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InsiderOnline Blog: March 2013

When the Patient Spends His Own Money

Fixing health care could be as simple as making consumers see real prices. That’s what happens when physicians stop taking insurance and accept only direct payment from their patients. More and more doctors are turning to that model, as Jim Epstein reports, and their experience shows that bypassing third-party payers leads to lower prices:

Dr. [Ryan] Neuhofel, based in the college town of Lawrence, Kansas, charges for his services according to an online price list that’s as straightforward as a restaurant menu. A drained abscess runs $30, a pap smear, $40, a 30-minute house call, $100. Strep cultures, glucose tolerance tests, and pregnancy tests are on the house. Neuhofel doesn’t accept insurance. He even barters on occasion with cash-strapped locals. One patient pays with fresh eggs and another with homemade cheese and goat’s milk. 

“Direct primary care,” which is the industry term for Neuhofel’s business model, does away with the bureaucratic hassle of insurance, which translates into much lower prices. “What people don’t realize is that most doctors employ an army of people for coding, billing, and gathering payment,” says Neuhofel. “That means you have to charge $200 to remove an ingrown toenail.” Neuhofel charges $50. […]

This model is growing in popularity. Leading practitioners of direct primary care include Seattle, Washington-based Qliance, which has raised venture capital funding from Jeff Bezos, Michael Dell, and comedian (and Reason Foundation Trustee) Drew Carey; MedLion, which is about to expand its business to five states; and AMG Medical Group, which operates several offices in New York City. Popular health care blogger Dr. Rob Lamberts has written at length about his decision to dump his traditional practice in favor of this model. […]

When she was operating a traditional practice, [Dr. Lisa] Davidson witnessed firsthand how our “payment plans for routine expenses” drive up prices and block innovation. She recalls that one insurance company paid $118 for a routine PSA test. Now that her patients pay the bill directly the cost is $18. Insurance used to pay $128 for a bag of IV fluid. Now Davidson doesn’t bother passing on the cost of IV bags because they run $1.50 each. [Reason, March 13]

Posted on 03/13/13 01:53 PM by Alex Adrianson

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