Some physicians are choosing to make upgrades to transition their practices into the medical home model — an arrangement that can result in attractive payor contracts — but find themselves bearing the cost and not hearing from insurance companies, according to a Wall Street Journal report.
Scott Hammond, MD, made changes to his practice in Denver over the past four years. The practice switched to electronic medical records, staff call patients more to check on their health and the practice coordinates with local specialists and hospitals. Although many of these enhancements aren't covered under traditional insurance contracts, Dr. Hammond thought they would appeal to health insurers for long-term medical home contracts and eventually pay for themselves.
But Dr. Hammond says he hasn't seen any concrete offers from insurers, despite publicized plans from companies like UnitedHealth, WellPoint and Aetna that pay physicians more for quality metrics and reduced costs. The lack of payor interest makes it hard for the practice to plan future budgets and stirs doubt among providers. "I'll believe it when I see the checks," Dr. Hammond said in the report.
Due to the investments and staffing increases made to operate as a medical home, Dr. Hammond says the "bottom can drop out" of his practice any day. "We could be bankrupt next month," he said in the report, noting that if a physician were gone for more than two months, the practice wouldn't be able to make payroll.
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Scott Hammond, MD, made changes to his practice in Denver over the past four years. The practice switched to electronic medical records, staff call patients more to check on their health and the practice coordinates with local specialists and hospitals. Although many of these enhancements aren't covered under traditional insurance contracts, Dr. Hammond thought they would appeal to health insurers for long-term medical home contracts and eventually pay for themselves.
But Dr. Hammond says he hasn't seen any concrete offers from insurers, despite publicized plans from companies like UnitedHealth, WellPoint and Aetna that pay physicians more for quality metrics and reduced costs. The lack of payor interest makes it hard for the practice to plan future budgets and stirs doubt among providers. "I'll believe it when I see the checks," Dr. Hammond said in the report.
Due to the investments and staffing increases made to operate as a medical home, Dr. Hammond says the "bottom can drop out" of his practice any day. "We could be bankrupt next month," he said in the report, noting that if a physician were gone for more than two months, the practice wouldn't be able to make payroll.
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