Posted in Access to healthcare, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Health Insurance, Healthcare financing, Independent Physicians, Medical Costs, Patient Choice, Price Tansparency, Self-Insured Companies, Uncategorized

Jay Kempton: An Unorthodox Benefits Solution – Healthcare Americana

Healthcare Americana, Chris is joined by Jay Kempton of The Kempton Group and co-founder of the Free Market Medical Association (FMMA).

Chris and Jay discuss novel ways of implementing employee benefits, why there are barriers to change, and the upcoming FMMA conference.

https://healthcareamericana.com/episode/jay-kempton-an-unorthodox-benefits-solution/

Posted in Access to healthcare, advance-pricing, American Presidents, Consumer-Driven Health Care, Crony Capitalism, Economic Issues, Government Regulations, Healthcare financing, Influence peddling, Medical Costs, News From Washington, out-of-pocket costs, Patient Safety, Policy Issues, Price Tansparency, Uncategorized

Hospitals pledge to fight Trump admin price transparency plan in court | Healthcare Dive

The old aphorism is true, leopards don’t change their spots!

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For these three entities that oppose the new HHS price transparency rules, and for many others to be sure, there is no incentive to hold down healthcare care costs. In fact, the incentives of the current system of healthcare financing are such that it’s in their favor for prices to always go up.

In all cases, whether it be a percentage of claim cost, percentage of premium or percent of discount margin, these same price-hiding crony pals continue to benefit financially when the price of medical care rises.

https://www.healthcaredive.com/news/hospitals-pledge-to-fight-trump-admin-price-transparency-plan-in-court/567474/

Posted in Access to healthcare, Direct-Pay Medicine, Economic Issues, Health Insurance, Healthcare financing, medical inflation, out-of-pocket costs, Re-Pricing Scams, Uncategorized

Pillars of the FMMA | Free Market Medical Association

1. PRICE

  • PRICE is NOT a product. CARE is the product.
  • Selling access to pricingis anti-free market.
  • Discount brokers” who get paid by selling “savings” are not transparent.

2. VALUE

  • VALUE is established when the buyer and seller agree on a FULLY DISCLOSED, mutually beneficial price for care.
  • If a vendor adds or changes that price IN ANY WAY, those amounts should be truthfully disclosed

3. EQUALITY

  • PRICE EQUALITY is the basis of a free market.
  • Cash is KING.
  • Any willing cash buyer should be offered the same price regardless of any factor.

https://fmma.org/pillars/

Posted in Access to healthcare, Consumer-Driven Health Care, CPT billing, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relationship, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Health Insurance, Healthcare financing, Medical Costs, Medical Practice Models, Patient Choice, Patient-centered Care, primary care, Quality, The Triple Aim, Third-Party Free Practices, Uncategorized

DPC and Self-insured Employers: Lifestyle-friendly Care for the 21st Century

http://ushealthmedia.com/dpc-and-self-insured-employers-lifestyle-friendly-care-for-the-21st-century/

In a typical insurance-based practice, meaningful face-to-face time between doctor and patient is somewhere between 5-10 minutes. Interesting, but surprisingly, shorter visits tended to result in more prescriptions being written and less time trying to get to the root of clinical problems.  And prescribing is usually a poor surrogate for good counsel and reassurance.

“What do you get when you mix low overhead with high technology and wrap it around an excellent physician-patient relationship? You get an ideal medical practice – a practice model designed to enhance doctor-patient relationships, increase face-to-face time between doctors and patients, reduce physician workloads, instill patients with a sense of responsibility for their health and cut wasted dollars from the entire system.”

The quote above is NOT from a Direct pay doctor or advocate, even though it precisely describes the attributes of DPC.  The quote is from the American Association of Family Physicians: The Ideal Medical Practice Model: Improving Efficiency, Quality and the Doctor-Patient Relationship.  

Notice how many of the characteristics of the Ideal Medical Practice looks very similar to the characteristics of a typical Direct Primary Care practice.  The ability to provide exemplary service is a natural element that arises from Direct Primary Care and other direct-pay models.

This direct engagement, absent the complexities and barriers created by the third-party network billing apparatus, enables a level of lifestyle-friendly involvement that naturally leads to a more satisfactory patient-doctor relationship and potentially superior clinical outcomes.

It’s hard to argue with cheaper and better.

Source: DPC and Self-insured Employers: Lifestyle-friendly Care for the 21st Century

Posted in Access to healthcare, Affordable Care Act (ObamaCare), Direct-Pay Practice Models, Employee Benefits, Employer Mandate, Employer-Sponsored Health Plans, Essential Benefits under the ACA, Health Insurance, Health Reimbursement Arrangement (HRA), Health Savings Accounts (HSA's), Healthcare financing, Individual Mandate, Policy Issues, Tax Policy, Uncategorized

Healthcare: What to Watch For

“…it is important for employers to be fully aware of what the regulations may impact them to safeguard against inadvertently putting themselves, or their employees, in an untenable situation.

It is important for an employer looking to offer an unconventional or untraditional benefit package to speak with an independent health plan attorney or CPA (not employed by the agency selling the program) regarding potential liability and compliance with federal and state laws regarding employer sponsored health plans.

Can your employee afford to reimburse the IRS for taxes not collected on an inappropriately structured HSA? Can your business afford a fine of $100 per day per employee for every day that the unqualified arrangement was offered? These are just some of the potential liabilities.”

http://ushealthmedia.com/healthcare-what-to-watch-for/

Posted in Access to healthcare, Direct-Pay Medicine, Direct-Pay Practice Models, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Free-Market, Health Insurance, Medical Costs, Medical Practice Models, Price Tansparency, primary care, Self-Insured Companies, Self-Insured Plans, Uncategorized

DPC and Self-insured Employers: A Benefits Trifecta


By contracting with a Direct Primary Care practice and re-routing subsequent encounters away from the more expensive insurance-based protocols, Self-insured employers can utilize creative plan designs to cut costs and improve employee satisfaction. The savings can be substantial even after accounting for membership costs.

http://ushealthmedia.com/part-2-a-marriage-made-in-healthcare-heaven/

Posted in Access to healthcare, advance-pricing, Direct-Pay Medicine, Economic Issues, Free-Market, Healthcare financing, Medical Costs, Patient Safety, Price Tansparency, Uncategorized

Pillars of the FMMA | Free Market Medical Association

The Pillars of the FMMA were created due to the wildly varying definitions of free market and transparency.  As this movement grows, many want to utilize the work of the true free market warriors to create new programs, products, and schemes that are not truly free market, or transparent.  All members agree to abide by the literal definition of the Pillars, and the spirit and intent in which they were created.

Join FMMA Now

Source: Pillars of the FMMA | Free Market Medical Association

Posted in Access to healthcare, advance-pricing, Consumer-Driven Health Care, Direct-Pay Medicine, Direct-Pay Practice Models, Doctor-Patient Relations, Economic Issues, Employee Benefits, Employer-Sponsored Health Plans, Health Insurance, Healthcare financing, Independent Physicians, Liberty, Medical Costs, medical inflation, Medical Practice Models, Network Discounts, Organizational structure, out-of-pocket costs, outcomes, Patient Choice, Patient Safety, Policy Issues, Price Tansparency, Quality, Self-Insured Plans, Third-Party Free Practices, Uncategorized

A Brief History of the Free Market Healthcare Movement: A discussion with Jay Kempton & Dr. Keith Smith

by Megan Freedman – Editorial Manager, Free Market Healthcare Solutions magazine

These names are, in many ways, synonymous with the current free market movement, and for good reason. These men are the mavericks of healthcare. When Dr. Smith and Mr. Kempton were introduced in 2011 by a mutual friend and client, they had no way of knowing that their partnership would become what it is today and create an entire movement in the healthcare space.

 

Jay.Keith.headlinephotoJay Kempton: When you understand how this business really works, you can see the effect of the dysfunction which I just described; but when you learn more about the cause, you can see that the patients’ actual financial concern is not even on the radar of so many entities that are part of big healthcare.  Hospitals really do not understand that the gouging of pricing that they do trickles down into basically wage stagnation to employees. They say, “We’re raising our prices, but it only hurts the big insurance companies.”  No, that’s never the way it works.  It eventually makes it way as an increased cost to the employer. They can’t afford to just absorb the increase, so how do they offset that?  By lowering or decreasing the increase of wages or they reduce the benefits, or both.

What is the greatest obstacle that this movement and the FMMA faces?

Dr. Keith Smith:    The answer may be counterintuitive.  I think the greatest obstacle the FMMA and this movement faces is ourselves. We are so programmed and conditioned to look to outside leaders or to the government for solutions and answers. They are ultimately responsible for all the problems that have led to our current system.  The answer is looking to ourselves and having the courage to face the possibility that, in innumerable ways, we have been duped. Admitting that is a very personal and difficult experience for many people—to look in the mirror and acknowledge that they’ve been lied to. Even worse, we have believed these lies and have acted accordingly.  People must acknowledge that it is a ground up movement, not one where solutions rain down on us from our rulers or our leaders. They must do their own thinking and not allow those who would like to be protected from innovation to stop us.

Jay Kempton: The obstacle that’s not so benign is how people in the healthcare business get paid.  Brokers, consultants, and agents have tremendous influence over employers and patients, and the way that they see healthcare.  Many people in the employee benefits business get paid when they make money off the problem. In other words, they’re making a percentage of the healthcare spend.  The problem gets bigger, their income goes up. 

If you could tell someone just one thing about the free market in healthcare what would it be?

Dr. Keith Smith: The one thing I would tell them is that the free market is not about sellers having their way with consumers.  The free market is not about brutalizing the poor, or people who are trying to pay for their own care.  
The free market is about an exchange between buyers and sellers that is mutually beneficial, where both parties emerge feeling like it was a good exchange. Any time that the media quotes some corporate healthcare exec or politician bemoaning the tough future that one of the sellers might face given some policy that might be enacted should be discounted or ignored. The focus has to be on the consumer, and on whether a consumer’s decision to buy A or B is a value to that person.  The one message that I would give is to know that this movement is about servicing consumers. Period. Any concerns or desires that sellers have to be protected from the preferences of consumers must be seen as the source of the problem that we all face in health care today.

Jay Kempton: The free market and healthcare is the only true healthcare reform that has a chance of being sustainable. Anything else is just rearranging the deck chairs on the Titanic.  

http://ushealthmedia.com/free-market-mavericks-%E2%80%A2-dr-keith-smith-and-jay-kempton/