Primary care physicians are facing increased responsibilities in today's health insurance climate. They're now relied upon to manage patients' diverse acute injuries, chronic illnesses, and genetic abnormalities that were once handled by teams of specialists.
This is good news for patients and primary physicians in three important ways:
Lifelong familiarity with a patient is developed
A patient with lifelong, chronic diseases, injuries, and anomalies is often best examined and treated by one central health care practice. The staff has a complete record of the patient's medical history combined with a familiarity with the person's health issues and problems. These unique features of the primary care practice allow providers to more quickly notice physical changes, keep up with required diagnostic tests and realize when something is seriously wrong.
Patients living with issues like Down Syndrome are at a greater risk for certain problems including choking, ear infections, and thyroid issues. A primary care physician is perfectly suited to keep track of the many assessments and lab tests that the American Academy of Pediatrics recommends for children with Down Syndrome. Additionally, children who are sensitive in social situations may feel more comfortable with primary care doctors or practices they have seen and visited all of their lives.
More power is reflected in Medicare payments
The recent physician fee schedule released by the CMS (Centers for Medicare & Medicaid Services) recognizes the power of the primary care physician in achieving CMS goals. The increased payments to primary care and other doctors reflect a trend of enhancing what's called "patient-care-centered health management"--meaning your medical records, procedures and treatments are accessible, coordinated and ongoing.
The proposed plan encourages primary care physicians to spend more time helping patients who suffer with multiple chronic conditions. The new fee schedule also reflects a greater reliance on primary care physicians to manage care for patients with behavioral health issues and dementia, and it promotes using a patient-centered approach for cognitive and behavioral issues. Adequately compensating primary care physicians for these additional health care services means they can spend more time with patients and less time justifying the needed services to Medicare.
Direct primary care and wraparound options are increasing
You may soon be able to join a primary care doctor's "club" with your moderate dues of $50 to $125 per month going directly to the physician. Membership includes a fixed number of office visits, e-mails, and phone consultations with your primary care physician, and no insurance companies are involved. A certain number of well visits, and preventative and diagnostic procedures are covered with your membership as well. The plans should reduce doctors' overhead costs and protect families from paying costly out-of-pocket diagnostic and preventative expenses.
The only problem with the DPC (direct primary care) model is that you aren't covered for catastrophic health care for a serious accident or debilitating disease. You'll need a wraparound policy to cover the more expensive risks to life and limb, but most health insurance companies are not offering these kinds of supplemental policies just yet.
If you do want to partake in DPC it's a wise choice, since your primary care physician will actually be regularly assessing you to catch problems before they become a threat to your health and wallet. Shop around to find wraparound coverage, or ask your primary care physician's office for a recommendation if they offer DPC memberships.
For more information, contact services like Rural Health Services Consortium Inc.