Doctors Meet in Mpls. About Ditching Health Insurance

Updated: 08/11/2013 9:35 PM By: Stephen Tellier

If you've ever had a problem with your health insurance company, there's a new health care concept that might merit your attention. More and more doctors are ditching insurance companies, and letting patients pay them directly for their care.     
There was a conference on "direct pay" health care held for local doctors in Minneapolis on Saturday, the first of its kind in Minnesota. Business models vary from practice to practice, but the general model is this: Patients pay a membership fee, or a fee for each visit and service, and that's it. No insurance company necessary.
It's a concept that's creating a lot of interest -- and controversy.
Dr. Lee Beecher dove into direct pay health care eight years ago.
"I decided I wanted to practice psychiatry in a way that was being discouraged by the insurance companies," Beecher said.
Beecher is now the president of the Minnesota Physician-Patient Alliance (MPPA), and he's so satisfied with the switch at his St. Louis Park practice that MPPA sponsored the conference, aimed at educating other local doctors about the merits of the model.
He said direct pay means working for patients, not insurance companies.
"I feel my goal in doing my work is to empower the patients, and to have them pay as they go, it seemed to be a better model for my practice," Beecher said.
Proponents say direct pay slashes costs for doctors by cutting out insurance paperwork. Beecher said they can pass those savings on to their patients, and provide higher quality care because doctors are able to give more time and attention to each individual patient.
But opponents say it favors the wealthy, limits access to doctors for low-income patients by freezing them out of some practices, and still requires most patients to pay for insurance to cushion against the costliest procedures.
"For me, this is the start of learning more," said Maya Babu, a neurosurgery resident in Rochester who attended Saturday's conference.
Babu said she likes what she hears.
"If there's a way for us to provide more transparency and to allow patients to understand what they're getting into, but then also for physicians to understand the costs that patients have to incur, I think it's a win-win," Babu said.
She said she does worry about how patients who develop chronic or costly illnesses would cope, but also sees direct pay as the future.
"I think you'll see more doctors heading in this way, where they're really kind of striking it out on their own," Babu said.
Most estimates put the number of direct pay physicians at 4,000-5,000. There are already at least a few dozen such practices in the Twin Cities metro, and their numbers have been growing the past few years.
According to the Concierge Medicine Research Collective, right now, direct pay practices are mostly physicians. About three out of four direct pay patients are in their 40's or 50's. They're mostly middle- and upper-income patients who need regular but fairly routine care.