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Avoiding the Emergency Room Bill

Imagine you wake up in the middle of the night with severe stomach pains. You think something is seriously wrong so you go to the Emergency Room.

3 hours later you find out it was constipation and go home with some severely overpriced laxatives. Now you are exhausted because you were in the ER until 4:00 am and 3 weeks later you get a big emergency room bill.

If you had access to your doctor 24/7, this all could have been avoided. Learn how a Primary Care membership model can get you and your employees this type of access in the video below.

Today's topic: What are the benefits of direct Primary Care last time we defined that direct Primary Care is a membership model of primary care like a gym membership. That membership buys you unlimited visits with your primary care physician with zero copay at time of service since this model is membership based these providers now have a known Revenue stream. The number of patients times the monthly membership fee. This means that they don't Bill insurance anymore, which cuts out a ton of administrative waste it also affords them to cut the number of patients that they see from a minimum of 2400 in a traditional model to a maximum of 600 patients in this model. This is where the magic happens because this drastic cut in the number of patients allows the premier direct Primary Care Providers to offer the following two hour initial appointments one hour follow up appointments same or next day availability unlimited number of visits in 24/7access to your physician because a direct primary care provider has all this extra time now, they can handle 80% of your health care needs, which is really what they were trained todo. This additional time reduces the need for specialist visits for Unnecessary emergency room visits virtually eliminates Urgent Care visits and provides navigation to the highest quality lowest cost providers. When you need to go outside the four walls of your primary care physician while this is all great for the patient the employers saves money in these scenarios and has more productive employees. It's how every patient should enter to Healthcare System.

About the Author

Mike Kroupa, Self-Funding Insurance Expert

I grew up in a house that was constantly under construction and the experience helped me uncover one of my passions, remodeling. After running a successful remodeling business with my brother during college, I decided I wanted to keep this as a hobby. Instead, I took my advisor’s recommendation and started down the actuarial path, which ultimately led me to insurance.
Since then, I have focused my career teaching employers how to better manage their health insurance plans. I found myself frustrated year after year of doing the same thing because it didn’t feel like I was making an impact. Healthcare costs were continuing to increase, and it felt like the only options employers were left with was increasing deductibles, increasing contributions, and switching carriers.

There was a turning point for me in 2020 as I found Health Rosetta, an ecosystem for scaling adoption of practical fixes to our health care system. As my clients started adopting these fixes, I found myself getting passionate about what I was doing for the first time. Then I realized my hobby of remodeling was driving the passion because I was remodeling health plans. Even better, I was having an impact because patients (employees, spouses and children) were getting the best care they ever have and saving a lot of money in the process.

Get in contact with Mike: 

Phone: 630.738.1835     Email: mkroupa@gocgo.com     LinkedIn: Mike Kroupa

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