Unbiased Analysis of Today's Healthcare Issues

Seattle doctors try flat-rate no-limit primary care

Written By: Jason Shafrin - Jul• 08•09

Primary care doctors in Seattle are looking to eliminate insurers from the medical care process

Qliance customers pay $99 to join, then a flat monthly rate of $39 to $119, depending on age and level of service. Patients can quit without notice and no one is rejected for pre-existing conditions…Co-founder Norm Wu said per-patient revenue is triple that of insurance-based clinics. He said many costs are fixed so the firm, now losing money, will turn to profit as business grows.  More than 50 noninsurance clinics operate in 18 U.S. states, based on different business models, Wu noted.”

In essence, primary care doctors are providing taking on the risk of excessive patient illnesses.  However, since Qliance only treats patients in the primary care setting, its risk is minimized.  If a patient gets too sick or needs to be hospitalized, Qliance is not liable for these types of medical treatment.  Patient who participate in the Qliance plan need to buy catastrophic health insurance in order to cover hospitalization and speicalist care visits.  This health care model seems feasible for Qliance’s end since primary care visits much more predictable than hospitalizations. 

Will the primary care docs at Qliance simply refer all patients to specialists to save money?  They will certainly have this incentive is the clinic becomes busy, but that will be tempered by competitive pressure to provide quality service.  If quality drops, patients may return to a traditional insurance plan. 

The key assumption here is that patients are able to judge quality in the primary care setting (e.g., physician friendliness, wait times to see a doctor, time spent with a doctor), whereas they may not be able to judge hospital quality or specialist quality when they are severely il and have complicated diseases.

I doubt the membership model will revolutionize healthcare, but I am willing to bet that it will carve out a significant market share from patients who are willing to pay for better primary care.

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  1. James Lansberry says:

    within 6 months the Washington Department of Insurance will accuse these doctors of practicing unlicensed insurance, mark my words.

    I think it’s a great idea, and it won’t break the market open, but it’s *one* option that ought to be allowed and is a great thing for those who are “uninsurable” because the doctor can help them control a chronic disease for an affordable monthly cost, even without insurance.

  2. These are Healthcare boutique, massive popular here in the Bay Area. Couple this with an HSA, and a High deductible plan…golden.

    I hope James L. is wrong. Hope.

  3. Tom Leith says:

    I bet they’re OK in Washington State — it looks like the docs got the laws changed in 2009 to permit this without being regulated as insurers.

    Lookee here: RCW 48.150.010

    But specialists are left out:

    […] “Health care service contractor” does not include direct patient-provider primary care practices as defined in RCW 48.150.010.


  4. […] of lower quality care may opt to spend more money on more personalize health care (e.g., flat-rate no limit primary care doctors) which would decrease savings.  The net effect on savings is […]

  5. […] I like the idea of “concierge” medicine, even though there are many vocal opponents of the concept.  I reject their argument that it is necessarily something that will limit itself to the richest and best-off in society.  I present to you PartnerMD and Qliance.  Much more has been written on Qliance here, here, and here. […]

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