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POLICY: Docs See Direct Pay Model Making Progress in D.C.

By Physicians News Network

DPC Coalition Steering Committee at a fly-in and policy summit where we shared the good news with Congress and the Administration about how Direct Primary Care is changing health care across the country.

DPC Coalition Steering Committee at a fly-in and policy summit where we shared the good news with Congress and the Administration about how Direct Primary Care is changing health care across the country.

JULY 10, 2014 – Two Los Angeles and Orange County direct primary care physicians said that recent meetings of the American Academy of Family Physicians (AAFP) and the Direct Pay Primary Care Coalition (DPCC) with congressional leaders in Washington, D.C., are encouraging signs of an increased interest among politicians and organized medicine in the direct pay model.

Dr. Thomas LaGrelius and Dr. Marcy Zwelling, who are also on the board of the American College of Private Physicians (ACPP), told PNN that after years of lobbying efforts, there is hope that the direct pay primary care model — or concierge medicine, as it is commonly referred to — will be included with other innovative models that Washington is ready to get behind. “Let’s all pull together and make it happen for the whole country with lots of models and designs,” Dr. LaGrelius said.

Dr. Garrison Bliss, president of the Qliance Medical Group and chairman of DPCC, told PNN they put together 22 meetings in two days with Washington officials as well as a presentation co-sponsored by AAFP and DPCC for key Senate and House health policy staffers.

AAFP’s announcement that it will help support the direct primary care business model for family physicians is a major step and will hopefully become a unifying factor for all the groups advocating for the direct pay model, Dr. Garrison told PNN.

Dr. Garrison said their coalition and other stakeholders are pushing hard to get the IRS to fix the Healthcare Savings Account (HSA) problem that currently prevents monthly fees for direct primary care from being classified as a tax-deductible medical expense.

Although the IRS has no official stance yet on the issue, those calling the IRS are often told by IRS officials that membership fees for primary care are possibly payments for a health plan.

“This is surprising,” Dr. Garrison said, “given that the Affordable Care Act specifically defined monthly fees for direct primary care medical homes as fees for a medical service, not for insurance.” He also noted that because HSA plans are paired with high-deductible health plans and are prohibited from being combined with any other insurance entity, most companies with HSA plans are currently hesitant about contracting with direct primary care physicians.

Other issues the coalition is trying to address are making concierge fees count toward health plan deductibles and passing legislation to allow Medicaid and Medicare to pay part or all of the monthly fee for direct primary care.

Dr. LaGrelius told PNN that his concern is making sure that anything that is being considered does not involve insurance companies, employers or government acting as a third party, an intermediary between physicians and their patients. He said the voucher system is the only sensible model when it comes to helping anyone, including people on Medicare or Medicaid, pay for the care they receive from physicians who participate in a direct pay (concierge) practice model.

Source:

Two Los Angeles and Orange County direct primary care physicians said that recent meetings of the American Academy of Family Physicians (AAFP) and the Direct Pay Primary Care Coalition (DPCC) with congressional leaders in Washington, D.C., are encouraging signs of an increased interest among politicians and organized medicine in the direct pay model.

Dr. Thomas LaGrelius and Dr. Marcy Zwelling, who are also on the board of the American College of Private Physicians (ACPP), told PNN that after years of lobbying efforts, there is hope that the direct pay primary care model — or concierge medicine, as it is commonly referred to — will be included with other innovative models that Washington is ready to get behind. “Let’s all pull together and make it happen for the whole country with lots of models and designs,” Dr. LaGrelius said.

Dr. Garrison Bliss, president of the Qliance Medical Group and chairman of DPCC, told PNN they put together 22 meetings in two days with Washington officials as well as a presentation co-sponsored by AAFP and DPCC for key Senate and House health policy staffers.

AAFP’s announcement that it will help support the direct primary care business model for family physicians is a major step and will hopefully become a unifying factor for all the groups advocating for the direct pay model, Dr. Garrison told PNN.

Dr. Garrison said their coalition and other stakeholders are pushing hard to get the IRS to fix the Healthcare Savings Account (HSA) problem that currently prevents monthly fees for direct primary care from being classified as a tax-deductible medical expense.

Although the IRS has no official stance yet on the issue, those calling the IRS are often told by IRS officials that membership fees for primary care are possibly payments for a health plan.

“This is surprising,” Dr. Garrison said, “given that the Affordable Care Act specifically defined monthly fees for direct primary care medical homes as fees for a medical service, not for insurance.” He also noted that because HSA plans are paired with high-deductible health plans and are prohibited from being combined with any other insurance entity, most companies with HSA plans are currently hesitant about contracting with direct primary care physicians.

Other issues the coalition is trying to address are making concierge fees count toward health plan deductibles and passing legislation to allow Medicaid and Medicare to pay part or all of the monthly fee for direct primary care.

Dr. LaGrelius told PNN that his concern is making sure that anything that is being considered does not involve insurance companies, employers or government acting as a third party, an intermediary between physicians and their patients. He said the voucher system is the only sensible model when it comes to helping anyone, including people on Medicare or Medicaid, pay for the care they receive from physicians who participate in a direct pay (concierge) practice model.

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