MD’s everywhere are increasingly fed up with the insurance industry. They are discovering, as Dr. Jon Seeman and I have, at our state-of-the-art Sport & Spine Center in Greenwood Village, Colorado, that the “insurance-only” model is unsustainable for doctors.   In a nutshell, the “insurance-only” model incontrovertibly leads to assembly-line medicine. The fixed-payment, contract-for-services insurance model preserves profit margin for the insurance company executives at all costs.  (To wit:  The $106 million in salary and stock options paid to United Healthcare’s CEO.)

Doctors who are struggling to make ends meet with higher regulations, higher administrative costs, escalating malpractice rates, and lowering reimbursements for healthcare services can only do one thing:  see more patients per hour.

For patients, that translates into longer wait times, less time with the (more stressed out) doctor, and an inevitably lower quality of healthcare.  And this is UNTENABLE for me and my chiropractic, acupuncture and medical massage therapy colleagues at The Center for Spine, Sport & Physical Medicine.

Just my opinion?  Nope. See U.S. News & World Report for more.

OUR SECRET TO PRESERVING HIGH QUALITY CARE

To be honest, we’ve looked long and hard at chucking participation in insurance plans altogether.  But we think we’ve found a middle ground.  Our priority is, and has always been, to deliver the highest quality care that can be rendered at the lowest possible cost for every patient.

We continue to accept most insurances.  But we staunchly refuse to limit our care to only those services that insurance companies cover.  Patients’ needs will dictate what we provide — no more and no less.

When we provide a needed service that is covered by insurance, a claim is submitted to the insurance company. When patients need a service that is not covered by insurance the patient is given the option to decline that service or pay for it on a cash basis.  In some cases insurance requires that we complete forms proving we notified the patient of our intention to provide non-covered services.  This is not a problem for us or for our patients.  And it’s certainly no worse than the mountain of paperwork we’re already mandated to produce by the insurance industry.

WHY ARE NON-COVERED SERVICES NEEDED?

The answer to this question might seem so obvious it need not be addressed. Most of us know that insurance companies are covering less and less, casting more — often really beneficial — services into the outer “non-covered” darkness.

But I’ll answer anyway…

As a serious,  industry-leading, results-oriented provider group we use cutting edge technologies and treatments to produce results that are not infrequently faster than the norm.  And often, MUCH FASTER. By adding therapies that are considered “non-covered” by the insurance industry we can shave off days, weeks or even months of suffering.  That means fewer treatments.  And cost savings. And LESS out of pocket responsibility for our patients than if all treatment was restricted to only “covered” services.

Our hybrid model is, at least for the present, giving us the freedom to continue providing high-quality, attentive care to ALL our patients. We’re resist assembly-line healthcare at all costs.  So don’t ask insurance companies for permission to deliver care beyond their ivory tower restrictions and limitations.  Our patients’ best interests are our primary directive.  With their permission (sometimes written and formalized for insurance’ sake,) we JUST DO IT.

And happily, our patients are GENUINELY saving on out-of-pocket dollars!  They willingly pay cash for non-covered services in addition to the deductible paid for “covered” services.  They are very happy to do so because they’ve done their homework.

As Obamacare continues to cast a heavier economic burden on the average American, a hybrid model such as ours makes economic sense — when coupled with relentless allegiance to fast results. Our model preserves the freedom for our providers to deliver high quality care.  And it accesses — to best advantage (if there is such a thing) — the dwindling coverages still offered by the insurance industry.