@brittanytrang @STAT

4. #maine is one of many states that still have Certificate of Need laws that had the goal of reducing oversupply/use of services but now protect hospital networks (mostly regional monopolies) from lower priced competitors.
It's not rare for me to send patients out of state for cheaper studies, procedures, etc. The price savings are often big enough to make the trips worthwhile for them. The shorter wait for consults are a bonus.

#costsofcare

https://www.pressherald.com/2021/04/07/board-wont-recommend-central-maine-healthcares-proposed-topsham-surgical-center/

@brittanytrang @STAT

2. A large proportion, if not most, of medical care is routine, non-urgent and potentially 'shoppable' but we prepay for it with the same mechanisms we use for ER visits and big inpatient stays causing great harm. It's like using auto insurance for oil changes or homeowner's to have the plumber fix the toilet.

Yes, I'm biased as a #directprimarycare doc but this realization was a big part of why I left #insurance paid practice eight years ago.
#dpc
#costsofcare

@ProPublica
Another reason I'm glad we left the insurance racket eight years ago.
#healthinsurance
#MedMastodon
#costsofcare
#dpc
#directprimarycare

@pluralistic
Thrilled to see you mention #healthcare in your newest article on monopolies.
#MedMastodon
#costsofcare
#healthcarereform

'And I would put my babies to bed, and they'd say, "How many charts do you have left tonight, mommy?"'

#PBS with a story about #directprimarycare ( #DPC ):
https://www.pbs.org/newshour/show/innovative-clinic-helps-doctors-avoid-burnout-and-makes-healthcare-more-affordable
#MedMastodon
#costsofcare
#familymedicine

https://www.nytimes.com/2023/06/15/magazine/doctors-moral-crises.html

'...Until the system changes, some doctors are finding ways to opt out. I spoke to several physicians who have started direct-care practices, in which patients pay a modest monthly fee to see doctors who can offer them more personalized out-of-network care, without having to answer to administrators or insurers..."

#familymedicine #directprimarycare
#MedMastodon
#costsofcare

@bicmay @rvaughnmd In our experience, low income patients find us less expensive than local hospital ($160 or $300 for the two most common visit types) plus we get them labs and generic meds for 20% over wholesale (labs are 3-5x more at the hospital).

We encourage #medicaid or a subsidized ACA plan which works well for care beyond #DPC but 20% are still uninsured. Both of those work well with DPC (paid out of pocket).

#directprimarycare
#costsofcare
#healtheconomics

1/2

@STAT #flu
The local branch of #maine 's big hospital network won't run flu tests locally. "Rapid" test results come back the next day so we added point of care flu testing this week to reduce antibiotic use for pneumonias that might be due to flu.

Since the tests only cost us $10, we don't charge for them. We try not to nickle and dime our patients.

#costsofcare
#familymedicine
#directprimarycare
#dpc

@rvaughnmd @SolNataMD
No, we don't work for free but we only charge $35-$80/month so we get a nice socioeconomic mix of patients.

We also donate memberships to a free clinic to help the local safety net.

The alternative here is working for the local hospital monopoly with obscenely high prices and horrible access.

#costsofcare
#DPC
#directprimarycare
#familymedicine
#primarycare

I've been explaining to patients for years that they don't need annual lipids. Nice to have it confirmed again in this episode of my favorite podcast.

We even have some third party administrators (TPAs) that here require them of insured patients.

These are only about $20 at our office but the big hospital network here in #Maine charges over $100 for a lipid panel test. That comes out of pocket for many patients.

#medmastadon
#foamed
#costsofcare

https://therapeuticseducation.org/episode-528-proving-you-dont-need-to-repeat-cholesterol-measurements/

Treatment sequencing: cumulative costs are lower when starting with time-limited venetoclax + obintuzumab in first-line CLL (compared to starting with oral continuous therapy), in both TP53 WT & mut disease. Important implications for health systems. #ASH22 #lymsm #costsofcare

Elated to see an oral session dedicated to financial toxicity and costs of care at @ASH_hematology@twitter.com #ASH22! Kudos to Dr. @UDurani@twitter.com moderating. I'll tweet out the abstracts. #costsofcare