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Saturday, April 18, 2015

The group-to-individual strategy

In the interim since my last post, my practice has made leaps and bounds towards the realization of its goals.  The time spent working on the practice, as well as in the practice, has led to increasing attention by local media, business owners and individuals/families for whom the DPC model is an ideal complement to their high deductible plan, cost-sharing plan or no plan.  My enrollment had risen to 280 patients by the end of the eighth month; there has been no single month with fewer than 30 new patients.  I have hired a nurse to complement my receptionist who works primarily as a care manager.  I have begun to enroll groups of patients whose monthly fee is paid by their employer.  

The most important development in my DPC transformation has been the recognition of an ideal strategy for employer engagement in the DPC model: the group-to-individual strategy.  An employer (with fewer than 50 employees) who wishes to provide coverage as a health benefit for his employees has several good options when combined with a DPC physician/group of physicians.  The expensive group insurance coverage can be discontinued, allowing the employees to purchase individual coverage with subsidies if they qualify, since their employer no longer offers them coverage.  The employer can, if he chooses, increase the employees pay by an amount that allows them to purchase their coverage, with or without also paying for their direct primary care.  The end result, even if the employer provides both benefits, is greater than 50% reduction in the cost per employee (more if the employees qualify for subsidized coverage) and unlimited access by their employees to a physician, keeping them healthier and happier with less missed work due to illness.  Everyone wins!  Even lobbyists for the insurance industry should be happy because insurance still needs to be purchased.  

As I engage more employers, I will be able to hire a small network of physicians, at guaranteed salaries, who will start with a panel of patients.  The network will then be able to engage larger employers, allowing a larger network, etc. etc. This will be the model that delivers on the promise of a reformed healthcare system.

So family medicine residents who are in their second or third year, who would like to practice DPC in Tampa/St. Petersburg/Clearwater FL at a guaranteed minimum pay, with a path towards "franchise ownership" of their own practice, should contact me to begin early discussions about the opportunity.

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