Affordable Care and Health Insurance, Too

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LAWTON – MainStreet Clinic announced the second community forum on the topic of “Affordable Care and Health Insurance, Too,” to be held on Monday, December 7 at the Lawton Public Library beginning at 6:00 p.m. The Lawton Public Library is located at 110 SW 4th Street in Lawton, Oklahoma.

Participants will “get the skinny on finding accessible care and wrap-around health insurance coverage that most people can afford in Lawton and southwest Oklahoma,” said Dr. Brian Birdwell. He will provide general information about direct primary care, an innovative health care payment model, where patients pay a flat monthly membership and receive full access to all clinic services, unhurried clinic visits, same day or next day appointments, and after-hours access to the clinic.

Joining Dr. Birdwell in the presentation will be Lynette Wallace, outreach and enrollment director at the Lawton Community Health Center. She will describe how Lawton residents may be able to access health insurance plans that wrap around direct primary care membership at prices most people can afford.

This community forum is free to attend. Please R.S.V.P. at (580) 248-9966.

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Can I afford health insurance and the costs of getting health care, too?

LAWTON – MainStreet Clinic will sponsor a community forum Thursday, November 19 at the Lawton Constitution community room beginning at 6:00 p.m. titled Can I afford health insurance and the costs of getting health care, too?

Participants will “get the skinny on finding real, accessible care and wrap-around health insurance coverage that most people can afford,” said Dr. Brian Birdwell. He will provide general information about direct primary care, an innovative health care payment model, where patients become clinic members and are assured

  • access to all clinic services on the same day or next day;
  • unhurried extended-time clinic visits;
  • contact with the clinic after hours by text or phone;
  • discounts on many generic medications; and
  • other premium services.

Joining Dr. Birdwell in the presentation will be Lynette Wallace, outreach and enrollment director at the Lawton Community Health Center. She will describe how Lawton residents may be able to access health insurance plans that wrap around direct primary care membership at prices most people can afford.

This community forum is free to attend. Please R.S.V.P. at (580) 248-9966.

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Public Invited To MainStreet Clinic Open House Nov. 4

LAWTON – November 2, 2015 – Dr. Brian Birdwell, Lawton internist, announced the relocation of his medical clinic, formerly Birdwell Ferris Clinic, to 415 W. Gore Blvd and the clinic name has been changed to MainStreet Clinic. An Open House will be held Wednesday, November 4, 2015 from 3:30 until 5:30 p.m. and the public is invited. A ribbon cutting ceremony will take place at about 4:30 p.m., conducted by the Lawton-Fort Sill Chamber of Commerce “Red Hat Committee.” Also at that time, Dr. Birdwell will present contributions from the Clinic to Habitat for Humanity and The Salvation Army. Please R.S.V.P. at (580) 248-9966.

MainStreet Clinic introduces an innovative health care payment model to Lawton, called direct primary care clinic membership. For a flat monthly membership fee

  • patients are assured access to all clinic services on the same day or next day;
  • unhurried extended-time clinic visits;
  • contact with the clinic after hours by text or phone;
  • discounts on many generic medications; and
  • other premium services.

No health insurance is required, since claims are not filed with any health insurance companies.

“It’s really old-fashioned. We are available for whatever you, the patient, may need — even house calls. We have time for you. Some people say, ‘It’s like having a doctor in the family,’” Dr. Brian Birdwell said.

Across the U.S., employers have begun revamping their group health benefits plans to make direct primary care membership the centerpiece, and reimburse employees for their clinic membership fees. Several Lawton employers are considering this approach now.

Consumers who must buy individual health insurance plans on a market exchange find that direct primary care membership combines well with a high-deductible health plan (HDHP). Dr. Birdwell will host a public community forum titled “Can I afford health insurance and the costs of getting health care, too?” at a date and time to be announced soon.

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Birdwell Ferris Is Now MainStreet Clinic at 415 W. Gore Blvd

LAWTON — Birdwell Ferris Clinic has moved to 415 W. Gore Blvd, across from the Lawton YMCA, and we are now the MainStreet Clinic. We look forward to seeing you at our new location.

While the address has changed, our team is the same and we remain focused on your care and well being. Reach us at (580) 248-9966 or fax number 248-6458.

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Direct Primary Care Legislation Signed Into Oklahoma Law

OKLAHOMA CITY — April 21, 2015 — Senate Bill (SB) 560 was signed into Oklahoma law today by Gov. Mary Fallin, having passed the Oklahoma House 83-0 on April 15 and the Oklahoma Senate 44-0 on March 2. Titled the Health Care Empowerment Act, this legislation is intended to protect patients’ and physicians’ rights to enter into direct-pay relationships, including direct primary care membership agreements. Read legislative history and the final enrolled version of the law.

Direct Primary Care Legislation Summary

Under Section 2 of this Oklahoma law:

  • direct primary care membership agreement” means a contractual agreement between a primary care provider and an individual patient (or legal representative) in which:
  • primary care services are provided for a flat periodic (monthly) fee;
  • direct primary care providers will not bill third parties on a fee-for-service basis;
  • any per-visit charges will be less than the monthly equivalent of the periodic fee.

The Act provides these protections for primary care providers and consumers:

  • a direct primary care membership agreement is not insurance and is not subject to regulation by the Oklahoma Insurance Department;
  • direct primary care providers are not required to obtain any (insurance) certification to market or sell a direct primary care agreement;
  • a direct primary care provider is not required to register as a medical discount plan;
  • it allows either party to terminate the agreement (immediately) upon written notice to the other party;
  • provides that fees are not earned by the direct primary care provider until the end of the month; and
  • provides that, upon termination of this agreement by the individual patient, all unearned fees are to be returned to the patient.

“We are very appreciate of the authors for delivering such a clean, articulate bill that gained unanimous support in both houses of the legislature and protects free-market, innovative medical practice in Oklahoma going forward,” said Rob Bartlett, Jr., executive director of Direct Care Partners, LLC.

SB 560 was introduced by Sen. Rob Standridge of Norman and co-sponsored in the Oklahoma House by Rep. David Derby of Owasso. This bill ensures that “Oklahoma citizens maintain control over their own access to quality health care at lower costs,” said Sen. Rob Standridge. It received “widespread support in the Oklahoma legislature, because it emphasizes individual responsibility for health care choices and payments, while it restores the patient-doctor relationship,” said Rep. David Derby.

SB 560 was supported by the national Direct Primary Care Coalition, an organization of physicians across the U.S. promoting direct primary care as an innovative alternative payment model that protects patient choice and promotes restoration of the doctor-patient relationship.

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Direct Primary Care Legislation Passed Oklahoma Senate

Legislation passed by the Senate Insurance Committee February 19 was passed in the Senate on March 2 by a vote of 44-0 and has been co-sponsored in the Oklahoma House. Senate Bill (SB) 560 is intended to protect patients’ and physicians’ rights to enter into direct-pay relationships, including direct primary care membership agreements.

This legislation allows employers to offer new, innovative health benefits to workers of all incomes that ensures employee access to a personal physician. When signed into law, this bill will ensure that direct primary care membership agreements are not treated as insurance products by state regulators.

SB 560 was introduced by Sen. Rob Standridge of Norman and is co-sponsored in the Oklahoma House by Rep. David Derby of Owasso. This bill ensures that “Oklahoma citizens maintain control over their own access to quality health care at lower costs,” said Sen. Rob Standridge.

“Widespread support is expected for this bill in the Oklahoma legislature, because it emphasizes individual responsibility for health care choices and payments, while it restores the patient-doctor relationship,” said Rep. David Derby.

SB 560 is supported by the Direct Primary Care Coalition, an organization of physicians across the U.S. promoting direct primary care as an innovative alternative payment model that protects patient choice and promotes restoration of the doctor-patient relationship.

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Quality Health Care Is About Time, And The Time Is Now

By Jeff Davenport, MD (Edmond) and Brian Birdwell, MD (Lawton)

First published in the Lawton Constitution

Grand schemes by government and large corporations to reform health care in the U.S. always have good intentions and yet they all share one failure: they overlook the front lines of health care, which is the primary care physician’s office.

Primary care doctors have been put in a vise by the efforts of insurance companies and Medicare to manage health care costs through price controls and imposed regulation. The paperwork burden on physicians for coding, filing insurance claims, submitting documentation and phone calls to payers adds $50 on top of the real cost for every patient encounter. Adding insult to injury, both public and private payers restrict the compensation physicians can receive for providing patient health care, which inevitably cuts down the time we may spend with our patients. To make financial ends meet, the typical primary care physician has less than 15 minutes of actual face-time with each patient.

This might be an acceptable burden if it led to quality care and patient satisfaction. But sadly, quality and satisfaction are the worst casualties of public and private sector attempts at managed care.

The most valuable component of primary medical care is TIME: time with patients; time to listen and to let patients know they are being heard; time to learn about everything that impacts our patients’ health; time to coordinate all the factors and render the highest quality of care, based on our medical training and professional judgment; time to actually care. Because “it’s about care, not coverage.” *

Entering into primary care has become an unappetizing career path for residents emerging from medical school. And this at a time when public health experts are pointing to a potential crisis in insufficient numbers of primary care doctors.

But there is hope.

A new medical and business model for the primary care doctor’s office is catching on. We call it “direct primary care,” because it is based on a simple idea: the patient joins the doctor’s clinic as a member, pays the doctor directly, and now, the doctor works only for the patient.

For around the cost of a monthly cable or cell phone bill, most consumers can be assured of access to their doctor, when they need it, and comprehensive primary medical care throughout the year, including preventive care.

We have established this direct primary care model in our clinics and hear from many other Oklahoma physicians who want to do the same in their health care practice. We agree that health insurance is an important protection, and with this model, insurance can be reserved for its true purpose: unplanned or prohibitively expensive procedures for an individual or their family.

As primary care doctors, we are not alone. Innovative employers are stepping up to offer their employees reimbursement for direct primary care membership fees. And now, thanks to the leadership of Senators Rob Standridge of Norman and Ervin Yen of Oklahoma City, the Oklahoma Senate Insurance Committee has passed Senate Bill (SB) 560 to protect patients’ and physicians’ rights to enter into direct primary care membership agreements without the interference of insurance regulations.

Voters, please contact your representatives in the legislature and thank them for supporting SB 560 in the Senate and the House. And physicians, please take a close look at direct primary care and ask if this health care model is right for you and your patients. It’s about time.

Jeff Davenport, MD is a family physician and owner of One Focus Medical in Edmond. Brian Birdwell, MD is an internist and occupational medicine physician, owner of MainSt. Clinic in Lawton. 

* “It’s about care, not coverage.” is a registered trademark in the U.S. by Direct Care Partners, LLC in Lawton, Oklahoma.

Posted in: Community Health Policy, Direct Primary Care

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Top 10 Most Costly Workplace Injuries

$1 Billion Each and Every Week

That is about what U.S. businesses spend on direct costs for workplace injury ($50 Billion per year), not to mention lost time and other indirect costs, according the Occupational Safety and Health Administration (OSHA).

Direct costs include workers comp payments, medical costs and legal services. Indirect costs may include replacement worker expense, accident investigation, lost productivity, damaged equipment and the cost of low morale and absenteeism.

According to Liberty Mutual Insurance, these are the Top 10 most costly workplace injuries, totaling ~85% of all workplace injury costs:

Overexertion injuries caused by excessive lifting, pushing, pulling, holding or throwing  $12B
Fall on the same level slips and falls  $6B
Fall to a lower level  $5B
Bodily reaction injuries caused from slipping or tripping without falling  $5B
Struck by object such as a tool falling on a worker from above  $4B
Struck against object such as walking into a door  $3B
Highway incident  $2B
Caught in/compressed by  $2B
Repetitive motion injuries due to repeated stress or strain  $2B
Assaults or other violent acts  $1B

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Membership Program Ensures Primary Care Access For Medicare and Private Insured, As Well As Uninsured

Speaking at the Senior Summit today, held at Southwest Medical Center, Brian Birdwell, MD announced a new program offered by the Birdwell Ferris Clinic called  “Ferris direct care: It’s about care, not coverage.™” Membership in this direct primary care program ensures full, open access to all clinic services, plus an array of exclusive member services, for a monthly subscription fee.

Known as the “direct primary care” model, this membership-based approach to primary medical care is gaining popularity across the U.S. with more than 100,000 patients now being served by direct care physicians in 24 states, according to the Direct Primary Care Coalition.

At today’s summit, Dr. Birdwell described a worsening crisis in primary medical care for older Americans, caused in part by the inefficiencies of paying for routine and preventive medical care through insurance coverage. Dr. Birdwell said that

  • nationally, the average time between doctor and patient is eight (8) minutes for a primary care encounter, which is inadequate for managing the multiple diagnoses, numerous medications, and complex medical circumstances many seniors experience;
  • insurance coding, billing and collections cost about $50 per doctor-patient encounter.

The direct primary care model eliminates this bureaucratic expense, applying those resources instead to more time for patients and improved quality of care.

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Direct Primary Care, A Simple Solution

The current health care system has become unsustainable, with costs for health insurance spiraling upward year over year at a rate several times greater than inflation. And while costs have risen sharply, the system has also failed to deliver affordable primary care to a large slice of the U.S. public, 50,000,000 by some counts.

After 25 years of experiments with insurance managed care, the result is

  • ineffective cost management,
  • decreased quality and availability of primary care for many people, and
  • loss of professional satisfaction among physicians.

The direct primary care solution is simple: De-couple care from coverage and offer health care consumers a low monthly clinic membership. Imagine primary care like this:

  • patients subscribe directly to the clinic of their choice,
  • pay modest monthly membership dues, and
  • receive the primary care they need, when they need it, on their terms.

Direct primary care membership ensures same day or next day appointments, along with longer, unhurried clinic visits. By eliminating insurance reimbursement, coding, billing and collections, as much as $50 per patient encounter is also eliminated. Costs are lowered. And the physician now works only for the patient.

Direct primary care membership is based on a simple, entrepreneurial business model, that supports a better medical model of primary care.

Posted in: Direct Primary Care, Health Blog

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