DPC ultimate goal: capitation without accountability?

At the moment, there does not appear to be a snowball’s chance in hell of the DPC/HDHP/HSA fix of the “Primary Care Enhancement Act” passing Congress. But let’s explore what DPC advocates would demand after PCEA passage Allowing an HSA holder to use pre-tax dollars to buy subscriptions only gets DPC operators so far. TheContinue reading “DPC ultimate goal: capitation without accountability?”

Risk adjustment and more badly needed for KPI Ninja’s Strada-brag

Amended 6/26/20 3:15AM The Milliman report’s insistence on the important of risk adjustment will no doubt see the DPC movement pouring a lot of their old wine into new bottles, and perhaps even the creation of new wine. In the meantime, the old gang has been demanding attention to some of the old wine stillContinue reading “Risk adjustment and more badly needed for KPI Ninja’s Strada-brag”

Why is subscription DPC the precise hill on which self-styled “patient-centered” providers have chosen to make a stand?

A subscription model is not the most patient-centered way. Consider this primary health care arrangement: Provider operates a cash practice no insurance taken no third party billed Provider may secure payment with a retainer balance is carried refreshed when balance falls below a set threshold Provider may bill patient for services rendered on any basisContinue reading “Why is subscription DPC the precise hill on which self-styled “patient-centered” providers have chosen to make a stand?”

Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine. Short version.

A 1.8 billion dollar subsidy to support subscription-model contraction of primary care patient panel sizes is a problematic policy in a country when there is a shortage of primary care physicians. I came to this trying to figure something out. We hear that Ron Wyden kept the DPC/HDHP fix for subscription fees out of theContinue reading “Why a policy wonk like Wyden might (and, perhaps, should) kill a DPC/HDHP fix for subscription medicine. Short version.”

Pandemic effects on DPC enrollment

Possibilities to think about: DPC members who lose employer coverage will have the ability to go to ACA-compliant marketplace plans. Many of these will reach the low income levels at which ACA provides robust cost-sharing reduction is available. The relative desirability of DPC will fall. Some DPC members who lose income will become Medicaid eligible,Continue reading “Pandemic effects on DPC enrollment”