In partnership with Illinois Free Market Medical Association, Prairie Spine is exploring new options for patient payment to help reduce the costs and headaches associated with healthcare.

The Affordable Care Act implementation has been one of the more confusing and difficult mandates in the modern era of medicine. Mixed in the confusion is the notion that more insured Americans will equate to more patients for specialists. It isn’t that simple, though.

First, many of the plans available on the Insurance Exchange have low reimbursement rates for procedures, meaning that many physicians will close their doors to these newly insured patients. Second, many of these plans have traded low premiums for high deductibles, some up to $6,000. Meeting these deductibles may be challenging for patients wishing to have procedures, and will leave them with high out of pocket costs.

A growing number of specialists and ASCs are taking a page from the Primary Care playbook and exploring a variation of the concierge medicine model, a reduced rate for cash pay patients and employers. These are global fees for service and include the professional, anesthesia and facility components in one bill.

For specialists exploring these payment structures, a significant amount of time and consideration must be taken to define the audience and price structure. Both individual patients and employers are in the market for reduced fees without reduced quality and outcomes.

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