More doctors are switching to cash-only practices
The numbers are still small but rising, creating both cost savings and some new headaches.
Earlier this year, Dr. Michael Ciampi sent a letter to patients at his family practice in South Portland, Maine, telling them he would no longer accept any form of health insurance. He now posts prices on his office website and asks patients to pay for services out of pocket.
Ciampi is part of a small but growing number of physicians who are switching to a cash-only model (not strictly cash -- most also accept payments by check and credit or debit cards) in order to streamline their costs.
CNNMoney says about 4% of respondents to a survey conducted last year by the American Academy of Family Physicians said they took only cash at their practices, up from 3% in 2010. And a physician compensation report by WebMD site Medscape found 6% of doctors had a concierge or cash-only practice this year, compared with 4% in 2012.
Doctors who go the cash-only route get some very tangible advantages. "This arrangement generally enables much lower overhead because claims processing, patient billing and countless hassles related to managed care can be eliminated," the AAFP noted several years ago.
The cash-only approach also creates challenges. According to the AAFP, some health insurance companies prohibit patients from seeing physicians who terminate their contacts, if only for a limited amount of time. Doctors who switch to cash-only practices are also considered out of network by many insurance groups. And patients who want to stay with a cash-only doctor but need to be reimbursed have to file their own insurance claims.
There's also the argument that only healthy and wealthy patients benefit from the cash-only system and that such practices reduce a doctor's range of care because patients with long-term, acute and costly problems will most likely seek out physicians who accept insurance.
Ciampi says his decision to go cash-only cost him several hundred of his 2,000 or so patients.
"It's been almost unanimous that patients have expressed understanding at why I’m doing what I'm doing," he told the Bangor Daily News, "although I've had many people leave the practice because they want to be covered by insurance, which is understandable."
But going to a cash-only system also means Ciampi can practice a more flexible form of medicine. The insurance companies no longer tell him what to charge. He can also offer discounts to financially struggling patients and even make house calls.
"I'm freed up to do what I think is right for the patients," he said. "If I'm providing them a service that they value, they can pay me, and we cut the insurance out as the middleman and cut out a lot of the expense."
I think that more and more doctors are going to do this. In fact, instead of Obummer care, why not expect patients to pay for most routine care out of pocket, and pick and choose the health insurance coverages they most need, which includes catastrophic care. That would bring health care costs down for everyone and make the health care marketplace more competitive.
Instead, we are forced to take policies with more coverage than we need (not everyone needs maternity coverage, free birth control, mental health services, etc.) Why not be able to pick and choose the coverages that we DO need, and shop across state lines among many insurance companies for competitive pricing for the services that we need? I'll take the free market approach any day of the week over the government run bureaucracy.
Just don't ask for personal information like my Social Security Number.
The unemployed are still a market and growing more every day.
My niece is a medical biller and she gets 10 calls a day from people who say, "I don't have insurance and I will be paying cash; how much for a doctor's visit?"
F**k you and your co-pays; cash is still king.
My physician operates this way and the practice(he has another doc working with him), also do not take medicare or medicaid patients.
I pay cash or use my HSA, and submit to my insurance co.
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