OK, makes sense. Honestly, this sounds like a great system. Do you think that specialization will ever fit into a "direct" method of healthcare?
There's an ortho near me who does a membership model with a few other orthos, but with a twist. The company these surgeons formed markets themselves to other companies, so now they have a panel consisting of all the employees at that company. They travel between a couple cities, so they have a private jet to get them to the employee's hospital quickly and begin surgery. There are similar models for corporate med in primary care.
I also wanted to point out that there are a few more pros to the direct care system that haven't been said yet, and unfortunately one major con:
Pros:
-imaging is typically reduced in cost due to negotiation between the primary doc and the imaging center/practice due to all the doc's patients being cash pay; no hassle for immediate payment
-many states allow docs to dispense medications (not 100% sure on the ins-and-outs of this), so the docs can give at cost medications, as well
-more time between the doc and the patient
Cons:
-due to the smaller panel sizes, the community as a whole suffers from the loss of a healthcare provider (it's like losing a part time equivalent doc)
I was about to add that those who lose the most here are those who have the most to lose, but that's not true in all situations. Those who couldn't afford healthcare insurance would have previously gone to the doc and been hit by a large bill afterward, or they may have just not gone to the doc. These people are harmed by this system in that they lose a clinic to go to when they need assistance (so they'll most likely just go to the E.R. at a larger cost).
Atlas' model could really help a family that is struggling to support themselves and pay a hefty health insurance premium at the same time. Basically, it's for those who were already paying for health insurance, but now they can buy the cheaper-by-the-month high deductible plan and save a lot per year, with some or all of those savings now going to the membership. In return, they get greatly increased services.
The guy who first did this was a former professional sports team doc in the Northwest who decided he would charge $25,000 annually for an entire family and then he accepted several dozen families into his model. He has since said that if his model were to really gain a great deal of traction, there would be public backlash and legislation aimed at forcing doctors to take more patients. That's the balance: a sweet deal for a select few and their doctor on the one hand, a good deal for many working families in the middle, and a crappy deal for the doc forced to take Medicare/aid on the other end if the whole thing gets too big.
The most recent data I read about this movement was a survey from, if I recall correctly, a physician recruiting company that stated roughly 9% of family docs were considering this model, with a smaller proportion actually putting it into practice. In the current and upcoming (Clinton) political climate, if that number reaches 15% or so, there's going to be a lot of discussion about legislative restrictions.
I haven't looked at larger corporate models like MedLion, but there are some other interesting ideas out there to be investigated.
