Payment reform is a hot topic of discussion with in health reform circles, but CNN Money
reports that some physicians are taking the matter into their own hands, too. "Like a lot of their patients, doctors are sick of long waits in the waiting room and dealing with insurance companies. That's why a growing number of primary care physicians are adopting a direct fee-for-service or 'retainer-based' model of care that minimizes acceptance of insurance. Except for lab tests and other special services, your insurance plan is no good with them. In a retainer practice, doctors charge patients an annual fee ranging from $1,500 to as high as over $10,000 for round-the-clock access to physicians, sometimes including house calls. Other services included in the membership are annual physicals, preventive care programs and hospital visits. Doctors argue that this model cuts down their patient load, allows them to spend more time per patient and help save the system money. However, some industry groups caution that these emerging trends are a consequence of a health care system badly in need of reform" (Kavilanz, 8/17).