Practices See Membership Models As One Piece Of Future Success

By Lea Chatham, Editor, Getting Paid Blog

Healthcare reimbursement is changing, and independent practices are looking at different payment models to help them stay successful. Some are adding services like telemedicine. Others are joining forces through accountable care organizations (ACOs) and independent physician associations (IPAs). While still others are testing and using membership models like direct primary care (DPC) and concierge.

Many of these practices are taking a practical approach to new models. Few are switching entirely. Instead, they are adding a membership as just one option in their practice. According to a 2015 survey conducted by Kareo and the American Academy of Private Physicians, 24 percent of providers are already using some kind of concierge, DPC, or another membership program in their practice.

When asked what percentage of their entire patient panel were members, 37 percent said only 25 percent or less of their patients were members. Just 28 percent of practices had all of their patients as members. Everyone else fell somewhere in between. The study suggests that more physicians than previously thought are using these models but most aren’t using them for all of their patients.

“We’re testing out some direct primary care in our practice right now,” says Douglas Hansen, MD, founder of Altitude Family Medicine in Littleton, CO. “We’ve definitely seen that this is a growing trend for patients with high deductibles, and we wanted to provide the option to patients who are interested.”

Altitude is a great example of how practices are trying a range of options to stay independent. They are also part of a large ACO and are being reimbursed under some value-based programs in addition fee-for-service. “We’re still largely fee-for-service—about 70 percent—but the other payment models are a growing part of our business.”

Another example of a practice using various models and technology to stay independent will be presented at HIMSS16 in the session Creating an Agile Medical Practice to Meet Consumer Demands. Dr. Lee Peter Bee, DO, CEO of Southern Illinois Medical Specialists, will present alongside Dr. Tom Giannulli, CMIO of Kareo, to detail how using solutions such as telemedicine and participating in an ACO have helped his practice grow in much the same way as Altitude.

The infographic below on the 2015 Practice Models Perspectives Survey shows the growing interest in membership models, who is using them, and why. It also highlights some of the key differences between traditional fee-for-service and these newer models.

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