Consumer-Driven Health Care Spurs Innovation in Physician Services

Brief Analysis No. 559 by Devon M. Herrick

Consumer-driven health care (CDHC) is leading to new models for the delivery of medical services. Consumer-driven health plans generally include personal accounts — such as Health Reimbursement Arrangements or Health Savings Accounts — that allow patients to directly control some of their health care dollars. Because they have a financial stake in their own spending, patients have incentives to shop for the best price and to make tradeoffs between convenience and cost.

Insurance recordkeeping and claim filing represent a significant expense for physicians. Physicians can speed up their cash flow and reduce billing costs by attracting patients who pay cash or use the debit cards that some plans provide. Thus a growing number of medical providers are offering innovative services to meet the demand of empowered patients.

These new physician services tend to have two characteristics: (a) they offer patients greater convenience and (b) they step outside normal reimbursement channels — requiring payment at the time of service, accepting insurance reimbursement from only a handful of large provider networks, or requiring insured customers to file their own claims.

Convenient Service: Telephone Consultations. Many medical concerns can be resolved with a phone call. However, few insurers reimburse physicians for telephone consultations or e-mail exchanges. As a result, patients often find access to their physician is limited — especially after-hours and on weekends. Entrepreneurial providers, on the other hand, are making it easy for patients who pay cash to reach them by phone....for more of the story from NCPA