An interesting article and concept from the Milwaukee Journal Sentinel
Milwaukee Journal Sentinel
January 16, 2012
Thomas Willett, country doctor, is still tilting at medical windmills. Willett is now in the second year of an experiment to bring affordable healthcare to Green Lake, WI, by wringing out back-office costs and passing on the savings to patients.
"The concept is just so simple," Willett said this week during a follow-up visit from the Journal Sentinel. In November 2010, the newspaper wrote about Willett's attempt to take a "scalpel to insurance" as he set up the Access Affordable Healthcare clinic to provide "quality medical care for less."
In a pamphlet that contains a fee schedule for services, it says, "No bills, insurance forms or hassle. Simply pay at the time of service."
Willett's prices remain remarkably low, from $39 for an office visit up to $500 for a vasectomy. The avuncular, 69-year-old doctor has now fully transitioned from running his long-established family practice to operating the clinic.
What Willett figured is this: Overhead at his practice was eating up 62% of revenue, largely because of costs associated with insurance for things such as dictation, coding, electronic claims submission and reimbursement.
By charging patients up front, Willett surmised he could slash most of the back-office costs and lower prices by up to two-thirds. Willett said he has accomplished that first goal. But he has another goal: to show others they can make it financially under his system.
"I need to get to a certain patient load to prove to the doctors that their income level won't change," he said. "Most don't understand they work for the hospital or someone else. If I charge $125 (for a basic visit under insurance), I still only get $39."
To make it work financially, he said, a doctor would need to see up to 25 patients daily. Right now, in his clinic, Willett sees 10 to 12 patients daily.
Helping hand
Willett runs the clinic with the help of Holly Thorp, the longtime manager of his old family practice. Thorp is a dynamo who keeps the books, negotiates prices with labs and schedules patients. She also wrote up an advertisement that played on a local radio station to draw more people to the clinic.
"Watch us go," Thorp said. "I think the practice will go big guns." Added Willett: "We want to notify all the area businesses, all the human resource departments, let them know how much they can save."
Green Lake County recently contracted with Willett to provide service for its employees. Willett sees the patients and is reimbursed by the insurance provider, WCA Group Health Trust. Co-pays and deductibles are waived for the employees, and Willett bills the insurance company directly, eliminating much of the normal paperwork. Around 10 to 15 county workers have used Willett's services.
Willett is also making his case to politicians. This week, he met with U.S. Rep. Tom Petri (R-Wis.) to detail the cost savings of the program. He also made a pitch for using Green Lake County to develop a pilot Medicaid program for the state.
Under Willett's program, those enrolled in BadgerCare would receive a debit card with a predetermined amount of money that could be used at Access Healthcare and with other participating physicians in the county. He estimates Green Lake County could save $550,000 on office visits alone because of the lower rates charged.
Such a program would need a waiver from the federal government. "Unfortunately, it's a slow process to get any kind of change," said state Sen. Luther Olsen (R-Ripon), who added he would like to see the pilot program in Green Lake County.
"I thought it was an interesting idea. One of the concerns, of course, is the record-keeping. A lot of money and time and manpower go with all the records that need to be kept. His system does not have the middleman or the record-keeping. The question is: Can the healthcare industry survive without all the documentation?"
Keeping them happy
Willett's patients appear to be quite satisfied to go to his clinic. Andrew Stobb, 19, who was delivered by Willett, stopped by for a quick physical in anticipation of signing up with the U.S. Army. Instead of fooling with co-pays, he simply paid $39. "The way he does his job is still the same," Stobb said. "As a taxpayer, I think they should just do it this way all the time."
Green Lake County Clerk Margaret Bostelmann's family was in Willett's practice for decades. They continue to see him at the clinic. "With Tom's thinking, it goes back to the way he started his business of being able to work with a patient and concentrate on a patient," she said.
Bostelmann said she would be delighted if Willett could put his BadgerCare idea into practice in the county. "We're small. We have 20,000 people. I guess if you would do a pilot program and the state could review the bills to see what is happening to these folks, you could see how it would work."
Meanwhile, Willett remains on the job, working hard, trying to heal patients and make the medical system work better for all. As he made his pitch to Petri, Willett paused, smiled and said, "It's a good time in my life. The good Lord has been good to me."
