Primary Care Physicians Increasingly Offer Flat-Fee, Prepaid Health Plans

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Prepaid Health Plans

Several hundred primary care physicians have begun to offer patientsprepaid plans, a practice that supporters maintain "tackles two crisesin U.S. health care: the rapid decline of doctors practicing primarycare medicine and the growing number of Americans who are eitheruninsured or underinsured, the Wall Street Journalreports. Under many prepaid plans, patients pay a monthly fee inadvance for unlimited access to primary and urgent care services, suchas office visits, laboratory work, X-rays and generic medications.Supporters maintain that prepaid plans can reduce administrative issuesand costs, as well as increase profits, for primary care physicians.

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Inaddition, supporters maintain that prepaid plans can improve access tocare for patients. However, opponents, such as health insurers and someregulators, have raised concerns that patients might purchase prepaidplans in place of broader coverage or overpay for such plans. Prepaidplans also "might become a competitive threat to insurers' business,especially if doctors can provide prepaid care without having to jumpthe same regulatory hoops as health insurance," the Journal reports.

According to the Journal,the debate over prepaid plans highlights "how the medical establishmentremains at odds over the delivery of basic care": Health insurersmaintain that high medical and prescription drug costs require them to"police doctors' treatments and rates," and physicians maintain thatthe "hassles of processing insurance claims and referrals means lesstime with patients."

Paul Ginsburg, president of the Center for Studying Health System Change,said, "We all talk about how we'd like primary care to change, but wedon't pay for those activities," adding, "That's why you have doctorstrying to fund these services in a new way" (Fuhrmans, Wall Street Journal, 10/22).
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Reprinted with permission from kaisernetwork\t\t\t\t\t\t\t

Reprinted with permission fromkaisernetwork.org.You can view the entire KaiserDaily Health Policy Report, search the archives, andsign up for email delivery at kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published forkaisernetwork.org,a free service of The Henry J. Kaiser Family Foundation.

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