DPC News

DPC JOURNAL EXCLUSIVE: ‘Choosing Your DPC Suppliers & Partnerships With Community Hospitals’

By Catherine Sykes, Publisher, Managing Editor, The DPC Journal

AUGUST 7, 2014 – The strength of your Direct Primary Care (DPC) menu of healthcare services largely depends on the quality of your local laboratory partners and equipment suppliers. It’s your responsibility to handle patient care, comply with government regulations and standards, and provide quality service, all while keeping in mind your patients budget and costs down for them as an added benefit of the direct-pay style practice and to ensure patient satisfaction and increase monthly, quarterly and annual patient retention inside the DPC practice. Without a local vendors, labs, clinics and suppliers you can trust, your brand in the local community has no chance of getting off the ground.

Every industry has an example of a business that has found a way to scale beyond the owner by focusing on something that is teachable to employees, valuable to customers and repeatable so as to create a recurring stream of revenue. It’s harder to find scalable models in some industries, and being in DPC may be one of the toughest — but not impossible.

While traditional doctors charge for each treatment and test—which can add up to hundreds of dollars per visit—Qliance, MedLion and other clinics charge flat fees that generally include basic checkups, treatment of minor ailments and electrocardiograms, or EKGs.

The Wall Street Journal recently wrote: ‘Services like blood work, X-rays and vaccines can cost extra, but DPC [and concierge medicine] doctors often negotiate with specialists and labs to secure discounts for patients who would otherwise pay out-of-pocket.’

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The prices you see above are meant not to be guides — simply examples of what others are doing in the marketplace.

Dr. Brian Forrest, who describes his $39-a-month Access Healthcare clinic in Apex, N.C., tells WSJ that he’s obtained prostate-cancer tests for $5 from the same lab that would charge a Medicare patient at least $175, $350 mammograms for $80, and colonoscopies for $400 when the official rate is $2,000. “Sometimes, it might be cheaper for them to use their insurance, but in some cases it isn’t,” Dr. Forrest says.

As we all know, there are a lot of local labs, vendors, clinics and DME suppliers to choose from, and figuring out which one you should go with can seem pretty daunting.

“No one particular company has stood out of the crowd as a recommended vendor or are currently offering substantial discounts to DPC providers en masse,” said Michael Tetreault, Editor of The DPC Journal. “DPC physicians tell us that doctors may want to contact LabCorp or even Quest for some of their lab services. That has been quite common in many of these DPC medical offices. A number of doctors have had good success negotiating with private imaging centers for radiology services as well. We recommend you speak with a few of your local colleagues in practice in your area and see which companies and vendors they like.”

Here are a few things to think about when choosing your DPC suppliers:

Compare Prices

Compare prices on the items you’ll need most and look for cost effective solutions. Will X-Rays at your own practice provide you a costs savings … and are you and your staff up to the tasks you want to deliver inside your practice? How many routine blood chemistry panels will you do each month? Do you have the square footage and storage space to hold items you can’t use or sell each day? Are you better off referring out to a company like LabCorp or buying tests like these locally with your community hospital?

If it’s DMEs or prescriptions, request a price quote or catalog from the national or regional suppliers you’re interested in and compare the goods you’re most likely to order locally with those prices. While it’s not a good idea to make a decision based solely on price, it should certainly be included in your evaluation.

“We believe that providing a more comprehensive list of services than the standard office is crucial to patient enrollment and retention in our practice [Foundation Health®],” said Ginnie Meyers, Wellness Partner at Foundation Health® in Boulder, CO. “As direct care providers, our job is to provide value in every possible way. And unlike the standard managed-care system where insurance companies act as a barrier to accountability, we need to earn our patients’ business in every facet of our practice. For example, we have invested in equipment that allows us to provide a number of labs in-house within a matter of minutes, all included in our monthly fee. In addition, we have an on-site allergy program at a deeply discounted rate. We also provide nutrition and supplement counseling on-site and referrals to Foundation Health approved wellness partners for services like pain management and fitness consultation that provide significant value to our customers at discounted rates.”

Supplier Reputation

Check online and with your local Better Business Bureau to find out if the supplier has any serious, unresolved complaints. Speak with other DPC operators and physicians in your area to find out if they have dealt with the facility of company your considering using for certain screenings or tests. You can also search news stories online to find out if any companies in your area have been responsible for negligent quality issues.

Checking company history can provide you with a lot of extra information. Most companies have an “About us” link on their website with information about the company and its history. How long a company has been in business, and how they present themselves, adds to their credibility and ultimately, yours too!

Leverage Your Local Community Hospital vs. Larger Big Box Hospital Network.

A Community hospital can be purely a nominal designation or have a more specific meaning. Specifically, it refers to a hospital that is accessible to the general public, and provides a general or specific medical care which is usually short-term, in a cost-effective setting, and also focusses on preventing illnesses as on treating them.

“Let me tell you what I did for my patients,” says Dr. Marcy Zwelling, physician and CEO at Choice Care in Los Alamitos, Calif. “We actually had ‘Cash Sundays’ and offered MRI’s for cash …. it isn’t every Sunday but you can set aside specific days and work with ortho in the area to get the patients taken care of promptly.  I started by talking with my local community hospital and noticed their MRI machine wasn’t being used on Sunday’s. I said to them, ‘will you provide my patients with a cash-rate for the MRI on Sunday’s while this machine isn’t being used on weekends?’ They agreed and it’s been great for my patients.”

RELATED STORY
Is the Community Hospital a Dying Model, or is it the Future of Healthcare?

What else do they offer?

The relationship you are encouraged to forge with some screening and test suppliers is more like a partnership than a delivery service. Since supplier success depends on their clients’ success (i.e. YOU), they may offer educational brochures, in-depth test descriptions and useful screening information, reports, cost calculators, and other tools to help you manage your DPC practice,  control costs, and track usage. Information is a powerful business tool.

Ask additional questions

Before you make your final decision, find out about their hours of operation if you do the shopping yourself or their schedules, safety standards, ordering and billing practices. The right supplier will have the answers that fit your needs and offers advice and support beyond the initial point-of-sale.

Choosing the right screening and healthcare testing suppliers is absolutely critical in your DPC practice success. The success of any DPC practice depends on the relationship, cost, quality, safety, and value of the services you offer beyond the front door of your lobby. There are always other considerations such as staffing, customer service, parking at these locations and how well you understand the local patient-base, but the bottom line is in the relationship you have with your patients. If your personality, service and staff are outstanding and your price hits the customer’s price point, more patients will return.

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4 replies »

  1. While I am obviously a strong proponent of DPC, a few thoughts on pricing. MD’s be very careful about building a DPC practice around price lists posted on social media. For instance in Massachusetts, Labs cannot charge below the pricing that Medicare sets forth. The same is true for monthly membership fees. I have a formula that helps to determine equitable fees based on geographic/economic factors. Don’t set your fee’s based on a list you see on-line.

    • Oh I agree, however they are quoted to me everyday, and usually by someone who felt “If I build it they will come”…..and they didn’t. This only hurts the DPC movement. We can fix a struggling DPC practice, but it makes more sense to get it right the first time. Thanks, Mike.

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