Aging Options

Is a direct pay physician in your future?

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A Portland Maine family physician quit accepting all forms of health insurance in April of this year.  “Now I work for patients.  I don’t work for the government and I don’t work for insurance companies.  To be honest, if more people did this we’d see the price of healthcare go down, not up,” said Dr. Michael Ciampi in an article in the Bangor Daily News.

Ciampi joins a growing number of doctors that either have already or plan to switch to direct pay only practices.  Nearly seven percent of doctors say they are exploring changing to some form of direct pay care in the next three years and 50 percent plan to take steps to reduce patient access to their services, according to a survey by the Physicians Foundation.

For older adults, the result is often that they find it difficult to find a physician.  Yet according to this article direct pay doctors may help patients receive higher-quality care.  Many direct pay physicians such as Ciampi offer models of care that have previously disappeared such as house calls or other patient-centered care.

As of 2012, approximately 12,629 Washingtonians used direct pay physicians.  Washington state led the nation on direct pay practices (one article called Washington state a “hotbed” of direct pay physicians) thanks in part to a 2007 Washington state law which encouraged direct pay services as “a means of encouraging innovative arrangements between patients and providers and to help provide all citizens with a medical home.”

If you choose to go with a direct pay practice, understand what your rights are under the law and do some investigation on what will be covered by your physician.  Here’s the Washington State Office of the Insurance Commissioner website to help get you started with understanding how direct pay services work and your rights under Washington state law.

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