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Direct Pay Reduces Practices' Administration Hassles, Costs

MONDAY, May 12, 2014 (HealthDay News) -- Direct-pay practice models can allow doctors to reduce, or possibly eliminate, the administrative hassles and costs of dealing with insurance, according to an article published April 24 in Medical Economics.

According to the author of the article, Lisa Zamosky, direct-pay models generally incorporate a retainer fee paid directly from patients, rather than physician reliance on fee-for-service reimbursement from third parties. These models share the aim of high service levels and increased access for patients. Specific services covered by the retainer fee vary, but often include all primary care services, care management, care coordination, and basic tests at no additional charge. Access is heightened and often includes seven-day-a-week, around-the-clock access to doctors; same-day appointments; office visits of at least 30 minutes; and phone and e-mail access to the physician.

Zamosky notes that some models include concierge medicine (with a full conversion or a hybrid model) or a direct primary care model. The benefit to physicians for participating in these direct-pay models include reducing patients panel sizes (often by nearly half), minimizing of administrative and staffing costs, increasing the amount of time spent with patients, and potentially increasing incomes. But, physicians must assess their patient population to consider how many will actually pay the fee.

"Although these models can look different, at their core, experts say, they share the common aim of providing high service levels, and increased access for patients," Zamosky writes.

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