Great contrast & comparison of a model that's been forced to evolve. Primary care has never been lucrative by comparative means, but it operated on FFS platform just fine for many years until the administrative burdens of insurance companies and expectations of VBC imposed operating costs that exceeded their earnings. Granted, masses of people weren't as chronically ill as they are now, but many of the healthcare costs being seen today are a direct result of unnecessarily complicated administrative processes. Thank you fighting the good fight, Dr. Bricker.
I always thought PC/IM docs received income from a source you did not mention. I always thought that Internal Med docs received a percentage cut of the revenue from endo, cardio, pulmonary, and other specialist when they refer patients to these and other specialist/sub-specialist. I have to research this further for accuracy. Thank you so much for providing this valuable information. It has truly given me a broader perspective on the US heath care system.
I wonder how many others think this. Maybe 15 yrs ago, doctor got a gift basket for Christmas. No kickbacks allowed. If doctors help out a business, it is generally by accident.
Thank you, Imd and Nip, for educating me on this topic. I have to look back to Dr. Bricker's research and podcast on medical "steering" and who, if anyone benefits financially from this practice. I appreciate Dr. Becker is taking the time to gather the information for these podcasts. They have definitely made me think more thoroughly about my health care decisions.
@@GH-zs9fj its not the doctors but adminstrators at the top. thats why you have rampant burnout, horrible access and incredibly overpriced services. brought to you by large hospital systems.
Hi, thank you for posting. I always learn so much through your content can a practice be profitable through captation but in a not full risk contract or are the PM p.m. revenue not sufficient?
they didn't 'figure out' anything they were backed by VC and never profitable. As long as you don't have to turn a profit have an endless money supply you can look amazing.
Inelastic high margin services paying referral fees or other forms of revenue sharing would make fee for service primary care work just like your examples of airline credit card "partnerships" However, Fee for service primary care doesn't work because of "anti Kickback" statutes .
Amazing video as always. Can you please do a video about NP salary and the value they provide? How much they are billing and how profitable they are for hospital system and how low their salary is comparatively? Or if that’s not the case. The math behind it?
Excellent suggestion. Yes, the APP concept (NP, PA, & CNS) has most definitely contributed to the ability of primary care practices and specialty areas to keep pace with demands (volume, illness burden, admin processes) Many of the group practices I've worked with are increasingly relying on them to meet the need.
Very Interesting! I wonder how primary care providers might differ with trying to enticement to high margin inelastic demand, when their current model has claims backed accounts receivable, which delays the deployment of operational needs. It is almost like a combination of subscription and high margin inelastic demand might be the best of both worlds. Amazon might have had the intention to do this with their One Medical buy (subscription based + access to other services)
One more reason that doctors, electricians, and plumbers do not scale: all of these require a license or certification. Pest control does not, so the talent of the person performing the work is not nearly as important.
this isn't fair to primary care physicians. the things you are stating don't help us who actually create all the value outside of a dpc practice which knocks out about 95% of the population. creating value for a hospital system or a PE backed venture like chenmed is great for those at the top but doesn't help us in the trenches
the 4 big insurers and medicare and medicaid refuse to ever give us any sort of stable capitated rate. medicaid capitation is barely enough to keep the lights on. Medicare advantage capitation is decent but you only have so many of those patients and everyone and their mother is fighting for them. Commercial refuses to ever provide any sort of capitated rate so we remain stuck in ffs hell. That is about 95% of the population
Thank you for your feedback. Is there a way to make meaningful progress toward sustainability for your practice in the next 12 months? I’m hoping the answer is Yes.
Great contrast & comparison of a model that's been forced to evolve. Primary care has never been lucrative by comparative means, but it operated on FFS platform just fine for many years until the administrative burdens of insurance companies and expectations of VBC imposed operating costs that exceeded their earnings.
Granted, masses of people weren't as chronically ill as they are now, but many of the healthcare costs being seen today are a direct result of unnecessarily complicated administrative processes.
Thank you fighting the good fight, Dr. Bricker.
Thank you for watching and sharing your perspective.
Very entertaining presentation, the comparison between business models outside of healthcare makes the concepts very relatable.
Thank you for watching and for your feedback.
Awesome. Amazing way to explain a complex problem. Keep going, sir. Your videos are precious.
Thank you for watching and for your support.
Amazing insights. Please keep up the good work
Thank you for watching and for your feedback.
awesome vid doc! loved the comparisons bw primary care models other professions
Thank you
I always thought PC/IM docs received income from a source you did not mention. I always thought that Internal Med docs received a percentage cut of the revenue from endo, cardio, pulmonary, and other specialist when they refer patients to these and other specialist/sub-specialist. I have to research this further for accuracy. Thank you so much for providing this valuable information. It has truly given me a broader perspective on the US heath care system.
Thank you for watching and for your comment.
They can't accept any such revenue (gifts or cash) in exchange for their referrals. That's illegal.
I wonder how many others think this. Maybe 15 yrs ago, doctor got a gift basket for Christmas. No kickbacks allowed. If doctors help out a business, it is generally by accident.
Thank you, Imd and Nip, for educating me on this topic. I have to look back to Dr. Bricker's research and podcast on medical "steering" and who, if anyone benefits financially from this practice. I appreciate Dr. Becker is taking the time to gather the information for these podcasts. They have definitely made me think more thoroughly about my health care decisions.
@@GH-zs9fj its not the doctors but adminstrators at the top. thats why you have rampant burnout, horrible access and incredibly overpriced services. brought to you by large hospital systems.
How this applies or relates to solo practice?
Hi, thank you for posting. I always learn so much through your content can a practice be profitable through captation but in a not full risk contract or are the PM p.m. revenue not sufficient?
It can be. Direct Primary Care is straight PMPM. Typically $50-$120 PMPM depending on the location.
One medical seemed to have figured it out a while ago, correct? I believe they both charge a subscription fee plus file claims to insurance.
Thank you for sharing your perspective.
they didn't 'figure out' anything they were backed by VC and never profitable. As long as you don't have to turn a profit have an endless money supply you can look amazing.
What's your view on CVS' acquisition of Oak Street Health?
Foray into MA care delivery as a hedge against PBM crackdown by govt.
I hope you do a video on this. This sounds quite interesting!
Inelastic high margin services paying referral fees or other forms of revenue sharing would make fee for service primary care work just like your examples of airline credit card "partnerships" However, Fee for service primary care doesn't work because of "anti Kickback" statutes .
Thank you for watching and sharing your thoughts.
How do you feel about full risk Medicaid models?
Different set of challenges, but a very good idea.
Amazing video as always. Can you please do a video about NP salary and the value they provide? How much they are billing and how profitable they are for hospital system and how low their salary is comparatively?
Or if that’s not the case. The math behind it?
Thank you for your suggestion.
Excellent suggestion. Yes, the APP concept (NP, PA, & CNS) has most definitely contributed to the ability of primary care practices and specialty areas to keep pace with demands (volume, illness burden, admin processes) Many of the group practices I've worked with are increasingly relying on them to meet the need.
Thank you for the insightful video. What is your opinion on General Catalyst taking over Summa Health? Will the cost of health care increase?
Optimistic. Thank you for your question.
Very Interesting! I wonder how primary care providers might differ with trying to enticement to high margin inelastic demand, when their current model has claims backed accounts receivable, which delays the deployment of operational needs. It is almost like a combination of subscription and high margin inelastic demand might be the best of both worlds. Amazon might have had the intention to do this with their One Medical buy (subscription based + access to other services)
Thank you for watching and for your comment. 'Enticement to high margin inelastic demand' is just a complicated phrase for 'refer to a specialist.'
Can you make a video series about optum.
He is one I already made: th-cam.com/video/dHAr0s33Gns/w-d-xo.htmlfeature=shared
Dr. Eric - We need to chat!
One more reason that doctors, electricians, and plumbers do not scale: all of these require a license or certification. Pest control does not, so the talent of the person performing the work is not nearly as important.
Thank you for sharing your thoughts.
this isn't fair to primary care physicians. the things you are stating don't help us who actually create all the value outside of a dpc practice which knocks out about 95% of the population. creating value for a hospital system or a PE backed venture like chenmed is great for those at the top but doesn't help us in the trenches
the 4 big insurers and medicare and medicaid refuse to ever give us any sort of stable capitated rate. medicaid capitation is barely enough to keep the lights on. Medicare advantage capitation is decent but you only have so many of those patients and everyone and their mother is fighting for them. Commercial refuses to ever provide any sort of capitated rate so we remain stuck in ffs hell. That is about 95% of the population
Thank you for sharing your experience.
Thank you for your feedback. Is there a way to make meaningful progress toward sustainability for your practice in the next 12 months? I’m hoping the answer is Yes.