Access Health Care

With the passing of the Health Care Reform Act, employers will be dealing with America’s health brokers in a different way. Many of the provisions for larger business employers (over 100 employees) will remain very similar to the status quo, but there will be a few changes that may be beneficial to the employee.

SEC. 311. HEALTH COVERAGE PARTICIPATION REQUIREMENTS

(3) CONTRIBUTION IN LIEU OF COVERAGE- Beginning with Y2, if an employee declines such offer but otherwise obtains coverage in an Exchange-participating health benefits plan (other than by reason of being covered by family coverage as a spouse or dependent of the primary insured), the employer shall make a timely contribution to the Health Insurance Exchange with respect to each such employee in accordance with section 313.

What this means is that the employee can opt to enroll in the business health insurance plan, or the employee can opt to seek a more affordable health insurance plan by seeking out a prospective deal through America’s health care brokers via the exchange. The details of the exchange have not been thoroughly set, as of now, but the direction of it is leaning towards a state to state variance where many of America’s health brokers compete to offer health plans at an affordable price.

It may be in the employee’s best interests to enroll in an employee medical insurance plan, because group health insurance will always be more affordable than individual health insurance. Another alternative would be to collaborate with a group of individuals to create an affordable group health insurance plan through the exchange.

A key point of interest for employees who work for a large company (over 100 employees), and are seeking health insurance coverage, is that their health insurance premium will automatically be covered by “not less than 72.5% of the applicable premium” {SEC. 312(1)(A)}. For spouses and children, “Not less than 65% of such applicable premium of such lowest cost plan” {SEC. 312(1)(B)}. As far as family health insurance plans go, it may be difficult to find a medical benefit plan that through the exchange that can compete.

By the year 2014, it will be required by law for every U.S. citizen to have personal health insurance coverage. Those who do not conform will be penalized for it. In order to reduce the problem with big businesses, there is a section that requires auto enrollment by employers. With the progression of smaller businesses merging with larger corporations, there is security in knowing that health insurance benefits are ideal for larger corporations. No longer will pre-existing conditions be a cause for non-enrollment or discontinuation of an existing plan.

America’s health brokers will have a much larger consumer base when the new law takes effect, which means that not only do the consumers win, but they do as well. In an era of sweeping change in the health care industry, group health plans will be beneficial to all who are involved. They will be beneficial to either a personal health plan as well as a family health plan. America’s health brokers will have a number of new avenues, but the greatest prospect will still be with larger businesses.

You need someone you can count on, a health life insurance company that will work for you in your best interest. America’s Health Brokers is that company. We tailor our plans to fit your needs, regardless of your budget. Our partnerships with many A+ rated companies allow us to provide you with a variety of options offering financial flexibility. Plus, we are the only company that offers a concierge customer care plan with all of our plans.

(Part 1 explained physician alternatives to private medical practice-focused on concierge medical practice.)

According to the Society for Innovative Medical Practice Design, a professional society of concierge physicians, there were over 5,000 doctors in concierge practices in 2005 (total number of physicians in U.S. over 950,000).

Accumulated data confirm many concierge medical practices are composed of just 300 patients, charged an annual encompassing fee of ,800 equates to a practice gross income of 0,000. Not bad for starters…..you think? Compare that with AMA statistics indicating the average solo primary care general practitioner physician in the United States averages out to about ,000 net.

Sure, the net income a physician takes home depends on a hundred “this’s” and “that’s.” The point is that there are practice choices open for serious consideration you may have not felt worthy of

consideration yesterday.

Doctors Busch, Flier, and Cortiss report that 98% of concierge subscribed patients in their 900 patient practice renew annually. It’s a measure of “patient wants” from physicians and of their loyalty and benefits from that method of delivery of health care.

Traditional medical practices usually claim a practice load of 2,500 to 4,000 patients. The usual successful concierge practices run well with 500 or less patients. Just imagine having the time to spend an hour with each patient and appointment. Something you’d love to do? You would have the time to strut your “stuff,” and pile on your expertise if necessary, within limits of course. This is the perfect scenario for doing some referral marketing that I have mentioned in previous articles-recruit a “promoter” for free.

Since your own medical practice volume will keep dwindling over time, it will become necessary for every entrepreneurial physician who cares to continue private practice, to increase or maintain practice income using marketing and effective business strategies. These will become an absolute necessity just to maintain their present practice volume, let alone increase their patient load-and income. Do you really believe you can avoid that probability? I don’t.

Some concierge medical practice models that might be exactly perfect for you:

Some of the most practical models to choose from:

• Hybrid Model-blending of concierge with your present practice.

• Innovation Model-start from scratch.

• Transformation Model-convert present practice completely to concierge practice.

• Private Group Model-concierge practice in a group practice model.

• Commercial Model-concierge practice partnered with business, industry, or other.

Although concierge medical practices share some common similarities, they vary significantly in structure, payment requirements, and operational systems, among others.

All claim they offer 24/7 coverage either by cell phone or email, provide complete in office healthcare services, meet the quality standards of medical care provided throughout the medical profession, have few limitations to healthcare coverage and services, are compatible with any and most health insurance programs in the U.S., and have extended time with physicians.

Sample Concierge Medical Practice video: http://www.choice.md/doctors/doctor-video/

Differences include:

• Some practices do not accept any health insurance of any kind (cash only and direct primary care). It’s done primarily to reduce overhead and administrative costs and provide more affordable

health care.

• “Concierge practice” is one which requires annual or monthly fee plans instead of, or in addition to,

a fee for each medical interaction. The annual fee should not be construed to be a substitute for medical insurance and does not cover outside consultations, lab procedures, medicines, hospitalizations, or emergency care.

• Some concierge practices which accept health insurance plans, also accept Medicare, but ask for fees to cover additional services provided under the insurance coverage.

• Some medical insurance companies refuse to provide patient coverage if they are treated by an annual fee based concierge practice. Some do, with restrictions.

• Some concierge practices provide extra medical services such as detailed research into a patient’s medical problem, or permit some patients to join free or at a discount when they are under distressed financial situations, among others.

Hybrid Model:

With respect to the sensibilities of your patients, the hybrid model doesn’t disenfranchise your patients or contribute to physician shortage, contrary to the propagated image of “cash only” medical practice. The commonly used transition method is to recruit from 10 to 20 of your patients who elect to join the concierge practice model for an annual fee. Other patients who are not interested, continue with their primary care physician as usual. The downside for physicians is that they have to juggle between patient categories among a continuing large number of regular medical patients.

It’s reasonable to assume that by the time the patients who have not joined the concierge group become so disturbed about the increasing co-pays, 8 minute office visits, longer waiting periods to be seen, that they will see the benefits of joining the concierge model willingly. The old “capitation model” of practice in the 1970′s was similar but never really caught on.

Once a physician is comfortable with the concierge model, understands the value of such a model to himself, his practice time, and his lifestyle improvement, it’s time for decision making. He recognizes by converting his practice completely over to the concierge model, he or she will have to see and care for less than 500 patients to earn the same amount of money they earned before with 3000 regular patients.

But, also will assuredly provide better medical care because of having time to read more journals, go to more medical education meetings, able to take more time to increase their skills and training, and, most of all, have more time with their family. Can you imagine that?

(Continued in Part 3–more on concierge models-details on the establishment of such a practice)

The author, Curt Graham, M.D., an experienced physician, author, and marketer with expertise in medical practice business and marketing strategies, is an expert author and motivator for professionals in the business world. He is a platinum expert author with EzineArticles.com and has been published in Modern Physician and elsewhere.

Discover how to make your medical practice flourish and exceed all expectations with simple business and marketing strategies. Click here now for the effective ways to do it. http://www.MarketingAMedicalPractice.com

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