atlanta primary care physicians :: Article CreatorAtlanta Doctor Nixes Insurance, Offers $100 A Month Unlimited Primary Care
Georgia doctor nixes insurance for flat-rate fee
Highland Urgent Care and Family Medicine's Dr. Nick Beaulieu he would no longer accept insurance, but instead would offer unlimited office visits for $100 per month. The pros and cons of deal.
ATLANTA - Last fall, Highland Urgent Care and Family Medicine's Dr. Nick Beaulieu announced to his patients as of December 1, 2022, his Atlanta practice would no longer accept private insurance.
Instead, he told them, he was switching to a fee-based system: unlimited care for $100 a month.
"You need to call me, call," Dr. Beaulieu says he told his patients. "You want to text, text. You need to come in, I'll see you as many times as you need to come in."
They call this direct primary care.
For $100 a month, or $1,200 a year, Highland's patients can come in as often as they would like.
"You need to come in 12 times, no problem," Dr. Beaulieu explains. "There's no co-pay to try to limit you coming in. There's no co-insurance to make it sting because you wanted to see your doctor. There's no deductible to be met."
Beaulieu is part of Pear'd, a network of six metro Atlanta primary care clinics, all of them connected to urgent care clinics, that have switched to the direct care or fee-based model.
Under the current system, primary care providers typically reimbursed on a fee-for-service model, based on the number of patients they treat, and the number of procedures they perform.
"The entire model is based upon treating disease because that's where the money is," Beaulieu says. "We've got to see between 25 and 30 patients in an 8-hour period, in order to make the quotas that are imposed upon us by employers like hospitals," Beaulieu says.
By getting rid of the insurance middlemen, he says, he no longer has to see up to 30 patients a day.
"I get to see 10," Beaulieu says. "Most time, when I see you, I'm going to have half an hour, 45 minutes, an hour to see you."
Dr. Harry Heiman, is a clinical professor at Georgia State University's School of Public Health, who practiced family medicine for 20 years in Marietta, Georgia.
Heiman says many primary care providers are struggling.
"I think doctors are under tremendous pressure," Dr. Heiman says. "And it's time pressure, it's economic pressures."
Much of the pressure, Heiman says, comes from the problematic way primary care doctors are reimbursed.
"We have a fee-for-service system that it is inherently toxic and aligns incentives around dollars and not around patients," Dr. Heiman says.
The reimbursement system, he says, leaves primary care physicians with little time to spend with their patients.
"The more patients you see, the more revenue you can generate," Heiman explains. "So, there's choice there. And, the other thing driving volume is we have a profound shortage of primary care providers."
So, Heiman says, he understands why some primary care doctors are moving towards concierge or direct care medicine.
Still, the trend troubles him.
"The reality is, in doing that, they're pricing out those people that need primary care the most," he says. "They're pricing out low and middle income people. They can't afford that additional $1,200 a year. And, I think that's very problematic."
Even with unlimited primary care, both doctors point out patients will still need a catastrophic health insurance plan to cover a major medical emergency or serious illness, like cancer.
The direct care model also does not include specialty care beyond primary care.
If you need labs, Beaulieu says, they have negotiated lower fees with specific providers.
However, Dr Beaulieu says the direct care model takes the insurance "middlemen" out of the picture and buys him time to focus on keeping his patients healthy.
"When you see in 30 patients a day for seven minutes, you don't know your patients and you really can't help," Dr. Beaulieu says. "We want to produce something between two people who have equal investment in the process."
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New Grady Health Center Offers Primary And Specialty Care For ...
Grady Health System held a ribbon-cutting Tuesday for its second outpatient center south of I-20, continuing its efforts to keep up with increasing demand for health care services in the area, particularly since Atlanta Medical Center closed nearly two years ago.
The newest health care center is a 16,000-square-foot building in the Lee + White mixed-use development in Atlanta's West End. The center will offer primary and specialty care, including geriatric, orthopedic, HIV, mammography and behavioral health. It will also have an on-site pharmacy, X-ray equipment and a lab.
Grady now has eight neighborhood centers in metro Atlanta, including this newest addition and a similar outpatient clinic that opened on Cascade Road last year.
The new centers will help meet the health care needs of the community closer to their homes and fill the "health desert in central and south Fulton" left when Wellstar's Atlanta Medical Center closed in 2022, according to Fulton County Chairman Robb Pitts. "This is a lifeline" for people in the area, he said, and the center will be close to MARTA and the Atlanta Beltline, making it an accessible and affordable choice.
Grady Memorial Hospital and other Atlanta facilities have reported rising patient volumes since the closure of AMC hospitals. Grady is regularly deemed "dangerously overcrowded" in one state dashboard that monitors emergency department activity.
ExploreGrady to open emergency room in South Fulton County
Grady Memorial Hospital in downtown Atlanta provides emergency and indigent care for patients in Fulton and DeKalb counties. Its burden grew when Wellstar closed its two Atlanta Medical Center locations — in downtown and East Point — which served many uninsured and underinsured patients in south Fulton County.
The community hasn't fully recovered from the loss of the health services provided by the AMC hospitals, Pitts said, but the new clinics are another step toward satisfying the health care needs of the area. He added that the new clinic is on par with others offered by area hospitals.
The need to handle additional patients sped up Grady's expansion strategy, though plans for the new health centers were in motion even before the two AMC closures.
Grady began developing plans to increase health care access for residents along the Beltline nine years ago. However Grady didn't have the funding in place until 2022, around the same time as the downtown AMC location closed, according to Shannon Sale, Grady Health System's chief strategy officer.
ExploreGrady Hospital, counties seal deal on new clinics and subsidies
"In two years, we have gotten two clinics," Sale said.
She said it took about 1½ years to develop each of the new buildings. The Cascade center had previously been a Wellstar clinic. The Lee + White business center was developed from a renovated industrial warehouse.
Grady was able to expand the neighborhood clinics in underserved areas of south Fulton County through a Georgia Department of Community Health-directed payment program, Georgia's Advancing Innovation to Deliver Equity, which uses federal and state funding.
The health system estimated that each of the clinics will provide up to 30,000 primary care visits annually and cost $5 million to $8 million to operate each year.
Fulton County last year agreed to provide Grady with $43.3 million in 2024 to be used to open the two new primary care clinics. In coming years, the county's funding will shift based on use of Grady services by Fulton's residents; and funding will increase according to the federal Consumer Price Index for medical care, which averages 3% annually.
The agreement runs for six years, with the option of two two-year renewals for a total of 10 years.
The new contract hinges on whether Medicaid expands coverage to households earning below 138% of the federal poverty line. If Medicaid expansion passes, the county would no longer subsidize Grady.
Throughout the pandemic, the requirement to annually renew enrollment in Medicaid was waived in exchange for additional federal funding, but that has ended.
Grady is Atlanta's only Level 1 trauma center, serving Fulton and DeKalb counties, and will treat patients, including those who are uninsured, underinsured and indigent. Level 1 trauma centers are capable of handling the most serious injuries.
Health system officials said Tuesday they knew the Wellstar closures would increase their volume of Level 1 trauma cases and said they saw a 35% increase in the first year.
An analysis by the AJC showed that when AMC-South closed, the population no longer 15 minutes away from an emergency room were mostly Black with below-average income.
A joint study by Fulton County, Morehouse School of Medicine and consultants Ernst & Young found that southern Fulton had no specialists in cardiology, pulmonology or infectious diseases. The area also didn't have any doctors that care for patients with heart disease, respiratory diseases or HIV and AIDS. All those conditions were prevalent in the area's 234,000 residents.
In addition to the latest outpatient clinics, Grady expects to open a freestanding emergency department in Union City in 2026.
Grady's Lee + White Center will officially open Monday and will continue to serve patients Monday through Friday, 7:30 a.M. To 5 p.M. For more information about Grady's neighborhood health centers, visit gradyhealth.Org/locations/.
1 Year After Atlanta Medical Center's Closure: Where Things Stand
A moratorium restricting new development at AMC's former site is currently in place, and Atlanta Mayor Andre Dickens has indicated he will renew the development ban for another six months, which prevents Wellstar from selling or redeveloping the land.
Meanwhile, Grady — the only level 1 trauma center in the city of Atlanta — continues to see an influx of patients who would normally have gone to AMC. Mercy Care, an outpatient clinic that serves homeless patients, has also seen a jump in patient visits over the past year, according to the report. The Atlanta Journal-Constitution's report also touched on a perhaps less discussed consequence of AMC's closure: Hundreds of physicians who worked at practices near the hospital have either moved, retired or have shut down their practices.
"In one swoop, you eliminated a large percentage of primary care doctors in an area that was already suffering," Tawian Livingston, MD, an internal medicine physician at a practice in Southwest Atlanta that referred patients to AMC, told the news outlet.
By the end of October, Grady plans to start using 182 newly added beds — an expansion made possible after the system received a one-time allocation of $130 million from Georgia's federal pandemic funds. Mercy Care has also been able to hire new clinical leaders. Still, it may take years for other area hospitals and clinics to have the staffing and infrastructure in place to consistently manage a higher patient load.
When Marietta, Ga.-based Wellstar said it was ending operations at the downtown Atlanta Medical Center last August, health system officials pointed to significant operating losses and said they had approached numerous stakeholders in search of partnerships to keep the hospital open. The system has faced criticism for pursuing a merger with Augusta (Ga.) University Health eight weeks after AMC's closure.
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