It is true not only for consumers, but for providers, as well. Every year physicians are becoming more challenged to make a profit. From regulatory changes brought on by the Affordable Care Act to insurance companies demanding more documentation, compliance and lower reimbursements for services.
Many in the healthcare industry are seeking solutions and opportunities, which allow them to do exactly what they entered the profession for: help their patients live a healthier and more fulfilling life.
One trend that is becoming very popular in metropolitan markets is "concierge healthcare." This model basically groups high net worth individuals together to hire a personal physician to oversee their healthcare. They pay the doctor a monthly fee and in return they experience health care like we all use to have years ago.
Dr. John Gerguis, owner of Total Health, Center for Family Medicine, has explored the model and determined that a variation of the model known as direct primary care is something that would work in a rural setting.
"Currently my patient load is around 5,000 individuals," he said. "We have to have these type numbers to make our practices profitable. With this model, I am lucky if I get to spend 10 minutes with each patient. I did not become a doctor to run a high volume clinic. With this level of volume it is difficult for me to truly invest the time I would like to completely manage my patient's care."
Dr. Gerguis acknowledged that, in addition to the high volume of patients, he also spends 35 to 45 percent of his budget and time dealing with administrative issues primarily involving filing insurance and complying with cumbersome regulations.
So, he made a decision. Beginning April 1, Dr. Gerguis will convert his practice to a direct primary care practice. The model uses a combined system of monthly installments and a la carte, point-of-service menu payments without direct billing of insurance. His goal is to provide patients with a full range of comprehensive primary services, including routine care, regular checkups, preventive care and complete care coordination for a flat, recurring retainer fee that is billed to patients on a monthly basis.
The model allows Total Health to handle a maximum of 1,000 patients between Dr. Gerguis and Jennifer Smith, NP. The plan is available for $85 per month for adults and $65 per month for children.
Dr. Gerguis said the plan does not replace insurance, but allows patients to adjust their health insurance plan to a higher deductible option, which covers specialists, hospitalizations and tests not available through the direct primary care.
Members of the new service will receive 24-hour direct access to Dr. Gerguis or Jennifer Smith, NP. Also, Members will be provided with significantly increased office visit time and same day or next day appointments. In the future, Dr. Gerguis hopes to offer home and work-site visits. All laboratory testing, diagnostic (such as x-rays, ECG, Lung Function Testing, etc.) medication injections, immunizations, in-office procedures will be included as part of the monthly fee or at a much lesser pre-negotiated cost.
If you are currently a patient of Total Health, you have until April 1 to sign up for the new network or choose another primary care provider.
"I understand this is a new idea for our community," Dr. Gerguis said. "It has proven to be very successful in other areas of the country and is now becoming available in smaller markets. This change will allow us to take back over the management of your healthcare from third party managers. With this change, my patients will see improved quality of care, I believe, at a much lower price than most are paying now."
To learn more about joining Total Health's direct primary care service, call (912) 871-7890.
Please email DeWayne at firstname.lastname@example.org or give him a call at (912) 489-9499.