Affordable Direct Primary Care. Lee S. Gross, M.D. Founder, Epiphany Health President, Docs4PatientCare Foundation
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1 Affordable Direct Primary Care Lee S. Gross, M.D. Founder, Epiphany Health President, Docs4PatientCare Foundation
2 What was the Epiphany? Primary care SHOULD be affordable! Why is basic health care so expensive? Third party disconnect from cost makes it expensive. Outside factors drive cost Hospital Administrative costs Pharmacy Imaging Labs Specialty care Physical Therapy
3 What is Epiphany Health? Direct Primary Care Membership Based Patient Centered Medical Home Includes: Comprehensive primary care and wellness services Access to a local network of steeply discounted labs, imaging, specialty care, physical therapy, pharmacy and more.
4 Free Market Model Over time, new technology prices come down in a free market
5 What about health care prices? Health care is not a free market!
6 Why is health insurance so expensive? It s not insurance, it s health maintenance Traditional Insurance is for catastrophic care, not first dollar coverage What would homeowners insurance cost? Light bulb replacement Landscape maintenance Housekeeping Routine repairs Third party coverage drives up costs I m paying for it, I m going to use it. Administrative costs
7 Balancing the cost of care All other care
8 Remove the cost drivers All other care
9 Most patients can be cared for at the primary care level
10 There is a solution!
11 How does it work? Separates routine from catastrophic care Monthly membership fee for primary care Clearly defined package of services Fixes the cost of routine care Catastrophic insurance becomes a true safety net again Not fee for service Total price transparency Network of discount providers
12 What s Included?
13 What s Excluded? There are no pre existing condition exclusions There are no co pays There are no deductibles There are two exceptions Our doctors do not treat chronic pain Our doctors do not prescribe chronic controlled substances
14 Examples of in office savings Service Typical Charge Your Cost Additional labs $ each $10 each Joint injection (knee) $150 $0 Skin biopsy $160 $0 Drain abscess $275 $0 Laceration repair $260 $0
15 Examples of network savings Service Typical Charge Your Cost Savings Nuclear Stress Test CT of the chest w/contrast Carotid ultrasound $1,470 $520 65% $940 $211 78% $425 $120 72% Colonoscopy $4,028 $1,127 71% Chest x ray $220 $22 90%
16
17 Hospital Charges Epiphany Charges Lab charges $38.14 Chemistry $ Hematology $1, Urology $ Chest x ray $ CT scan $10, ER Level 4 $2, TOTAL: $19, $8.00 $70.79 $15.00 $4.50 $18.00 $185 $0 $278.79
18 What Does It Cost? Monthly Membership Individual $80 with Spouse / Domestic partner $150 Family (Dependent child 5 27) $175
19 Savings with Epiphany Family of 4 = $ 175 per month 2013 Average PPO Insurance* Family of 4 = $1,836 per month Difference per year: $17,292 * healthcare costs surpasses 22000/
20 10 year projection Family of 4 $250,000 $200,000 $150,000 Total Savings Traditional PPO Insurance Epiphany + HDHP* [VALUE] $168,340 $100,000 $50,000 $51,960 $ *Aetna Health Network Option Value ($10K deductible, $258/mos)
21 Employer of 10: Ten year total projection $2,500,000 $2,000,000 $1,500,000 Total savings Traditional PPO Insurance Epiphany + HDHP $2,203,000 $1,683,400 $1,000,000 $500,000 $519,600 $ Assumes middle aged employees with families of 4.
22 Saving a profession Service Revenue Our Cost Annual patient dues $960 Labs $30 Mammogram $25 Influenza vaccine $6 Pap smear 25 office visits $28 50% overhead
23 Saving a profession Expenses of guaranteed services are covered with first month s dues $80 per month x 11 months = $880 net revenue per patient per year 500 patients x $880 = $440,000 annual revenue less 50% overhead = annual net $220,000 Epiphany can be added to an existing practice
24 Saving a Nation ACA estimates 32 million newly insured Many of the insured will be on Medicaid Estimated 26 million remain uninsured Current 10 year CBO projected cost $1.8 trillion
25 Saving a Nation If ALL 58 million uninsured were enrolled in Epiphany Health Total 10 year cost = $556.8 billion Net 10 year savings
26 Saving a Nation $1,355,200,000,000!!! $1.3 Trillion
27 Any questions?
28 Patient Epiphany Health Business Practice A Practice B Practice C Patient Other third party contracts Business
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