Gary Ratner

Brekke’s “Paying for Primary Care”, Comment on Part 1

In the winter of 2021, actuary Gayle Brekke penned a four–part–blogpost–series arguing that the cost of insurance primary care delivery in the insurance system is at least 50% higher the cost of delivering primary care through subscription model DPC. Notably, Brekke’s work was theoretical rather than empirical; she attempted to compute the relative costs ofContinue reading “Brekke’s “Paying for Primary Care”, Comment on Part 1″

DPC, one year after receiving a heart transplant, prepares to have old heart reimplanted.

I’m old enough to remember pro-DPC advocacy focussed on the long, in person, face-to-face primary care visits, the very “heart of direct primary care”. Surely that’s what motivated Doctor Steve Springer when he proudly opened Southwest Louisiana’s first direct primary care clinic. I say this because it certainly wasn’t telehealth Springer had in mind. AfterContinue reading “DPC, one year after receiving a heart transplant, prepares to have old heart reimplanted.”

Do economic forces lead to healthier patients self-selecting to member- funded DPC practice?

Yes. And, favorable selection to member-funded DPC is likely even greater than that already actuarially documented for employer funded DPC. [D]o economic forces lead to healthier patients self-selecting to a DPC practice? . . . . . . The value proposition for chronically ill patients– needing frequent visits and savings on ancillary services (labs, meds,Continue reading “Do economic forces lead to healthier patients self-selecting to member- funded DPC practice?”

Fauxtrage

While strongly endorsing direct primary care, the AAFP’s May 25, 2018 position statement to CMS on direct provider contractor models invoked the structural risk that the prevailing fee for service primary care practice model incentivizes the provision of unnecessary primary care services. As yet, the fee for service primary care physicians who comprise the vastContinue reading “Fauxtrage”

New DPC leader is incredible – unfortunately, not in the good way.

Let’s meet Cladogh Ryan MD, one of the new board members for DPC Alliance for 2021 who picked up the torch from some of those golden oldies. Dr Ryan cranked up a town meeting style event to recruit some of her Cook County, IL, fee-for-service patients into her new enterprise, Cara Direct Care. She layedContinue reading “New DPC leader is incredible – unfortunately, not in the good way.”

KPI Ninja and bad faith.

KPI Ninja missed so many boats — a whole fleet really — in its Nextera report, you may wonder whether they come to analysis in good faith. Well, there’s one note in their favor. Sometimes, KPI Ninja’s inability to make important adjustments disfavors their DPC client. In their analysis of DirectAccessMD, for example, an inducedContinue reading “KPI Ninja and bad faith.”

Nextera and Paladina (Everside): a race to the top of Mount Brag

Updated 9/4/21 In 2015, Qliance still towered over all in the Direct Primary Care Bragging World with its claim of 20% overall cost reductions. Even that, of course, was quite a come down from the extravagant claims previously spewed under the Qliance banner; fond memories still linger of those heady days when the Heritage FoundationContinue reading “Nextera and Paladina (Everside): a race to the top of Mount Brag”

In rural areas, decreased primary care panel size is a problem, not a solution.

Montana’s last governor twice vetoed DPC legislation. He was not wrong. Over the last month or so, DPC advocates from think-tanks of the right have trotted out the proposition that direct primary care could be “the key to addressing disparities in health care access in underserved areas of Montana facing severe shortages of primary care”.Continue reading “In rural areas, decreased primary care panel size is a problem, not a solution.”

Shorter KPI Ninja/Nextera SVVSD report

“We used a statistically valid risk measurement tool and determined that there was a a non-Nextera population had a 7.5% difference greater level of risk then our Nextera population. But don’t believe that result, because it was not statistically valid.” “We reduced inpatient hospital 92.7%. Want to know how great we are? Our statistically validContinue reading “Shorter KPI Ninja/Nextera SVVSD report”