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February 5, 2020 at 3:14 am #212977
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Associated Mutual is a health plan with strength in serving unions such as the AFL-CIO and Ohio Health Care Trust. They are based in Grand Rapids, Michigan. Associated Mutual â President, Tim Spink described how he was initially skeptical of offering DPC as it sounded more expensive than the per member per month costs for primary care that they assume in their baseline model. He thought if he was paying $x per year to a physician and many of those covered lives wonât go to the physician in a given year, it sounds like it would be more expensive than a traditional fee-for-service model. Or he compared it to HMOs. It can look like itâs significantly higher cost than HMO. The big difference that overcame his skepticism is the nature of the ongoing patient-provider relationship. Further, there is much more covered in the fixed cost going to the physician than what he initially thought. The way Spink looked at it is that itâs more about elimination of CPT codes. That is, there are two key byproducts of a DPC practice:
“This isn’t a definitive solution to the problem,” Brennantold Reuters. “We wanted to share what it was that we did andhave other people in healthcare, including other pharmacies,look at what we did and discuss what some more comprehensivesolutions might be.”
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