Dr. Greg Miller and guest Dr. David Usher from ReforMedicine presented a new way of obtaining healthcare to the club. This innovative model of practice - ReforMedicine - where primary care physicians are helping with the challenges of the cost of healthcare, provides high quality primary care to individuals and employer groups. 
In 1999, families paid about 11 percent of their median family income in health insurance premiums. By 2020, that number is projected to more than double; families can expect to pay upwards of 24 percent.*
 
Dr. Usher said that healthcare costs have increased because of a few factors:
  • Electronic Medical Records, which were supposed to make things faster, but ended up adding layers of cost through additional administration.
  • The Affordable Health Care Act, which created mandates for physicians about billing for care and structural issues for insurance companies.
  • Regulatory and payment burdens on physicians, leading to burnout and patient dissatisfaction.
Enter ReforMDirect, by ReformMedicine, a direct pay family practice.
 
ReforMedicine uses a direct pay method that provides low overhead, low, transparent pricing and no third party billing. It operates independently of all health systems, and is the first of its kind in Western Wisconsin. Since opening in 2011, it has since expended to nine employers in four locations, has a unique approach to lowering costs while raising satisfaction.
 
ReforMedicine focuses first on value-based primary care. It's different from other medical practices by a combining three unique opportunities for patients:
  1. A patient-centered perspective on the treatment of chronic disease.
  2. Transparency about the costs of diagnostic tests, medications, and clinical care.
  3. Patient accessibility.
 
ReforMedicine, a cash only practice, cuts costs through reduced paperwork and allows longer visits, giving doctors a chance to know their patients through longer appointments and more personalized care. More serious health conditions can be diagnosed earlier. Treatments can be less invasive and cost less. Plus, doctors can help the patient seek appropriate care through vendors who use transparent pricing.
 
Its goal is to provide satisfying primary care experience for patients, providers and staff.
 
The model provides lower costs for both providers and patients. It works because it builds trust in patients. They stop going to the Emergency room and urgent care, because they can get an appointment with their primary doctor quickly, and have their concerns addressed by someone who knows their history. The goal is to help patients stop avoiding seeking health care because of fears of high costs.
 
This model works for employers because
  • Employers can plan monthly primary care costs
  • Transparency vendors steer to value centers
  • They know their employees will have access.
It establishes trust in patients because patients
  • Know out-of-pocket costs
  • Pay $0 or very low office visit charges
  • Are motivated to seek preventive services
  • Receive no surprise bills.
Learn more about ReforMedicine.
 
*Commonwealth fund calculations
 
 
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