Innovating health care, some doctors shift to cash only

Published: Wednesday, June 19 2013 12:05 p.m. MDT

A new approach to medical service renders both insurance companies and emergency rooms largely redundant for routine care, saving money for consumers and lowering health care costs.

Diane Bondareff, AP IMAGES FOR CLOROX

Enlarge photo»

Family physician Doug Nunamaker of Wichita, Kan., is taking health insurance reform into his own hands, going cash only and dumping insurance companies.

Nunamaker, 32, takes monthly subscriptions that cover all office visits and basic tests. His office is open 24/7, making emergency rooms largely unnecessary.

"For adults up to age 44, Nunamaker charges $50 a month, pediatric services are $10 a month, and for adults age 44 and older it costs $100 a month," according to a UPI report.

Fees for lab services are negotiated and paid in cash, but they are far cheaper than insurance billings and, in fact, often end up cheaper than the copays of traditional insurance.

"A cholesterol test costs the patient $3," UPI noted, "versus the $90 or more billed to insurance companies; an MRI can cost $400, compared with $2,000 or more billed to insurance companies.'

Customers using Nunamaker's service will have to carry a catastrophic insurance policy in case they get badly injured or seriously ill.

The new approach to buying medicine is called direct primary care (DPC) or "concierge medicine," and he is not alone. At a website advocating the approach, Nunamaker illustrates the system with a recent case of a boy who had been bitten by a dog.

“We got him into an exam room by 10:15, washed out, sewn up and on the way home by 11 a.m.,” said Nunamaker. If the boy had gone to a local emergency room, "his $680 bill wouldn’t even have included the physician’s fee," the website said.

“That one episode was worth five years and eight months of membership for that child,” Nunamaker said.

Not everyone is enamored with the effort.

Kathleen Stoll, director of health policy at the consumer advocacy group Families U.S.A., told CNN Money "she fears that doctors who switch to a cash-only model will drive away the patients who can't afford a monthly membership fee or thousands of dollars for an operation."

"They cherry-pick among their patient population to serve only the wealthier ones," Stoll said. "It certainly creates a barrier to care."

She said she also fears that if a patient gets seriously ill, the doctors may not be able to get discounts for all the services a patient might need that are outside their practices.

"I'm always cautious when it's a cash basis," she said. "Are you somehow being put at risk? I'd have a list of questions."

Eric Schulzke writes on national politics for the Deseret News. He can be contacted at eschulzke@desnews.com.

Get The Deseret News Everywhere

Subscribe

Mobile

RSS