House-Calls Are Forging A New Path to Reduced Health Care Costs


New services providing medical house calls are popping up across the nation. Some, like Heal in L.A., send a doctor to your house in under an hour. Others provide nurse practitioners in a video chat. The cost only runs about $100 per visit or call.

All of these in-home services are cashing in on an unmet need in the marketplace. Consumers with large deductibles want low-level medical attention on their terms. These new services are just the latest development in a market in turmoil.

Health care costs are spiraling out of control. Consumers with higher incomes pick up the bills. In an effort to bring down their costs, these consumers might just forge a path to help everyone by developing a new method of getting medical services at a reasonable price.

Since the Affordable Care Act was implemented, we’ve been bombarded with information about how health care costs have risen at the slowest pace in decades.

Somehow that tidbit of data didn’t make its way to my insurance carrier, who bumped my premium by 30% in each of the past two years.

Cobbling together information from around the nation, I don’t think I’m alone.

While the amounts vary, premiums appear to have moved substantially higher all over. The only way to keep premiums in check is by dropping to a lower level plan, moving from a PPO to an HMO, or taking on a bigger deductible.

No matter which path you chose, the outcome is the same. You either pay more to keep what you have, or pay less and accept lower coverage.

At some point, I just want to get out of the entire game! That’s what makes the new house-call services so intriguing.

Assuming no one in my household has chronic issues, I’d be able to drop to a very low-level plan – say from a Silver PPO to a Bronze HMO – and save about $500 per month, or $6,000 per year. While the change in service might be dramatic, the cost savings are too.

It’s unlikely that I’ll keep all of those savings, however. Chances are that our favorite family doctors are not on the HMO.

When investigating moving to an HMO last year, an insurance company representative actually said to me that their low-cost plan was a great deal, but it didn’t include many doctors. Imagine that.

If I want to keep the doctors my family and I like, I’d have to pay for those visits. I guess there are worse things. It’s something I’ve done in the past.

Typically doing that costs just a percentage of what the doctor bills insurance companies. Figuring six visits for the family to a doctor not on the plan at $200 apiece, that’s $1,200. Adding in another four non-emergency house-calls like those listed above at $100 each brings the total to $1,600.

That would still leave me $4,400 in savings over my current cost structure.

The only problem is that these house-call services aren’t yet available in my area. That leaves me substituting with urgent care for non-emergency situations. It’s still doable, but not as appealing.

The broader issue is that many people like me – needing individual family coverage, not eligible for subsidies, and relatively healthy – are paying very expensive insurance premiums.

It’s like buying home owner’s insurance for triple the replacement value. There’s no question you need insurance, but the coverage, and the cost, seem like overkill. There’s got to be a better way.

The one I’ve described could be the best approach for many of us. With it, we have the convenience of getting minor treatment, on our terms. We can see a favorite physician for a reasonable amount of cash. All the while, we’re covered for catastrophic care in case something horrible happens.

To top it off, we can change our plans every year. If someone develops a condition requiring more coverage, or appears to need more care in the future for whatever reason, we can change the structure accordingly.

By taking the payment for small doctor’s visits out of the insurance system, we could attack two problems at the same time. Not only will patients have more control over and knowledge about their true costs, but also doctors will be paid immediately for their services, removing the headache of insurance reimbursement.

If we can rank care by complexity and cost, perhaps we can focus resources where we need them most, and actually make some progress on containing costs.

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