Recent changes to medical plans have made high deductible plans almost ubiquitous. With Obamacare rollbacks, we are also seeing a lot of people opting to forgo medical insurance and not have any at all. These situations have found many people in a place where they need to seek the most cost effective care they can receive. Independent doctors are uniquely positioned to provide this. There are a few reasons why this is so.
Why Independent Practices offer Low-Priced Quality Care
First, independent practices have decreased overhead. Compared to a large multi-physician foundation that employs a larger staff, an independent practice can keep its personnel to a minimum to support fewer doctors. This savings can be passed on to the patient.
Second, small private practices have decreased bargaining power. This is unfortunate for us, but you, the consumer, can benefit from it. Even with the discounted rates from insurance, services are going be cheaper through an independent practice. Unfortunately, small private practices do not have much negotiating power when dealing with insurance companies and often will be reimbursed less for similar services and therefore have a much greater discount for patients. Larger foundations and corporations can negotiate high rates and this translates to higher patient shares on high deductible plans and for cash payers. I have seen the EOBs (explanation of benefits) of large medical groups versus smaller independent practices and the difference can be staggering.
Third, supportive care can be more personal. When you call a private practice, you will often have a live person pick up the phone, as is the case at our practice. Bigger foundation practices often route you through a phone tree. When calling a large medical group, I had to dial 3 numbers to get where I wanted and then was on hold for 4 minutes. Unfortunately when I did talk to a person, he was unable to help me because he only knew scheduling and knew nothing about billing. He pointed me to a website where I could look up prices.
To prove my point I decided to do my own cost comparison. For the large medical foundation, I used their online cost estimation tool for a typical office visit for a cash pay patient and was quoted $138 discounted from the billed amount of $197 (cash pay is often given a discount to bring down the price closer to the negotiated rate from insurances). At our independent office, a similar visit will cost a person without insurance $66.50 discounted from the billed amount of $105. That is less than half the cost!
This cost savings also extends to ancillary services such as physical therapy and x-rays. For the large medical group I researched, a basic physical therapy initial evaluation will cost you $192 (discounted from $274) out the door. American River Rehab (a local independent PT) is cheaper at $100 for the initial evaluation if you are cash pay (and $75 for follow up). Again, almost half the price!
For radiology, I looked up the large medical foundation radiology services and inquired how much a screening mammogram would cost. I was quoted $337 discounted from the billed amount of $482. I compared this to Insight Imaging (a private radiology office in Grass Valley, a nearby town) where it is $192.50 discounted from the billed $293. This savings is significant. Here I only mention PT and radiology but this extends to skilled nursing facilities, labs, hospitals, home health and all other medical services.
Obviously I’m a little biased as I work at an independent practice. However, it is hard to argue with the numbers I present above. This is nothing against the doctors at these bigger groups. They are all very capable and comparable to independent doctors, but when it comes to value for services rendered, independent physicians come out on top. If you are happy with your doctor and the cost you pay, please stay with your current physician. But, if you are looking for a better value, do your own cost comparison and call around to your local big groups and small independent physicians. I believe your findings will be similar to mine.
This has huge implications in today’s medical field where spending continues to rise and doctors are being blamed. A recent study shows that by 2026, health spending in the US will rise to $5.7 trillion! To be good stewards of money flowing through the medical community it is our duty to take cost into consideration while still providing excellent care. ACOs (Affordable Care Organizations) have this as their primary goal and are where medicine is migrating. These organizations band practices together with the goal of providing superb care while keeping costs low and referring to low cost entities to save Medicare money. We recently joined National ACO with this in mind.
So, when you are looking for a new doctor or any ancillary services, take into consideration the cost. If you are outraged about the rising cost of healthcare, do some research. An independent practice will most likely offer you more value in your medical care. You can also choose a doctor affiliated with an ACO. As an independent doctor, I join with other independent practices and make the commitment to you and the community to provide excellent medical care while keeping the costs down.