Twenty-Six Percent Below the Benchmark
A Wisconsin shop in Stevens Point put direct primary care under their benefits four years ago. Anovia. Green Bay. Flat monthly fee. Thirty-minute visits. No RVU treadmill.
Phyx Innovation Labs pulled the claims. Gamber-Johnson's cost per member per year fell from $5,860 to $5,385. Down eight percent while the commercial benchmark climbed thirty-eight. They sit twenty-six percent below the market now. Last year the auditors counted $684,779 in verified savings across seven care lanes.
I am not shocked. When primary care is a membership instead of a claim, the rest of the system gets cheaper too. Surgery bundles forty-four percent under market. Imaging. Labs. Therapy. The doctor steers you to the good price because nobody is paying him to steer you to the expensive one.
I am not anti-insurance. Keep a policy for the wreck. Primary care is not a wreck. We take care of patients for a flat monthly fee. No claim. No network. You call. We see you. The number on the door is the number you pay.
Twenty-six percent is a price gap. It is also a doctor who had time.
Twenty-Eight New Patients From One Billboard
Twenty-eight new patients. One month. One Kansas City internist.
The Beacon just wrote her up. Myriam Ensling put her face on a billboard near Gregory and Troost. The line above the smile says it plain: No insurance? No problem. Last month she signed twenty-eight people who finally had somewhere to go.
I am not shocked. The system already collapsed for a lot of them. Premiums climbed. Deductibles turned into a second rent. Copays made a sore throat feel like a budget decision. They did not need another network brochure. They needed a doctor who answers the phone.
Down the street, a coffee shop on Troost covers direct primary care for its twenty-two employees. The owners could not swing full insurance. They could swing a flat monthly fee. A barista called it a luxury. That is what having a doctor used to be called before the claim form showed up.
The Direct Primary Care Alliance puts the Midwest average around eighty dollars a month. Unlimited visits. Text when something looks wrong. A panel of five or six hundred, not two thousand. Damon Heybrock said it the way I say it. Car insurance does not pay for your oil change. Keep a policy for the wreck. Primary care is the oil change.
I am not anti-insurance. Keep a policy for the wreck. I am anti a product that makes you ration the visit that keeps you out of the wreck. We take care of patients for a flat monthly fee. No claim. No network. The number on the door is the number you pay.
Twenty-eight is not a marketing metric. It is how many people found the door in one month because someone posted a real price.
Ninety Dollars Per Month Per Employee
A school district in Michigan put a clinic in a converted classroom. Cement-block walls. A pencil sharpener still hanging where the kids used to crank it. Bridge Michigan walked those classrooms. The superintendent said it out loud. This is health care the way it is supposed to be.
Corunna pays ninety dollars a month for each of its 255 employees. Two days a week. No copay. No deductible. Every visit that morning was booked for at least a half hour.
Thirteen people came in. Poison ivy. Pink eye. Blood pressure. A kid's sports physical. They left with nearly $550 in medicine and paid nothing for it.
I am not anti-insurance. Keep a policy for the wreck. About 110 of those staffers still carry the school plan for the hospital. The superintendent's math is the same one we use. One family, strep in the middle of the night, one ER, and that virus can cost the pool more than a year of this clinic.
We take care of patients for a flat monthly fee. No claim. No network. You call. We see you. The number on the door is the number you pay.
Ninety dollars is a price. It just happens to live down the hall from the gym.
Twenty Million
Mississippi is standing up a new health market. Twenty million dollars. Next year. They are calling it the Mississippi Option.
It is not a public option. It is a state portal for short-term plans. A couple hundred a month. You can sign up any day and quit any day. UnitedHealthcare will sell them. The plans do not have to cover maternity, mental health, or the pharmacy. They can turn you down for a condition you already have. The insurance commissioner said it out loud. If you need a liver transplant, or a knee you neglected, you are not getting coverage out of the plan.
Twenty million is what the state is putting on the table. The old high-risk pool still has a little over twenty-two sitting in assets. Last year Mississippians took about $2.2 billion in federal premium help. Twenty million is not going to get you very far.
I am not anti-insurance. Keep a policy for the wreck. I am anti a product that looks like insurance until you need it. We take care of patients for a flat monthly fee. No claim. No short-term. The number on the door is the number you pay.
Twenty million is a price. It is not a doctor.
Forty Thousand
Same Blue Cross plan. Same knee replacement. An hour apart on a North Carolina map.
At Catawba Valley in Hickory: about sixteen thousand dollars. At Mission in Asheville: about forty thousand. More than double. Serif Health pulled the numbers out of the price files hospitals are supposed to post. Mission was built by merging the two hospitals in town. Then it lobbied the profit caps off. Then HCA bought the monopoly.
I am not shocked. When you are the only hospital, you are not a price. You are a premium.
A nurse in Asheville tore her meniscus skiing. Mission said over nine thousand for the scope. She walked. An outpatient shop did it for less than a third. That is what a posted number is for. Shopping.
I am not anti-insurance. Keep a policy for the wreck. I am anti a ZIP code that doubles the invoice. We take care of patients for a flat monthly fee. No claim. No network. The number on the door is the number you pay.
Forty thousand is a price. It just only shows up if somebody bothers to compare the next town over.