$149 a month flat rate GoForward medical coverage

[QuarterMillionMan]

Forward | Doctors Dedicated to Your Long-Term Health (goforward.com)

No I'm not affiliated but seen commercials on TV, looks good for maybe those without coverage but I'm not replacing my current coverage with this.

[QuarterMillionMan]

Healthcare is Backwards. Go Forward with Zero Wait Time - YouTube

[disneysteve]

Concierge practices like this have been popping up for years. I know a number of doctors who have switched their practices to this model. It allows them to have 75% fewer patients under their care but spend a lot more time with each of them.

You still need to have traditional medical insurance for all of the care outside of the concierge practice, testing, specialists, hospitals, etc.

This model is one of many things that is wrecking primary care. Since the doctors who go concierge accept far fewer patients into their practices, it leaves more and more patients searching for shrinking supply of PCPs. I see a lot of patients coming to Urgent Care because their doctor switched to the monthly subscription model and went from 2,500 patients to 500 leaving the rest stuck finding a new provider and there just aren't enough to go around.

[rennigade]

Is there any point to a personal care physician anymore? It seems so antiquated. I always find it odd that whenever I go somewhere, the place will ask for my pcp...I just answer NA, because I dont have one. That seems like something the older generation still likes. They like seeing the same doctor. I dont believe there is some magical doctor/patient relationship. Doctors read charts. They make notes and skim over previous details. Ill take an urgent care model any day of the week.

[Like2Plan]

Interesting--concierge medicine. I can see some advantageous to this if it is a one stop shop. My fear would be the $149.00/month per person is an introductory price and the cost goes up to an unaffordable amount.

DH's practice sent out a letter a few years ago inviting people to sign up for concierge care. If you didn't sign up, they wouldn't kick you out--they implied you would just go to the back of the queue for appointments. And, you had to see a nurse practitioner. DH didn't sign up for it. In all honesty DH hasn't seen any difference in the care-he saw a nurse practitioner for annual visits before the change anyway. She refers him to specialists as needed.

We don't know if they get enough concierge patients if they will just chuck everyone else, but it has been several years since they made the change.

[disneysteve]

Is there any point to a personal care physician anymore?
Ill take an urgent care model any day of the week.

PCP and UC are, and should remain, two entirely different things.

UC is great for acute needs: strep throat, flu, sprained ankle, laceration, etc.

PCP is needed for ongoing care: high blood pressure, diabetes, high cholesterol, kidney disease, thyroid disease, etc.

For acute stuff, it really doesn't matter if you see a different person every time you go. The person who treats your strep throat need not be the same one who stitched up your cut finger.

For chronic stuff, an ongoing relationship with a single provider is very important. You want someone who knows your history and is following a unified plan to manage all of your medications and chronic conditions. You want somebody who knows that you can tolerate 5mg of amlodipine but your legs swell when you take 10mg. You want someone who knows that lovastatin gives you leg cramps but rosuvastatin does not (rather than just have a "statin" allergy listed on your chart). You don't want to have to tell your whole story again every time you see a new provider. You want someone who can manage and help coordinate all of your healthcare with other specialists and facilities. It's far more efficient. It's far more cost-effective. And it's far safer and less likely to result in unintended outcomes. The more fragmented your care, the more likely it is for things to go wrong and important details to get overlooked.

[disneysteve]

Interesting--concierge medicine. I can see some advantageous to this if it is a one stop shop. My fear would be the $149.00/month per person is an introductory price and the cost goes up to an unaffordable amount.

DH's practice sent out a letter a few years ago inviting people to sign up for concierge care. If you didn't sign up, they wouldn't kick you out--they implied you would just go to the back of the queue for appointments. And, you had to see a nurse practitioner. DH didn't sign up for it. In all honesty DH hasn't seen any difference in the care-he saw a nurse practitioner for annual visits before the change anyway. She refers him to specialists as needed.

We don't know if they get enough concierge patients if they will just chuck everyone else, but it has been several years since they made the change.

It sounds like that practice decided to do both. The physicians went concierge but they maintained a traditional model staffed by the NPs. Many practices simply go all concierge forcing hundreds or thousands of patients to find a new home.

[TexasHusker]

This is a nifty plan, but the truth is, doctors aren’t consuming the big bucks in medical care. That trophy belongs to the hospitals. A 3 day stay in a hospital without insurance can bankrupt many people. Drug costs are also high, particularly for new therapies.

The hospitals continue to rape and pillage unabated. The FTC allowed all of this when they approved various hospital mergers over the last 3 decades, eliminating competition in even the big markets.

The Fed bought into an argument made by the hospitals called “duplication of services” and the game was over. Yes, many services are no longer duplicated, but that goal is a purely socialist - if not communist - ideal, and now we are paying the Piper: Greatly increased prices for often crummy service.

[Petunia 100]

This is a nifty plan, but the truth is, doctors aren’t consuming the big bucks in medical care. That trophy belongs to the hospitals. A 3 day stay in a hospital without insurance can bankrupt many people. Drug costs are also high, particularly for new therapies.

The hospitals continue to rape and pillage unabated. The FTC allowed all of this when they approved various hospital mergers over the last 3 decades, eliminating competition in even the big markets.

The Fed bought into an argument made by the hospitals called “duplication of services” and the game was over. Yes, many services are no longer duplicated, but that goal is a purely socialist - if not communist - ideal, and now we are paying the Piper: Greatly increased prices for often crummy service.

I had a 2 night stay in the hospital last month. The bill was 34k and I did not have surgery.

[disneysteve]

I had a 2 night stay in the hospital last month. The bill was 34k and I did not have surgery.

How much did your insurance actually pay? It's often far less than the amount billed.

[Petunia 100]

How much did your insurance actually pay? It's often far less than the amount billed.

I don't recall, but it was far less.

[TexasHusker]

I had a 2 night stay in the hospital last month. The bill was 34k and I did not have surgery.

Very typical. That’s why health insurance is outrageous and only going higher. Elimination of free markets and competition usually produces disastrous results for everyone except the ruling class.

[TexasHusker]

How much did your insurance actually pay? It's often far less than the amount billed.

Likely still 5 times what they should have...

[ua_guy]

Very typical. That’s why health insurance is outrageous and only going higher. Elimination of free markets and competition usually produces disastrous results for everyone except the ruling class.

I don't understand your position. You want health insurance to be free-market, but not hospitals. There's also a false assumption that if health insurance were cheaper, that people would just buy it. Sorry, that's not how it's ever worked, even when the market was ripe with cruddy, low-cost insurance plans that covered almost nothing, that were created for pure profit.

Hospitals consolidated to better their position, but bad on them for doing so? You should be familiar with the cost of uninsured and under-insured care, as well as how reimbursement barely covers cost in some cases. Providers and their facilities provide the care so I think it makes sense that they take the lion's share in this equation.

What should healthcare cost? Are you saying that there should be a limit to the money that anyone should make in healthcare? They make too much? Hmm...

[TexasHusker]

I don't understand your position. You want health insurance to be free-market, but not hospitals. There's also a false assumption that if health insurance were cheaper, that people would just buy it. Sorry, that's not how it's ever worked, even when the market was ripe with cruddy, low-cost insurance plans that covered almost nothing, that were created for pure profit.

Hospitals consolidated to better their position, but bad on them for doing so? You should be familiar with the cost of uninsured and under-insured care, as well as how reimbursement barely covers cost in some cases. Providers and their facilities provide the care so I think it makes sense that they take the lion's share in this equation.

What should healthcare cost? Are you saying that there should be a limit to the money that anyone should make in healthcare? They make too much? Hmm...

The insurance companies' hands are bloody, too.

Hospitals successfully did what any other business would do if allowed - merge to foreclose competition. The FTC allowed it. Even massive markets such as DFW are down to two or three major health systems at most. There is little-to-no competition in the hospital space - for service or price.

For 24 years, I was intimately involved in hospital finance, so I have a pretty rounded knowledge of all of the games.

In 1994, I recall that at the major hospital I worked at, our average Medicare length of stay was 4.1 days, and average charges were $5405. Median family income in the U.S. in 1994 was $34,076. So an uninsured hospital stay was about 16 percent of median family income. Big, but not catastrophic.

In 2020, according to CMS data, average charges per discharge at my old employer are $55,671, with a ALOS of 4.67. Median family income in the U.S. in 2020 was $78,500. So an uninsured hospital stay is now 71 percent of median family income. Astonishing.

My first year at the hospital in 1994, we made $4 million in "profit" (though we are non-profit, haha), and we had a huge managers dinner/party with lots of big bonuses. Today, profits exceed $90 million a year, for a community hospital. The hospital was bought out a number of years ago by a hedge fund and is now 100 percent "for profit".

Runaway healthcare costs have a lot in common with runaway housing costs and runaway college costs: Government tampering. Works like a charm.