Doctors tout direct primary care

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Doctors tout direct primary care

‘It facilitates things for the doctor and the patient’
ABOVE: Dr. Kirsten Searfus of Mountain View Family HealthCare talks with patient Mike Andersen during an office visit. Searfus says the direct primary care model allows her to spend more time with patients during their office visits. BELOW: Searfus
Dr. Kirsten Searfus of Mountain View Family HealthCare talks with Mike Andersen during an office visit. “The reason I like direct primary care practice is I don’t deal with insurance billing. It facilitates things for the doctor and the patient,” Searfus said.
More alternative health plans likely coming to marketYoung, healthy workers may decline insurance

Cheaper policies that offer limited coverage are expected to proliferate with the penalty for not holding health insurance now set at $0. But costs for ACA-compliant policies offered to employees through their employers are likely to rise.
For people who are young and healthy, the changes could open more affordable health insurance options. For older workers and those with pre-existing conditions, who typically are denied coverage on alternative plans, the likely consequence will be increasing health insurance costs.
Ken Bates, owner of Durango Insurance Professionals, said he expects younger, healthier people in the workforce to migrate away from more expensive ACA plans as they gain access to cheaper, but less-generous noncompliant ACA-policies.
In addition, with the penalty for not holding ACA-compliant policies set at $0, dropping health insurance altogether becomes more attractive to the young and the healthy, he said.
“I think you are going to see more people going to alternative plans or choosing to go without,” he said.
Those making that decision, he said, are likely to be young and healthy workers, who can meet requirements of slimmed down alternative health plans, which typically do not accept people with pre-existing conditions.
“Typically, young and healthy people are who insurance companies want to offset older, less healthy people in the pool,” Bates said.
The likely result, he said, will be employers who are forced to increase deductibles and the employees’ share of monthly health insurance premiums to keep up with increasing costs of having an older and less healthy pool of people.
At least for the enrollment period for 2019, elimination of the penalty for not having ACA-compliant health insurance didn’t dissuade Coloradans from signing up for individual plans through the state health exchange, Connect for Health Colorado.
According to Connect for Health Colorado statistics, 169,672 residents signed up for individual ACA plans on the health exchange for 2019, a 2 percent increase compared with the 165,777 residents who signed up in 2018. In La Plata County, 3,123 people signed up for plans with Connect for Health Colorado in 2019, almost a 7 percent increase from 2018.
The increase comes despite increased costs for ACA plans through the exchange. A study conducted by the Kaiser Family Foundation reports the cost of the monthly premium for the lowest-cost silver plan through Connect for Health Colorado for a single 40-year-old in La Plata County increased from $132 in 2018 to $185 in 2019, a 39 percent increase.
Joe Hanel, communications director with the Colorado Health Institute, a nonpartisan, independent think tank with a mission to provide independent data analysis and research to decision-makers about health policy, said it is hard to get data about the number of people who are dropping their health insurance offered through their employer.
The attraction of an employer paying half to two-thirds of monthly health insurance premiums is a powerful motivator to not drop health coverage at work, Hanel said.
However, if rates continue to rise, he said, a combination of pairing a low-cost catastrophic policy with an affordable direct-primary care policy to care for routine needs will likely grow more popular.
One limitation, Hanel said, is the dearth of physicians offering direct primary care, which provides primary care for adults based on a monthly fee generally ranging from $50 to $100, with additional smaller fees to add children.
A study in June 2018 by Colorado Health Institute showed only 63,000 patients, about 1 percent of the state, were covered by a direct primary care physician, Hanel said.
Merida Odiorne with USHealth Advisors, said alternative plans will become increasingly popular with people who earn too much money to be eligible for an ACA-subsidized plan.
The plans, which offer less coverage than ACA plans, will be cheaper, but they often disqualify people with pre-existing conditions.
For most people, she said, it still makes sense to check with Connect for Health Colorado for plans, because most people will find they are eligible for subsidies offered through ACA.
She noted a family of four can earn up to $100,400 and still be eligible for a subsidy for an ACA plan.
parmijo@durangoherald.comThis story has been update to list Merida Odiorne’s correct affiliation with USHealth Advisors and to note US Health Advisors does not sell short-term plans.

Doctors tout direct primary care

ABOVE: Dr. Kirsten Searfus of Mountain View Family HealthCare talks with patient Mike Andersen during an office visit. Searfus says the direct primary care model allows her to spend more time with patients during their office visits. BELOW: Searfus
Dr. Kirsten Searfus of Mountain View Family HealthCare talks with Mike Andersen during an office visit. “The reason I like direct primary care practice is I don’t deal with insurance billing. It facilitates things for the doctor and the patient,” Searfus said.
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