Business

RETAIL MED. JOURNAL: QuadMed, Walmart, and DPC? YES! There Are Similarities.

QuadMed, a company that manages 120 clinics and recently signed a deal with Walmart … ‘Companies maintain lower cost insurance plans to accommodate major medical expenditures and more intensive procedures. In that sense, the model for healthcare is similar to that being pursued by a Dodge City DPC family doc, who is reducing his patient load by two-thirds, dropping insurance wrangling and adopting a “direct primary care” model paid with an (almost) all-inclusive subscription fee.’

County considers ‘near-site’ clinic for employee primary care

By Christopher Guinn, Dodge City Daily Globe

Subscribe-to-our-NewsletterPosted Oct. 24, 2014 – A pitch promising lower healthcare costs and greater access to primary medical care for employees has two Dodge City area employers considering taking up a new model for medicine — a clinic on retainer.

Ford County leaders have met with a health insurance consultant and a medical management firm describing a shared “near-site” clinic that would serve as the primary care provider for the county government and a major regional employer, County Chairman Chris Boys said.

In addition to Ford County and the private business, QuadMed, a company that manages on-site, near-site and shared clinics, is in talks with government agencies in Garden City and Liberal to manage similar shared primary care facilities.

“My long-term goal here is to have a community-based on-site clinic: one in Dodge City, one in Garden City, one in Liberal, and network those facilities, a local network available to employers’ (workers) and their dependents,” QuadMed’s Jeffrey Sealey said.

The in-development county health campus is being eyed as a location for the clinic that could be part of the three-city regional network. The initial cost for the building would come from Ford County but contracts could be written so that cost is refunded to the county as other employers sign up for the services.

Sealey said it will take a minimum of 500 souls and their dependents in each town to open a facility managed by his company. Garden City’s school district with its 1,300 employees is expected to discuss the issue in the coming months and Sealey has begun conversations with Liberal schools, employer of 660, he said.

If the plan takes off, he believes many other organizations and businesses would be interested in joining the shared clinic network.

“It seems we’re getting a lot of traction in western Kansas,” said Ryan Powell, an insurance consultant for IMA Corp. working with QuadMed and the county. “Folks just aren’t driving in droves to be (primary care) doctors out there so we need to find the right tools to get medical care. … In west Kansas, most don’t have a primary care physician, so they’re going to the ER, but it shouldn’t be used for that purpose.”

With on-site or near-site clinics, employees will use it as their default primary care provider. Under most management contracts, workers pay no co-pay for services, Sealey said. In addition to the services, companies would maintain lower cost insurance plans to accommodate major medical expenditures and more intensive procedures.

In that sense, the model for healthcare is similar to that being pursued by Dodge City family practitioner Dr. James Moffitt, who is reducing his patient load by two-thirds, dropping insurance wrangling and adopting a “direct primary care” model paid with an (almost) all-inclusive subscription fee.

“Our providers see three patients an hour and don’t file any insurance claims,” Sealey said. “It’s a novel concept: they can do what they went to medical school for and they don’t file insurance, which is the bane of their existence and they are not paid by how many people they see.”

Specifically, Sealey said, his company would be interested in recruiting any physicians that retired from the business, frustrated with the current insurance and regulatory climate, promising to free them from those elements of the industry and a $120 per hour salary.

The clinic would become the default primary care physician for companies’ employees, but workers can continue continue to see their existing primary care physician under his company’s plan, Sealey said, though they would be paying in cash or through insurance for the additional costs.

What QuadMed does, he said, is manage a health clinic for a monthly, per employee fee — all other costs are passed through at cost so there is no incentive for doctors or QuadMed to push procedures to claim a retail profit margin.

“The only thing we would do is manage the clinic to handle the liability. The last thing an employer wants to do is get into the business of managing a health facility,” Sealey said.

Currently, QuadMed operates approximately 40 of the type of multi-organization shared clinic being pitched for the southwest Kansas cities and 120 total clinics, but is looking forward to a rapid expansion over the next few years. In August, the New York Times reported that QuadMed and Walmart will aggressively build primary care and pharmacy services within the retailer’s vast empire.

Sealey is confident that the plan will come together. “This is a third quarter (2015) initiative,” he said. “This is going to happen in Ford County. They have the space, they have the money, they have the need.

“If this thing gets rolling, people will be calling me to get in on this deal.”

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