Why more health care providers are eschewing insurance

Panel of locals discusses innovating outside of payer system, appealing to cash patients

In efforts to cut costs and offer more flexibility, employers are shifting away from offering traditional health insurance. For the same reasons, a number of doctors are shifting away from taking it.

That was the message Wednesday at a health care reform seminar hosted by Bernard Health, which featured four nontraditional providers who are building their businesses by limiting or eliminating their interactions with commercial insurers.

The four described their disillusionment with traditional practice models, detailing the "rat race" of serving an ever-increasing number of patients to cover their overhead costs. By stripping down and simplifying, they said, they're able to practice medicine in a more patient-centric way.

"I just saw the writing on the wall that health care was going to become like running in and out to get an oil change, and that's not how I wanted to practice," said Dr. Melissa Langley, a Green Hills dermatologist.

Langley and her fellow Middle Tennessee panelists, nurse practitioner Clarissa Crunk, physician assistant Robert Tomsett and Dr. Ashley Woods, said their practices survive financially by cutting overhead and administrative costs. Those reductions, combined with the freedom to develop innovative payment models directly with patients, creates value for cash-pay consumers who may be uninsured or covered under a high-deductible plan or health savings account.

Forgoing insurance reimbursement in favor or accessible payment models can mean a short-term profit drop, but "it's an investment in the lifetime of the practice and your relationship with the patient," said Crunk, who does accept some traditional insurance but maintains a fixed patient load of 12 per day.

The challenge, however, is attracting patients without insurance companies, which traditionally funnel patients to providers in their network. Though the heath care system continues to become more consumer-focused, many patients are still unaware or uncomfortable accessing care outside of the traditional channels.

But if insurance costs continue to rise, many stakeholders expect patients to become increasingly cost-aware and seek out nontraditional, but high-value, health care providers.

"Health savings accounts are a good movement toward more cost accountability," Tomsett said.