Under a pilot program, thousands of teachers, police officers, firefighters and other government employees in New Jersey may get to spend more time with their doctors.
That’s an advantage for beneficiaries of the New Jersey State Health Benefits Program and School Employees’ Health Benefits Program, health plans which have a contract with an Elkins Park company called R-Health to provide direct primary care, according to Philly.com.
The members covered by those public-sector health plans do not have to pay a monthly fee for concierge or direct care access if their physicians are signed up with R-Health. For retired police officer Ronald Russell it means he no longer has to pay a $130 monthly fee, in addition to his health insurance, to cover his family members’ 24/7 access to their primary care physician, the report said.
The three-year pilot program began last month when R-Health’s contract took effect, covering as many as 60,000 state and local government employees. The free add-on to existing health insurance coverage gives patients more access to their doctors, with the goal of reducing long-term healthcare spending.
To participate, doctors must give up all fee-for-service payments, but they receive an undisclosed per-member free per month, typically $50 to $80, plus potential incentives based on clinical outcomes and patient satisfaction. Doctors are limited to 1,000 patients.
The new model is designed to give members more access to primary care, which means providers can offers same-day or next-day appointments, evening and weekend hours, little or no wait time in the waiting room, unhurried consultations, and access to a personal physician via phone and digital messaging.
“We have all been frustrated by how hard it is to reach our doctor and how long we have to spend in the waiting room before we are seen,” Mason Reiner, CEO of R-Health, said last month in an announcement. The model, he said, is designed to provide convenient access to care.
Other doctors have had success with direct care models, which allow doctors to focus on their patients, according to Rob Lamberts, M.D., a primary care physician in Augusta, Georgia. A California doctor, Emilie Scott, M.D., said switching from her traditional practice got off her off the "assembly line."