Lawmaker hopes to offer alternative for doctors, patients

Medical care has been in turmoil in recent years, first with increasing costs, then with the passage of the Affordable Care Act, and subsequent court challenges culminating with the recent Supreme Court decision approving subsidies in states which have not established health insurance exchanges.

CHI's standoff with Blue Cross/Blue Shield of Nebraska came to an end last week, an agreement putting CHI Health providers such as Kearney's Good Samaritan back "in-network."

Earlier, disgruntled physicians went so far as building their own separate hospital in Kearney and were considering a similar move in Grand Island.

Now a state senator plans to throw one more ingredient into the healthcare stew.

Sen. Merv Riepe says he will introduce a bill allowing doctors to provide "Direct Primary Care" in Nebraska.

Under the system, patients pay their doctors a flat, recurring monthly fee, priced similar to a utility bill.

In exchange, they receive routine care, regular checkups, preventive care and care coordination.

"Fee-for-service health care in Nebraska is just not working," he said. "We need creative solutions to allow value-based health care for Nebraskans."

Proponents say that by paying a regular monthly fee for healthcare services instead of relying on insurance, patients can see 90 percent better prices and doctors can concentrate on keeping patients well rather than doing paperwork.

Allowing DPC would give innovative doctors a chance to explore a new market, proponents say.

However, it is expensive to switch to a cash-based business, and difficult to attract new patients once doctors stop accepting insurance, according to observers.

Direct Patient Care is not the same a concierge care, in which insurance is typically billed for medical visits in addition to a monthly subscription for access. While DPC is explicitly included in the Affordable Care Act, concierge medicine is not.

We don't know whether Direct Patient Care is a good idea or not, but the Legislature should allow health care providers, and the free market, to find out.