Last time, we met Dr. Kathy Raver, founder of Well Life ABQ. Well Life is a Direct Health Care Provider. That means that they work directly with people to keep them healthy, rather than only coming in when people are sick. They also tend to avoid the involvement of insurance companies whenever possible. That saves them time and money because they don’t need to have people on staff whose only job is to deal with the insurance companies and their ponderous levels of paperwork. Now, it’s time to get into their business model.
Typically, most health practitioners work with insurance companies that are tied to an individual’s employer. The individual goes in with a problem, the doctor diagnoses the issue and sends the bill to the insurance company who pays a portion (usually most of it), which is taken out of money provided by the company which is either a separate expense or a premium taken out of the individual’s paycheck. Sounds cumbersome?
Historical fun fact, that cumbersome model is the direct result of government intervention. Salaries were capped by federal law following WWII and in order to compete, employers started offering health care benefits instead of better wages. Even after the wage law was rescinded, the employer based health care remained and developed into the present mess.
Fortunately, Dr. Raver has adopted a vastly simpler subscription model for Well Life. For $75 a month, members get unlimited visits and no copay, plus a few other benefits. How is that possible? For one, most people don’t go every month. All of that money goes into the bank to be applied to people who do come in. Second, as previously stated, with minimal involvement from insurance companies a ton of money is saved just in not having to do all the paperwork that entails. It’s amazing what you can do without middle men in the way.
What if an employer wants to provide benefits for its employees with this model? It’s easy, they just sign up for $75 times the number of employees per month. Their employees wind up with better healthcare and the companies save money in the long run because Well Life isn’t taking on a bunch of unnecessary expenses (no $50 aspirin here) and passing the costs onto an insurance company. Not to mention the fact that preventative care keeps people out of the hospital a lot more than the reactive model.
So, why don’t more employers sign up for this way of doing things? If it saves money and has better results why isn’t everyone adopting the direct provider model? Because inertia is real. Most people, in most times, tend to be content to do whatever they are already doing, or what others have done before. Getting people to change directions to try something different, something uncertain is always difficult. A business is no different. When a business looks at the direct care model, they see an unknown, a risk, and if there is one thing the modern business hates, especially the big ones, it is risk.
That doesn’t mean that some aren’t trying out this different model and having good results. The problem is that they are few and far between, scattered across the country, working with different providers. As more sign on, whether it be with Well Life or some other practitioner, more will follow. Success breeds success and slowly but surely, the massive ship that is employer based health care can be turned in a new direction, one away from the status quo and towards something better.
What can you do to help make that a reality? Sign up with TARTLE and be willing to share data related to your experiences with health care. Naturally, a business likes to do some research before making a major decision like switching how they provide healthcare to their employees. You can be part of that. By providing clear and accurate data, you can help them make better choices that will benefit everyone.
What’s your data worth? Sign up and join the TARTLE Marketplace with this link here.
