Four Updates Worth Sharing

1) State Policy Update - Remember we already have 14 states that have passed DPC Legislation, and 10/14 are helpful.  (For details about any below see the states pages.)

1) West Virginia 2006 (Bad law - makes DPC more difficult)
2) Washington    2007
3) Oregon            2011 (Bad law - makes DPC more difficult)
4) Utah                 2012
5) Arizona           2014 (Irrelevant law - offers no true "not insurance" protection)
6) Louisiana        2014
7) Michigan         Jan 10, 2015
8) Arkansas         Feb 19, 2015 (Bad law - vague definitions focused on "concierge")
9) Mississippi      Mar 18, 2015
10) Idaho               Apr 9, 2015
11) Oklahoma     Apr 21, 2015
12) Kansas            May 7, 2015
13) Texas              May 28, 2015
14) Missouri         July 2, 2015

Legislation has been proffered in Wyoming, Nebraska, and Virginia.  Prior Florida legislation that nearly passed may be reintroduced.  Discussions about potential DPC legislation are also taking place in Massachusetts, and North Carolina.  If you are aware of any states that I am missing please let me know.

2) Another Ignorant Commentary About DPC

This time it comes from an expected opponent with an obvious bias.  Since passing their legislation earlier this year many legislators in Michigan have continued to promote the benefits of DPC.  Well, Mr. Rick Murdock, the Executive Director of the Michigan Association of Health Plans wants everyone to pipe down.  In this letter Mr. Murdock calls DPC a "bad public policy idea" resembling "swiss cheese" with many "holes."  His arguments are based largely out of his own misunderstanding and/or attempts at deception - after all he does work for a "nonprofit" organization serving insurance companies that stand to lose a lot of money as the DPC movement continues to empower more patients.  
- He seems annoyed that the comprehensive primary care promised by DPC practices does not also have the ability to cover all emergency situations and guarantee that patients will never need to enter the hospital.  (Well - we are NOT selling insurance - after all.)
- He confounds Medicaid ideas in an absurd manner and insinuates that DPC worsens these problems.  
- He then argues that without the insurance company in place to (deny) review claims, no one will be able to detect fraud.  Why don't we rely on the patient?  The same patient that has now been empowered through price transparency to police his own care.  As Josh Umbehr would say "he who holds the purse strings holds the power."

3) Upcoming DPC Events

 Things typically quiet down during the holidays, but I will be speaking at two DPC winter conferences:  (See the events tab for direct links)

Jan 29, 2016 AAPS - Thrive, Not Just Survive XXIII - Orlando, FL
Feb 26-27, 2016 AAPP - Spring Summit on Private Medicine - San Diego, CA

If you will be attending either event and want to catch up in person, just drop me a note (phil@dpcfrontier.com) and we can plan a time to chat.

4) Washington Insurance Commissioner's 2015 Report

When Washington passed DPC legislation in 2007 the Insurance Commissioner fought against it, and one of his "wins" in the legislative debate resulted in a requirement that practices regularly submit data to the insurance commissioner.  The commissioner was excited that he would get to tally the complaints and failures of DPC practices... or so he thought.  Year after year the report simply highlights how well DPC is doing in the state, and the commissioner's office has to reluctantly gather the data and file the report each year.  So what are this year's highlights?

"Overall patient participation increased from 8,658 participants in 2014 to 11,504 in 2015; this is a 32 percent increase, a total of 2,846 patients."

"Complaints received: The OIC did not receive formal or informal complaints regarding direct patient practices in the past year."

"At this time, the highest monthly fee is $909 per month at MD² Bellevue; the lowest is $25 per
month at Roth Medical Clinic in Spokane."

I find it fun to point out that the skeptical Office of the Insurance Commissioner has zero patient complaints to report after eight years of DPC in the state!

Phil Eskew

The Mapper has Been Updated - Over 400 DPC Locations!

The DPC Mapper has now been updated.  Around twenty new locations were added and I am pleased to report that we are now north of 400 practice locations!  Colorado is in first place in the race for the most practices with 33 locations, now including DPC at the University of Colorado as well.  Hawaii, Iowa, Nebraska, North Dakota, and South Dakota are still lacking their first DPC practice.  As always, if your practice is missing from the mapper please let us know!

A Few Thank You Notes, Keep the Pressure on ACP

I would like to say a quick "thank you" to authors Michael Laff and Leslie Champlin for writing excellent news releases about my JABFM manuscript.  Here are some links (note that these were among several recent news stories added under the nonacademic articles page).

Researchers Study What 'Direct Primary Care' Really Means, by Michael Laff, AAFP News, Nov 10, 2015.

Small, Independent Practices Comprise Most Direct Primary Care Offices, by Leslie Champlin, Robert Graham Center, Nov 9, 2015.

To those that might have missed the last post about ACP - please go back and give it a quick read.  I'd be happy to hear your thoughts (you can always click the title of any blog post to comment and view other comments), and apparently ACP would still like to hear your thoughts as well.  I wholeheartedly agree with each of the comments made in my last post by Drs. Robert Nelson, Julie Gunther, and Shane Purcell.  So what do we DO about this?  

Any physicians that are ACP members should publicly reach out to the organization to express your disagreement with their policy statement.  Better yet - you might reach out to your state ACP chapter leaders (as Dr. Lee Gross has done in Florida) to ask that they publicly articulate their support for Direct Primary Care.  With enough pressure, the ACP might take the most appropriate action - an action Josh Umbehr is already promoting - retract the manuscript.

I hope to have an updated version of the mapper up soon!

If you have a question you would like answered in the next blog post, feel free to place it in the comments below and I'll give it a shot.