After years leading a mid size medical practice, Joe was known as the ‘code hunter’. Independent medical practices are under tremendous pressure to make a practice work. With the passage of the Affordable Care Act and mergers of hospital networks and insurance companies, the small independent practice has to be efficient in all their operations to survive. Joe built a network of practice in Tucson and Phoenix that he worked with. The Rainmaker model involved putting a technician in the practice to collect blood and urine samples. The Rainmaker technician also managed a number of complex programs for the practice. Rainmaker charged fees for these services.
Joe also consulted with these practices on projects from billing and coding analysis, Doctor compensation programs, HR policies and procedure over hall and marketing and branding support. Learn more in THIS video. Visit RainMakerMedical.com for more information.
Direct Medical Care
In 2014 the Arizona Legislature passed a law which Joe had started crafting 3 years ago. SB1404 allows Direct Contracting between an employer or individual and a medical provider. Arizona took a bold, free market step to put doctors and patients in greater control of their health care choices.
Mid size employers (51-200 employees) are stuck between a rock and a hard place when it comes to providing medical care to their employees. Government mandates coming from the passage of Obamacare are squeezing employers at ever direction.
This climate is ripe for a direct care model where by employers work directing with physician groups to handle primary care. Our model puts the Providers and employers together using already existing insurance brokers and HR companies. Here’s how we see the trend for direct care going:
- Large employers are bringing Doctors and clinics in house to care for their staff. This direct hiring cuts costs and employee sick days. Smaller firms can’t afford to hire a doctor but they can ‘rent’ a doctor group.
- Self insurance by businesses for their staff satisfies Obamacare mandates placed on employers (for now!) We are seeing Employers self insure, buy a large reinsurance policy (say at $50,000) and manage all the costs up to the reinsurance amount. Employers are taking on the risk. A direct physician group can help mitigate that risk.
- Employers are already moving to higher deductible plans. With an option like our Direct Care Model they can provider their employees with superior General Medical Care and not leave the employee exposed.
- The employer pays a monthly fee directly to your practice, the employee has a small co-pay to curb over utilization. The practice make stable monthly revenues and one time cash payments at point of care.
- A captive rate on a healthy working population of blue and white collar workers should be a win for the medical practice.
More on Direct Contracting with Employers from The American Academy of Family Physicians.
More about Direct Medical Care options can be seen in THIS video. More background on the opportunity can be found in THIS video.