This monthly newsletter contains information about medical cost sharing programs as well as health insurance plans offered through insurance companies that promote healthcare cost transparency. It provides information about tools designed to maintain or regain your health, articles on health and wellness, and information on complementary and integrative health. It also contains information on other cost-transparent products and services you can purchase or utilize to supplement either your medical cost sharing program or your insured health insurance plan.

Direct primary care physicians are able to achieve better access to medical care, better quality of care, and lower overall health care costs because they can offer their patients both immediate access and more time.  Health Excellence Plus offers a solution that combines the direct primary care concept for small medical expenses and medical cost sharing for large medical expenses.

The following is an excellent article by Dr. Alex Lickerman that explains how the direct primary care concept works:

Direct primary care  (DPC) is an alternative to the traditional fee-for-service payment model of primary care. In DPC, physicians don’t bill insurance. Instead, they charge individuals or an employer’s health plan a monthly fee in exchange for providing immediate and unlimited access, longer appointment times, and intensive coordination of care. The fee is typically between $60 and $150 per patient per month. Employers may or may not choose to cost share this expense with their employees. Patients still require health insurance to cover services rendered outside of primary care (lab tests, medications, specialty visits, x-rays, hospitalizations, surgery, ER visits, and so on), but utilization of these services drops precipitously once direct primary care enters the picture.

 

Why? The lack of immediate access patients have to fee-for-service primary care physicians makes it far more likely such patients will improperly over utilize emergency rooms and urgent care clinics resulting in more unnecessary and costly tests and procedures. What’s more, because of time constraints inherent in fee-for-service primary care, traditional primary care physicians often can’t adequately address issues that lie within their own area of expertise. As a result, they are more likely to refer their patients out for tests and to specialists who then run even more tests, many of which are often unnecessary. This leads to an increased likelihood of complications and additional out-of-pocket costs for individual patients and employers if the patient is covered in a self-insured health plan.

Please click on this link to determine how Health Excellence Plus combines the direct primary care model with medical cost sharing to create a strategy for improving patient care and offering a cost-effective way to reduce patient costs anywhere from 30 to 90% below costs associated with the traditional insurance model. If you’re interested in learning more and determining whether this strategy is a good fit for you, please call us at

877-734-3884 .

HOW TO FOLLOW THE NEW ADVICE ON DAILY ASPIRIN

More than half of all adults between the ages of 45 and 75 report taking an aspirin every day, according to a 2015 study published in the  American Journal of Preventive Medicine . And for years doctors have recommended an aspirin a day for otherwise healthy older adults to help keep heart attacks at bay. Within the past year, however, the thinking has changed dramatically, says Leslie Cho, M.D., section head for preventive cardiology and cardiac rehabilitation at the Cleveland Clinic.

Please read this article that appeared in the March 26, 2019 issue of the AARP Newsletter . This article explains how the guidelines have changed and explains what you need to know. In addition, it also tells you why you can’t stop taking aspirin cold turkey.

Read the entire article here .

HOW A COMMON BLOOD TEST CAN COST BETWEEN $11 AND $1,000

It’s one of the most common tests in medicine, and it is performed millions of times a year around the country. Should a metabolic blood panel test cost $11 or $952?

Both of these are real, negotiated prices, paid by health insurance companies to laboratories in Jackson, Miss., and El Paso in 2016.  New data , analyzing the health insurance claims of 34 million Americans covered by large commercial insurance companies, shows that enormous swings in price for identical services are common in health care. In just one market — Tampa, Fla. — the most expensive blood test costs 40 times as much as the least expensive one.

This New York Times article by Margot Sanger-Katz explains that discrepancies like this are unimaginable in other industries and that the lack of price transparency (i.e. knowing the price for a service ahead of time) in traditional health insurance is also unusual.

Read the entire article here .