Flat-Fee Medicine

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None - BACKGROUND: More than 43 million Americans are uninsured, according to the Centers for Disease Control and Prevention. Many of these people avoid simple medical care because it's often too expensive. They just don't have the money to pay for yearly check-ups, blood work or other screening tests. Now, some doctors around the country are offering an alternative that has patients back in their offices again.

FLAT-FEE MEDICINE: Patients at Fort Myers Family Medicine in Fort Myers Florida have a new option for medical care. H. Lee Adkins, D.O., offers his patients a "flat-fee" program. Patients pay $75 a month with a $10 co-pay per visit and get 15 visits a year. They get access to services including blood tests, EKGs and pap smears. The practice started the plan to encourage patients to continue to get preventative services. "Patients know that when they go into an emergency room that it will cost them between $800 and $1,200. If they walk into my office, it will cost them between $85 and $135, with a follow-up visit cost of $65 to $110, depending on the complexity," Dr. Adkins said in an interview with Doctors Digest. Dr. Adkins still advises patients to obtain a hospitalization insurance policy, which is more affordable than a full-coverage policy in case of catastrophic circumstances. His plan does not cover hospital care.

GOOD FOR PATIENTS AND DOCTORS? Dr. Adkins says the flat-fee program has helped his bottom line. One month, his revenues had gone up about 30-percent since the previous year. He says the approach saves him money by eliminating administrative costs that come with dealing with insurance companies.

A LA CARTE SYSTEM: If patients don't want to or can't pay the $75 a month, Dr. Adkins also offers an a la carte system where patients come in and pay per visit or service needed. Dr. Adkins lists the price of his services on his Web site for patients who are paying out-of-pocket.

A CRITICAL VIEW: In March of 2009, insurance regulators told one New York City doctor who offered a flat-fee program to his patients that he had to shut it down. This doctor was not charging his patients a co-pay for follow-up visits and was not limiting the number of follow-up visits allowed. The regulators said that the doctor was operating like an insurance company without the proper licensing. However, Dr. Adkins says his membership plan has been tailored to avoid the legal definition of an insurance plan as described in the Florida statues.