Trend: Primary care doctors create own prepaid plans

As FierceHealthcare readers know, hard-pressed primary care physicians are trying a wide range of strategies to keep afloat, including offering cosmetic procedures, setting up a high-priced concierge practice, creating one-person "micropractices" with low overhead and even charging monthly administrative fees. 

Another emerging practice model, meanwhile, is one in which PCPs charge a flat monthly fee for a fixed bundle of services.  For example, after struggling to make the numbers work under a traditional, insurance-based model, Wheeling, West Virginia-based PCP Dr. Vic Wood was recently kicked off a program under which he offers unlimited primary and urgent care for a monthly fee of $83 per individual or $125 per family. He's also offering lab work, X-rays and a selection of generic drugs. Dr. Wood chose his price by assuming that the average adult needs about 20 itemized services per year. To date, Dr. Wood has signed up 100 patients to this plan; he projects that he'll need 1,200 enrollees to support his entire clinic.

Not long after Dr. Wood kicked off his plan in 2003, he heard from the state insurance commissioner, who said he was operating as an unlicensed insurer. (Other states have issued similar challenges to physicians attempting to roll out this model.) Since that day, however, Dr. Wood has lobbied the state legislature to get his approach approved. Eventually, the legislature approved a three-year pilot program testing the prepaid primary care approach, with Dr. Wood as one of the first participants.

To find out more about this approach:
- read this Wall Street Journal piece

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.