Free Market Health Group is a new company focused on connecting self-funded employers, patients and payers with providers that deliver transparent, free-market healthcare. Reimbursements are declining and healthcare premium costs are skyrocketing, leading many employers and providers to explore alternative options to the traditional in-network contracting model. “Physicians are exploring the concierge model of care; cash pay is already abundant among primary care and internist practices,” says Free Market Health Group Founder Daniel Goldberg. “It’s only been explored recently for specialists as a viable practice model out of frustration with the current healthcare system.”
In the primary care concierge practice model, patients often pay $100 to $150 per month for unlimited access to their provider, and the internist can take care of 80 percent of their issues. However, the same model doesn’t make sense in specialty care where surgeons are focused on very specific issues. Instead, specialists are figuring out how to competitively price procedures for cash pay patients in their region.
“Most of the time these procedures are done in surgery centers because the overhead is lower,” says Mr. Goldberg. “ASCs have shorter OR times, lower anesthesia costs and implant costs. As a company, we are working with physicians to ensure their outcomes are the same high quality while reducing the cost.”
Some surgeons and ASC administrators are collecting hospital EOBs from patients to ensure competitive pricing. Others are setting price based on covering overhead costs first and then competing with others in the marketplace. Lower prices could even attract a higher volume of medical tourists seeking care in the lowest cost setting.
“As a self-funded employer, if you can pay for surgery at an ASC for $7,000 that would be $25,000 at the hospital, even if you’re flying the employee to another state and paying for a short hotel stay, your costs are significantly lower,” says Mr. Goldberg. “Our goal is to have a provider network across the country and give patients and employers information about providers on the free market."
Surgeons collecting outcomes data can use their numbers to attract patients or self-funded employers looking for high quality, low cost care. As more patients are insured under the health insurance exchange with high deductible plans — meaning patients are responsible for paying a larger portion of the bill — and reimbursement from those plans declines, physicians are looking for ways to accommodate patients willing to pay for care without insurance companies.
“Eliminating the insurance end of it lowers the overhead and gives physicians the ability to worry about practicing medicine more and billing less,” says Mr. Goldberg. “I think you’ll see more physicians who do this as the first physicians have success with the concierge practice model.”
Free Market Healthcare also provides marketing, public relations and facilitates the direct contracting between the employers and the physicians to physician practices building a cash-pay model.
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