Finally A Concierge Doctor in Mesquite, Nevada! Concierge Medicine is growing!
By Barbara Ellestad for the Mesquite Citizen Journal, July 23rd, 2013
You’re starting to hear about it more and more all across the country – a parting of company between doctors and insurance companies. Now, it’s coming to Mesquite thanks to one doctor who says “I just want to treat my patients the way I’ve always wanted to.” Thanks to concierge medicine.
Dr. Mike Gorman, a local Family Practice doctor currently associated with Mesa View Medical Group, is changing the way he practices medicine by charging patients a flat monthly fee they will pay directly to him on a recurring basis. In return, they will have direct access to him for same day or next day office visits. Patients won’t pay any extra for an office visit and neither he nor the patients will file any insurance claims.
“By keeping insurance companies out of the picture, I can reduce the costs of patient care by 30 to 40 percent,” Gorman explained to the Mesquite Citizen Journal.
With the flat fee creating a steady stream of income for his practice, “I can reduce my patient load from its current 3,000 patients to about 400. Patient visits can be up to 30 minutes or longer rather than the 15 minutes now allotted for each patient. My time with each patient will be much more manageable.”
“And I can create an average income for a Family Practice doctor,” he remarked.
In his last year on the Mesa View Regional Hospital Board of Trustees, Gorman is currently serving as its Chairman. “Typically, we are appointed to a three year term and for me that expires this year. I will still have admitting privileges at the Hospital so that doesn’t change.”
Gorman also explained that he will change his medical practice from Mesa View Medical Group to the new business model in October.
“I’ve been practicing for 12 years. The challenge from more regulations and more paper work has been growing. There are increasing requirements for more prior authorizations from insurance companies and the government. The government requirements for electronic medical records is growing. There are a lot of physicians who are very unhappy with all of these things,” he explained.
“Health insurance premiums are continually going up. People are losing their insurance. While the payments I receive from insurance companies and the government are staying the same over the years or dropping, my costs are continually increasing.”
Gorman also explained a lot of what patients don’t see or don’t realize about payments from Medicare and Medicaid and from private insurance companies.
“Medicare pays fast but the rates they pay doctors aren’t all that great. Private insurance companies sometimes take four to six months to pay me for a patient visit. And, the rate they pay has been dropping to the levels of Medicare and Medicaid or even below those rates,” he said. “We’re already in a type of socialized medicine when you look at it that way.”
“So if doctors are getting paid less and it takes longer to receive the payments, the answer becomes ‘see more patients.’ I don’t want to practice medicine that way. I think more and more physicians are going to retire, quit, or do what I’m doing.”
He also said that the payment level people see on their insurance Explanation of Benefit (EOB) statement is not necessarily the amount of money he personally charged the insurance company.
“When I sign a contract with an insurance company, the contract specifies the amount of money I will receive for a particular patient visit. After I see a patient, I fill out the insurance form with a code for that visit. I don’t put a monetary amount on the form; just a code number. The insurance company then completes the EOB with whatever amount of money they decide to show for that visit.”
For instance, if he sees a patient for a urinary tract infection, he enters a code on the insurance form for a UTI. The insurance company sends the patient an EOB saying the office visit costs $165 but they are only paying the doctor $65. “That makes the insurance company look good and they can say they are holding down medical costs. But I knew when I signed the contract I would only receive $65 for that procedure. I might have to wait months to get that $65 and pay one or two people to chase down the money. The overhead costs of having people pursue insurance payments are non-reimbursable costs to me.”
With the new business model that is becoming more popular all across the nation, Gorman says much of that is removed. “Doctors and patients are putting a lot of trust in this model. We develop a much stronger relationship with our patients who see the value of paying doctors directly for care and keeping insurance companies out of the mix.”
READ THE FULL STORY for more information on Dr. Gorman’s practice, Direct Primary Care and Concierge Medicine.
Dr. Gorman’s Concierge Practice
Direct Primary Care of Mesquite
Bertha Howe Ave.
Mesquite, Nevada 89027