Articles Cost & Spending Healthcare

Cash-Pay Primary Care

The world of insurance-based healthcare is a bit topsy-turvy. Insurance groups and medical groups take on a large burden of patients to maximize profits and hire the fewest clinicians needed to provide acceptable care. This leaves the patient wholly unsatisfied with the care and attention they desire.

Not all insurance-based primary practices are bad. In the end, the physician makes all the difference. However, my patients know they can hold me accountable in cash-pay primary care practices.

Getting Paid by the Patient

I pay the business owner directly when I go to a coffee shop. When my patient sees me at Digital Nomad Health, they pay me directly. No person or entity is in the middle to confuse who owes service to whom.

In the insurance model, we pay the insurance company, which then arranges physicians willing to care for us. These physicians are limited by time and sometimes incentivized to order tests and perform procedures to make the visit financially lucrative.

If the patient paid the doctor directly, perhaps there would be more accountability. Who knows? The cash-pay primary care model isn’t mainstream yet.

However, those patients and practitioners engaging in direct-pay models seem content. They are committed to their patients and not beholden to an insurance company.

And the patients are comfortable holding their physicians accountable because they pay them directly.

The Cash-Pay Practice

The cash-pay practice is often much more simple. It’s the physician and the patient. There is little pressure to fill out complicated insurance forms or create progress notes that satisfy the third-party payer.

At Digital Nomad Health, my patients pay me monthly using PayPal, allowing them access to me and my practice.

With less overhead and administrative burdens, there isn’t much that can distract me from helping my patients achieve their ideal health.

The Monthly Subscription Model

Though I could charge a fee for each visit, this isn’t financially viable. I am often driven to take on more acute-care patients, the urgent care style where I don’t really build long-term relationships.

This disjointed practice model results in less ideal patient health outcomes. They see me from time to time but have disjointed care.

The monthly subscription allows the patient access to me and my practice, and I sell a finite number of subscriptions to ensure timely access. After all, a primary care doctor can only be primary when you can reach them when needed.

I get their word that they are continuously committed to me and their health. I can hold them accountable as they can.

The Virtual-First Approach

In this cash-pay model, the goal is to maximize access and minimize the overhead. Using a virtual-first approach for primary care allows Digital Nomad Health to better connect with each patient without the headache of running that physical practice.

I’ll likely have a physical practice someday, perhaps somewhere near where the majority of my patients live.

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