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3 Signs that Retainer Physicians are the Future of Health Care


Frustrated that he was spending more of his time filling out forms than caring for patients, Dr. Richard Lewis left his urgent care practice at a Milwaukee-area hospital system to open Your MD, an independent clinic in Mequon. His goal is to offer family medical care services where both the patient and the doctor are able to develop long-term, trusting relationships and as a result, deliver excellent care.

Dr. Lewis is not the first physician to offer what some call near-site/on-site care, retainer medicine, or concierge care. I simply refer to it as the independent community physician because these physicians own and operate their clinics outside of health systems and insurance networks. With missions to bring quality and affordable care to members, I expect we will see the return of the independent community physician in clinics like Your MD all over the country, and especially in metro Milwaukee.

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The Case for Individual Coverage


Attention business owners with less than 50 employees: want to know how to cut health care costs? Stop offering it. Between government-funded subsidies, a wide net of networks and an enormous risk pool, you and your employees could be better off choosing individual and family health plans through the Affordable Care Act Health Insurance Marketplace.

First, remember that business owners with fewer than 50 full-time employees are not required to provide health insurance to their employees. If you value health coverage as a competitive advantage to recruit and retain employees, you can still offer health-related incentives without carrying the burden of administering a health plan.

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How to Shop for Care


As a healthcare consultant, I am continuously learning from the providers, insurers, and employers I work with on a daily basis. I?ve mentioned in previous posts that price transparency will be a game changer in a consumer-driven healthcare marketplace. Ross Bjella, co-founder, and CEO of Alithias brings truth in healthcare with his cutting edge software platform that offers accurate cost estimates which save self-insured employers and their employees millions of dollars per year. I asked Ross to share some insight on price transparency from his company's perspective, and he sent the following explanation.

With deductibles ranging from $6,850 (per individual) to $13,700 (family maximum) in the most popular plans offered under the Affordable Care Act and more employers offering high-deductible health plans, many patients now have a significant financial incentive to shop for care. Like it or not, high deductibles are making people think twice and ask more questions when they are told they need a specific test or procedure.

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In 2016, employees are in the healthcare driver's seat


The healthcare industry is evolving from a business-to-business model focused on employers buying group plans, to a business-to-consumer model influenced by the actions and needs of the individuals seeking care.

We've already embraced the following consumer-controlled features of modern health coverage:

  • Individual coverage plans offered by the Affordable Care Act means employees can now keep their coverage as they move jobs.
  • Increased deductibles across all types of plans means the more plan participants are required to pay out-of-pocket, the closer they will scrutinize the cost and quality of their care.
  • Wellness programs encourage employees to commit to and be held accountable for their personal health.
  • Cost comparison and second opinion requirements means insurers can charge a fee to employees if they fail to shop around before booking certain procedures, treatments and planned hospital stays.
  • Health savings, health reimbursement, and flexible spending accounts means incentive for employees to calculate their annual health-related expenses to set aside pre-taxed money.

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Anti-Obamacare Propaganda: Myth vs Reality


The Affordable Care Act was put in place to make health care more affordable, accessible and of higher quality. Implementation will run the course of many years, and has experienced some technological setbacks, but Obamacare is not going away.

As a health care consultant and Certified Application Counselor for the Affordable Care Act, it continues to surprise me when I see politicians, news reporters and respected consultants propagate concerns that the ACA will not fulfill its intended purpose, and instead will be bad for business and bad for communities. These opinions and predictions are simply not true. Employers who believe these myths are missing out on much-needed relief from what is becoming one of their largest operating costs.

The truth is that the ACA is going to squeeze some businesses in its quest for improving affordability, accessibility and quality - insurance agencies whose commissions are at stake, and health care providers who have not standardized or publicized their cost structures.

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The hidden cost of health plan illiteracy


It's that time of year again: back to school, start of fall, and the beginning of the annual health care enrollment process. If you are like most small business owners, you don't have a human resources director to take on the tedious, and, at times overwhelming burden of reviewing premium prices, comparing new plan options, and making the final decision with your insurance agent. It's all on your plate.

When you consider how rising health care costs will impact your business operations next year, make sure you consider one major cost that won't be listed on your contract: employee health plan illiteracy.

Ask anyone if they know their health plan inside and out, and not many people will tell you they do. However, if employees truly are ignorant about their coverage, they can easily make avoidable mistakes such as: seeing someone out of network, paying for doctor visits that would have been free as part of preventive care coverage, or becoming subject to penalties.

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