Thursday, April 29, 2010

Market-Based Membership Approach to Healthcare At the Same Monthly Cost As a Cell Phone Plan


From the Qliance website: "Traditionally, over 40¢ of every $1 you spend on health care goes toward insurance billing and overhead (see chart above). This means your clinician must work harder and faster, seeing more patients each day just to make ends meet. As a patient, you experience longer wait times, shorter appointments and higher costs.

Qliance is like a health club membership, but for health care. Your membership gives you unrestricted access to your Qliance clinician and services for one monthly fee. Instead of dealing with costly overhead, we reinvest that 40¢ in our clinics, electronic medical records and in patient services. You experience shorter wait times, longer appointments and lower costs."

From the WSJ: "Qliance operates three clinics in the Seattle area that offer primary care treatment to patients who pay a monthly membership fee ranging between $44 and $84, depending on their age. The company accepts no form of health insurance for its services. Qliance intends to use its financing to expand in Washington State, with plans to open clinics beyond the state as early as next year.

The company argues that its care covers roughly 90% of the medical issues that people see doctors for, from checkups to minor fractures to vaccinations, as well as ongoing care for chronic illnesses like hypertension. Qliance members typically pay other companies for insurance to cover emergency procedures and serious illnesses, such as cancer.

Qliance is betting it can profit by wringing many of the administrative costs out of health, especially the overhead that comes with haggling with insurance companies and billing patients. The company’s clinics are open seven days a week and says its doctors are able to spend more time with patients – at least a half-hour for routine appointments and an hour for physicals – than most physicians who take insurance do."

MP: This is another great example of an innovative, market-based approach to health care (similar to the 1,171 retail health clinics currently operating in 40 states, but with expanded services) that continue to develop, despite the government takeover of the health care system. By eliminating insurance and billing overhead, Qliance gets the monthly cost of health care down to about the same cost of a monthly cell phone plan. Unfortunately, Obamacare will send costs in exactly the opposite direction - higher and higher with an increase in bureaucracy, overhead and paperwork.

21 Comments:

At 4/29/2010 8:29 AM, Anonymous Anonymous said...

Sounds like they are offering insurance. State will put a stop to that...

 
At 4/29/2010 9:13 AM, Anonymous Chris said...

I remember reading about a doctor in NY who did something similar. The state insurance authorities deemed that his 'clinic membership' was actually an insurance plan. He was to change his service offerings to meet the minimum standards of NY health insurance plans or go out of business. Of course, it was cost prohibitive to meet NY's insurance requirements and doing so defeated the whole purpose of his clinic membership program. Naturally, he closed up shop. Like I say...government bureauweenies know best...

 
At 4/29/2010 9:14 AM, Anonymous Anonymous said...

"The company argues that its care covers roughly 90% of the medical issues that people see doctors for, from checkups to minor fractures to vaccinations, as well as ongoing care for chronic illnesses like hypertension. "

It is the other ten percent that kills you.

They are offering insurance and cherrypicking, like everyone else.

If I joined that club, they aould take one look at my health records and kick me out in a week.

 
At 4/29/2010 9:26 AM, Blogger juandos said...

Hmmm, here in the St. Louis, Mo area there are a couple of discreet health clubs where there's a yearly membership fee that covers most common doctor visits plus most common shots and vaccines...

Anything and everything else is cash & carry...

No insurance paperwork, no government paperwork, but I don't know what the overall cost would be compared to doctors that deal with insurance...

 
At 4/29/2010 10:17 AM, Blogger bix1951 said...

"Traditionally, over 40¢ of every $1 you spend on health care goes toward insurance billing and overhead

I strongly doubt that 40 cent number.

 
At 4/29/2010 10:51 AM, Anonymous SuhrMesa said...

This works best with a high deductible, HSA insurance plan. Unfortunately, the Democrat party hates high deductible, HSA insurance plans. Anything with a tax deduction makes them ill, due to an insatiable appetite for cash flow.

 
At 4/29/2010 10:52 AM, Anonymous Benny The Man said...

A terrific market response. But...it seems like they are not covering serious stuff, like surgery or cancer, for that monthly fee. It is only primary care.

That's okay, but not a solution to our national health care problems...and out real problem is that we spend way too much on health care and get the same results as any Euro nation. I think we are up to 16-17 percent of GDP headed for 25 percent, while Euros keep it to about 10 percent.

For myself I would prefer a top-down approach. We allocate 12 percent of GDP to health care, and then bid-out services to health care providors....

 
At 4/29/2010 11:00 AM, Anonymous gettingrational said...

bix1951, said that the claim of 40 cents of every dollar goes to insurance billing and overhead is doubtful.

Look at the article written by CEO Norm Wu, of Quliance, entitled "Who Killed Marcus Welby". In the article Mr. Wu presents a flow chart for the Economics of Insurance Based Primary Care vs. Direct Primary Care. Article Here!

The streamlining of the process, as presented in the flow chart makes a strong case for lowering costs. Dr. Garrison Bliss, Chief Medical Officer of the clinics, is a pioneer and driver in direct primary care clinics.

BTW, recent investors include Drew Carey, Jeff Bezos and Michael Dell.

 
At 4/29/2010 11:12 AM, Anonymous morganovich said...

there is a great deal of this around. my parents have a doctor that they simply pay an annual fee and can see or speak to whenever they wish.

that said, it's quite expensive. this is usually a high end kind of offering with a great doctor and few patients.

this is the first low priced version of this i've seen, but apart from getting some continuity with a doc, this looks considerably more expensive that the clinics offered by wal mart etc. $69/mo is very cheap for insurance, but unless you are seeing the doc every 3 weeks, it's probably cheaper to just hit a clinic.

 
At 4/29/2010 1:37 PM, Anonymous Anonymous said...

Sounds like single payor model--you.

 
At 4/29/2010 2:00 PM, Anonymous Lyle said...

AS noted its not the routine visits to the physician that run up the bills, its first the tests that can cost 10x the cost of the visit, and then when you get sick the hospital costs, as well as all the specialists. Recall that the HMO model was essentially this with the primary care physician acting as a gatekeeper to the expensive services. It was soundly rejected by the public who feel that they have a right to see a specialist.
So this does not solve the real problem it is only a band aid. (Physician vists are not much more than 100-150 until you go to a specialist).

 
At 4/29/2010 2:21 PM, Anonymous Anonymous said...

there is a great deal of this around. my parents have a doctor that they simply pay an annual fee and can see or speak to whenever they wish.

That is the old Chinese model, only they stop paying the doctor if they get sick.

 
At 4/29/2010 5:02 PM, Anonymous Anonymous said...

Hehe. During the 1990s Managed Care tsunami many companies took off with people's money after promising patients the moon and doctors the stars. Oxford was only the most famous case: declared bankruptcy after essentially running a Ponzi with premiums. You get what you pay for.

 
At 4/29/2010 6:42 PM, Blogger OA said...

Lyle, what do you mean by "does not solve the real problem"? Real problem for whom?

There's no restriction on this being the only source of medical care. Their "Insurance" page discusses making it work with an HSA, high deductible plan, and even Medicare.

Even if someone doesn't have additional coverage, at least they get to decide on this versus trying to negotiate every single visit someplace else. What share of people need more than routine care in a year?

Seems like it solves a lot of real problems. Of course it doesn't solve the problems like Medicare going bankrupt and improper economic incentives in regular insurance programs, but we have the big brains in DC to fix those.

 
At 4/29/2010 8:30 PM, Anonymous Lyle said...

The real cost problem is not doctors office visits its hospital costs and drug costs, driven by drug advertisements. This attacks the small end of the problem not the big end. Hospitals need to stop their arms race over equipment with other hospitals, etc. On Mal Practice, some states already have the restrictions on pain and suffering claims. Why not push in other states to restrict in the states.
Of course another way to restrict malpractice becomes standards of care. If a physician follows the standard of care defined he can get a rapid dismissal of the suit. This is the upside of effectivness research once we know what works, then doing that shields the physician from suits.

 
At 4/29/2010 10:37 PM, Anonymous Anonymous said...

"hospital costs and drug costs, driven by drug advertisements."

Care to back that up? Do you understand capitated payments? How are drugs and services billed in a Hospital setting?

"Hospitals need to stop their arms race over equipment with other hospitals, etc

Back that up too.

The rest is incoherent. States push states? What?

 
At 4/29/2010 11:40 PM, Anonymous Lyle said...

On Mal Practice Texas has put a 250k limit on pain and suffering why not have the states do it rather than the federal government.
The arms race how many hospitals have fancy equipment because competition forces them to.
If you look at most peoples medical expenses physician outpatient costs are a trival part of their costs. (For Medicare if you are over 65 but don't have 40 quarters of service Part A (hospital) its 465 a month while part B physicians and out patient services is 110. It is the hospital stays that bankrupt people, not the routine stuff, this is exactly the point of HSA's with the yearly costs to pay the routine stuff and the high deductible insurance for the hospital stays.
Assume for example you break a bone, beyond the physcians cost you will have an Xray that may cost as much or more than the physician, and this plan does not appear to cover that cost.

The arms race is so many hospitals decide they need transplant programs, and other things to maximize their prestige. After all in many respects until recently the hospitals customers where the physicians who decided where the patient went.

 
At 4/30/2010 8:17 AM, Anonymous Anonymous said...

I think this would be really good for for large families...

 
At 4/30/2010 9:27 AM, Blogger Texan99 said...

The system would work better if we'd budget this way for ordinary care (bone breaks, vaccinations, checkups, the flu) and use insurance only to cover the real catastrophes.

 
At 4/30/2010 1:45 PM, Blogger Christine said...

Why is the cost of health care procedures and treatments so mysterious? How come I don't know the cost of a test or an office visit?
www.whatstherealcost.org/45secondstoshare

 
At 5/03/2010 1:28 PM, Anonymous Qliance said...

Qliance ‘s approach to health care is similar to car insurance: pay out-of-pocket for inexpensive, routine maintenance (colds & flu) and use insurance for the rare and expensive occurrences (cancer & car accidents). We don’t expect car insurance to pay for new windshield wiper fluid or oil changes, why should we expect insurance to pay for a trip to the doc for a cold?

I work for Qliance and reader Chris brings up a great point about what exactly is insurance. In short, it depends on the state. In NY, practices similar to Qliance have been considered insurance, versus in Washington State where they are not considered insurance (WA Senate Bill 5958).

Also, reader Anonymous mentioned that after looking at his health history he would be "kicked out," but please let me say this is not so. Qliance does not deny membership or "fire" patients because of preexisting conditions. If you've got a lot going on, come on down, we'd love to see you to help get you on the road to better health. We’re gathering some really promising data and I encourage you all to visit our website, www.Qliance.com, to read more. Thanks again for your great comments!

 

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