March Newsletter

Ok, so it’s a little late, but special thanks to all of you for your patience while I had a spring break with the kids.  We found some warm desert sun in Utah and had a great time!

The Egg Myth

Eggs contain cholesterol, and therefore eating eggs should be bad for your cholesterol, and your health, right?  That was thought to be the case until more recently.  It turns out that eating a moderate amount of dietary cholesterol does not, in fact, raise your risk of heart attack and stroke.  The real “bad foods” for raising cholesterol are sugars, trans fats, and excessive saturated fat.  Eggs contain about 75 calories each, with 7 grams of protein, and contain lutein and carotenoids.  I usually advise my patients to consider eggs as a healthy choice when combined with fruits and/or vegetables for breakfast. Make sure to cook your eggs reasonably well, and farm-fresh eggs are a great way to support local farmers and avoid the hormones and antibiotics associated with commercially produced eggs.  I also recommend avoiding egg substitutes like cartons of “egg whites.”  In an effort to eat healthier, this carton version can actually be worse, often made with a long list of processed ingredients.  Choose the eggs in their natural form, and if you are concerned about the effects on your cholesterol, feel free to talk to me about checking some blood tests.  In summary, eggs with fruit/vegetables in the morning is way better for you than that boxed breakfast cereal, or bagel with cream cheese.  

Mid Rogue Imaging Provides Discounted Pricing

Did you know that we are very fortunate to have an independent imaging center right here in Grants Pass?  Mid Rogue Imaging provides patients the option of discounted pricing for all imaging tests, if you choose to not use insurance.  CT, MRI, ultrasound and plain x-rays all are offered for a discount if you pay at the time of service.  We are happy to get you a price on these tests as needed – our patients really appreciate the transparency.  You will know ahead of time what the cost is, and no surprise bills later.  Often this is a huge savings if you have a high deductible health plan, or are uninsured.

One Year of Direct Primary Care!!

It has been a whole year since GPFM transitioned to Direct Primary Care, and we are so pleased to have all of you with us.  The practice now has a waiting list, and we are taking new patients on a very limited basis.  By filling out a form on our website we can collect names, emails and phone numbers of patients who are interested in joining, and will likely be in touch with them within a few months.  If you have friends or family who are interested, it is not too late to do so, but we are definitely filling up.  It has been amazing to see the practice change and grow with our new “family” of members, and we truly appreciate you all!

Recipe of the Month

Breakfast Frittata

Preheat broiler to 400 degrees

1/2 yellow onion, chopped

2 yams, sliced or chopped into small chunks

2 handfuls baby spinach leaves

4-6 eggs, beaten

In a well-oiled pan suitable for the oven (cast iron or stainless steel handle), saute the onion and yams on medium heat for 15 minutes or until soft.  Cover the pan to steam the yams slightly.  Add the baby spinach leaves and stir, only until wilted.  Salt and pepper to taste.  Reduce heat to low and pour eggs into the pan, do not stir.  Cook until the edges of the eggs are done.  Place the pan under the broiler and cook for 5-7 minutes, watching closely.  When the top is slightly browned and the eggs look cooked, remove from broiler (watch out for the hot handle!)  Cut into wedges and serve with optional topping of your choice (scallions, spoonful of sour cream, or salsa).

We would love to hear from you!

Have a suggestion, some feedback, or a concern?  Shoot us an email at [email protected]  Our goal is to keep you engaged, educated, and healthy.  – Dr. Donna Givens

 

February Newsletter

Thinking of Spring…

Though we are still in the throes of Winter, I wanted to update you on some news from the practice and upcoming projects with our first monthly newsletter.  Thank you to all of you that answered the survey I sent by email, it helps with discovering what is important to our patients.  Future projects will likely include videos and groups – hang tight for more info on those soon!


     Medication dispensing…  and now available by mail!

Many of you are already seeing the huge savings with our generic medication program at the office.   Did you know that we can now mail you your medications automatically every 90 days?  For a $3-4 charge per shipment, we can provide you with automatic refills by mail for the medications you usually get from our office.  This is ideal for someone who takes medication every day for chronic conditions.  Please email us at [email protected] if you would like to start receiving your medications by mail.  Charges for these will automatically be applied to your next month’s invoice.


     Now is the time to enjoy citrus fruits

Citrus includes grapefruits, oranges, lemons, limes, and tangelos among others.  Vitamin C is what most people know already that is found in high levels in citrus.  Did you know vitamin C is an antioxidant?  Antioxidants are compounds that help to avoid cellular damage in the body.  Vitamin C may also prevent heart disease by helping to reduce plaque formation.  Vitamin C is used to build connective tissue in the body such as collagen, and is used to repair and heal tissue.  It also helps you absorb iron-containing foods in your diet.  The key is to get vitamin C from real foods.  Supplements are rarely needed as most people can enjoy the beautiful fruit itself and do not need to buy pills for this purpose.  


     Get your vitamin D somehow

We have seen an unusual amount of sunshine the last few weeks, but most people still do not spend a lot of time outdoors in the winter.  Taking a vitamin D3 supplement during winter months can help keep your levels from dropping too low.  Usually 1,000 IU daily is enough for most people, but if it is already too low, you may need more.  Vitamin D helps prevent some chronic diseases and increases your absorption of calcium, keeping your bones strong.  It can also be found in wild fish, some mushrooms, and egg yolks.  


     Recipe of the Month – Mango, lemon, ginger, turmeric smoothie

2 cups frozen mango chunks
1 cup frozen pineapple chunks
2 small bananas or 1 large
Juice of 1 lemon
1 inch chopped or grated fresh ginger
Generous sprinkle turmeric
Dash of nutmeg
1 can coconut milk (not from a carton)
Water to desired thickness

Makes 3-4 servings


     We would love to hear from you!

Have a suggestion, some feedback, or a concern?  Shoot us an email at [email protected]  Our goal is to keep you engaged, educated, and healthy.  I hope you enjoyed our first newsletter!  – Dr. Donna Givens

Direct Primary Care makes healthcare costs more simple and affordable

If your health insurance premiums are going up, or are just unaffordable, here are some ideas to help. 

This post is for non-Medicare eligible patients.  If you are a Medicare recipient, click here to read more about how DPC can help you https://grantspassfamilymedicine.com/direct-primary-care-can-help-medicare-patients/

The benefits of membership at our practice are huge!  Your flat monthly fee includes all visits with Dr. Donna Givens, who is Board Certified in Family Medicine.  She sees patients of all ages and stages of life.  Chronic disease management, physicals, urgent visits are all included.  Skin procedures like mole removals, freezing of skin lesions, and laceration repair would cost hundreds or over a thousand dollars at a traditional practice, but at our office they are included for your monthly fee, except for the pathology fees.   Lab tests are 90% off typical prices and wholesale medications are stocked in the office to pass on the savings to our patients.

Membership at our practice gets you affordable medical care at a predictable low monthly cost

Please click here   https://grantspassfamilymedicine.com/services/  to learn more about the benefits of joining Grants Pass Family Medicine and having a Direct Primary Care doctor who has the time to spend with you.  Visits are typically 30-60 minutes and not rushed.  Dr. Givens is available by phone, text and email.

Since Direct Primary Care includes all visits with your family doctor, it might be time to look at your health insurance needs a little differently.  Here are some options that our patients have paired with their DPC membership to make their overall costs more reasonable:

Health Sharing Ministries:  These are organizations that collect monthly payments (like a premium) and members “share” medical costs.  Generally much less per month than insurance, these plans can help individuals and families keep their insurance costs down without compromising coverage.  They can be selective, however, on who can join, so this option is best for those with very few or no medical problems.  Liberty Healthshare (https://www.libertyhealthshare.org) is one that is popular with our patients.  Liberty will even reimburse you part of your monthly charge at a DPC practice like ours.

Minimum Essential Coverage:  Though less common, these are becoming more of a viable option for those who want the most minimum coverage.  Check out Sedera Health as one option at https://myahe.org/hep

High deductible health plans:  These are your typical Obamacare marketplace plans such as the “bronze” option.  Generally the higher the deductible, the lower the premium.  Many of our patients have these plans.  Since your primary care physician can take care of 80-90% of your healthcare needs, this type of plan pairs very well with your DPC membership at our practice.

Switching to Direct Primary Care has helped many people save on their medical care, prescription prices and lab costs.

We are happy to answer any further questions you have about your individual situation, just give us a call!

541-476-3000

How Direct Primary Care Can Help Medicare Patients

Medicare, and its associated parts A, B, D and F can be confusing to anyone trying to sort out their options.  Direct Primary Care (DPC) offered at our practice is simple – care provided by your family physician.  It is not an insurance plan, and not meant to take the place of insurance.  Since I am not an insurance agent, this is not advice on which plan to choose.  But here are some examples of how our current members are utilizing membership at Grants Pass Family Medicine with their Medicare plan.

The Benefits of Direct Primary Care

“Why do I need to pay a monthly fee for a doctor when I already have coverage?”  Here is the answer to that question, and how your DPC membership at Grants Pass Family Medicine can get you the most value for your dollar.

Access to your doctor.  What does this mean to you?  Usually, this means calling your doctor’s office, requesting an appointment and being told that the next available appointment is weeks away.  Need a same day appointment for an urgent problem?  This is not usually available.  Have a list of issues to discuss?  It is all too common to be told that there is “only time today for one problem.”  Things are different here at Grants Pass Family Medicine.  Dr. Givens keeps her schedule open for direct access, either the same day or next day if you have an urgent problem.  New patient visits are scheduled for one hour, within 1-2 weeks of signing up.  Follow-up visits are 30 minutes or more, to allow for plenty of time to address all of your concerns.  Have a simple question?  Send an email, and Dr. Givens will answer you within the same business day, usually within an hour.  Texting?  No problem.  We do that all day.  Not everything here at GPFM requires an appointment, we communicate with our members freely and directly.

See the same doctor every time you visit.  Yes, you heard correctly.  Dr. Givens will get to know each patient individually.  Like the old-fashioned family doctor used to do.  You won’t get the run around with a different provider every time you visit.  

House Calls.  For those that are home bound, or recovering from a surgery or hospital stay, Dr. Givens makes home visits and visits to assisted living and nursing facilities.  All visits are included in your monthly membership.

No Hidden Fees.  Our prices are transparent.  One flat monthly fee for all the services provided within our office.  This includes skin procedures such as freezing of lesions, removal of skin cancer lesions, and other procedures like EKG’s and spirometry.  By signing up for a membership, an estimated 80-90% of all of your health needs can be addressed within our office, making your monthly budget for healthcare more predictable.  

Discounted generic drugs and lab tests.  Some patients have been paying for a Part D plan that “covers” their generic medications.  Truthfully, many times the cash price for those medications is MUCH LESS than the cost of the premium for the Part D plan.  We would be happy to give you an estimated cost for purchasing your medications directly through our office’s wholesale medication program.  For patients who require brand name medications, or use a lot of insulins or inhalers, keeping the Part D plan may make more sense.  Feel free to call us to discuss your individual situation.  We have in some cases been able to save patients more than their monthly membership fee.  Labs drawn in our office are charged at wholesale cost to patients, or billed through your insurance, whichever you prefer.  For example, a metabolic panel and cholesterol panel currently costs $9.99.  This may be less than the bill you receive for your portion AFTER insurance pays.

How Do Medicare Plans Complement Your DPC Membership?

Which Medicare plan would pair best with a DPC membership at Grants Pass Family Medicine?  Here’s the breakdown.

Medicare Part B  This is your “standard Medicare” benefit for outpatient services, and usually covers 80%.  Most of our Medicare patients at our practice have this as their coverage for outpatient services.  Why?  Because as mentioned above, with your membership, you get 80-90% of all of the services you will likely need included.  As many visits to Dr. Givens as you need are included.  Your Medicare Part B would only be used for tests done outside our office, or for specialist visits.  If you see a lot of specialists, and usually have a lot of tests, this may not be right for you, and you may want to purchase a different plan such as Part F or an Advantage Plan.  Talk to your insurance agent to discuss what may be best for your individual situation. Click here to learn more about what Part B covers: https://www.medicare.gov/what-medicare-covers/part-b/what-medicare-part-b-covers.html  Hospitalizations are covered under a different part of Medicare, called Part A, after you meet your annual deductible of $1,316.  Click here to learn more about what Part A covers: https://www.medicare.gov/coverage/hospital-care-inpatient.html

Medigap or Part F Supplement  This is used to cover the “gap” of what Part B covers (80%) for outpatient services.  So for every $100 billed from a doctor, Part B covers $80 and your supplement should cover the other $20.  This type of plan also helps if you see a lot of specialists.  Our current members vary on whether or not they utilize Part F plans.  Talk to your insurance agent if you think you would need a Part F supplemental plan.  Click here to learn more about Part F: https://www.medicare.gov/supplement-other-insurance/compare-medigap/compare-medigap.html

Medicare Advantage Plans  These plans are usually more comprehensive, and would take the place of Part A, B, D and F.  They usually have a preferred “network” that you must seek care within and seeing a specialist or having a test would need to be done within the network.  These plans can be either and HMO type or PPO type.  If you have an HMO type of Advantage plan, you are designated a “participating primary care provider” who then would need to do a referral for any testing or specialist visits you need.  This DOES NOT work well with a DPC membership, as Dr. Givens is not participating in any networks.  However, many of our Medicare members DO HAVE a PPO type of Advantage plan, and this works well for them.  Talk to your insurance agent about your options.  Click here to learn more about Medicare Advantage Plans:  https://www.medicare.gov/sign-up-change-plans/medicare-health-plans/medicare-advantage-plans/medicare-advantage-plans.html

Medicare Part D  This is prescription drug coverage.  As stated above, if you take generic medications, we may be able to save you significant amounts on prescription drugs.  We stock generic medications in the office, offering these as a benefit to members at wholesale cost + 10%.  For example, a patient may be paying $34 per month for a Part D plan (national average).  Our office could fill these medications for less than $10 per month in some cases.  Feel free to ask us about your individual situation to see how much savings you may find.  Some of our patients have been able to save more than their $85 per month membership fee.

In summary, having a primary care physician who is available to you, responsive to your needs, and communicates with you and your family is essential as aging brings on more complex health care needs and conditions.  Unfortunately, under the current Medicare billing system, it is difficult for the average primary care physician to find the time to truly get to know their aging patients, instead spending time on paperwork and filling out forms on computers.  This is not the case when you have a Direct Primary Care physician like Dr. Givens, since most of her time is devoted to patient care and not satisfying the Medicare billing requirements.  Our patients love the care they receive here, and we hope you will take the time to learn more by clicking here:  https://grantspassfamilymedicine.com/services/

by Donna Givens, MD

Kareo and AAPP Survey

IRVINE, Calif., Feb. 22, 2017 /PRNewswire/ — As statistics continue to show that a majority of physicians remain in small practices and that the “exodus” of doctors to hospital employment has not met earlier predictions1, a new survey by Kareo, the leading provider of clinical and business management software to independent medical practices, reveals some key trends among independent practices that impact patient care. The survey, conducted in partnership with the American Association of Private Physicians (AAPP), found significantly, that a full third of respondents to the survey said they were considering the addition of a new payment method, such as concierge medicine, direct primary care, or another membership model, within the next three years. This has a significant effect on the way patients consume and pay for healthcare, as well as on the time physicians spend with patients, their available services, and their satisfaction level. Click HERE to download the concierge medicine and direct primary care survey report and infographic.

The study is based upon responses from 766 clinicians (described as MD, DO, PA, or NP), practice managers, and practice owners surveyed during the second half of 2016. Of these, 26% were in practices described as private (concierge medicine membership) versus 74% in conventional (fee-for-service) practices, and responses between the groups were compared.

“The majority of Americans continue to receive their care from independent medical practices due to the superior combination of patient focus, healthcare outcomes, and lower costs. Emerging practice models such as direct pay and concierge medicine represent exciting new ways to preserve and enhance the independent practice model,” said Rob Pickell, Chief Strategy Officer of Kareo. “These newer models also address patient and physician demand for more proactive care, care coordination, and wellness programs. For these reasons, these new practice models should be of interest to both healthcare professionals and patients.”

The study asked respondents their primary motivations for adding or converting to a direct primary care or other membership model for payment rather than a conventional fee-for-service practice model. Nearly 70 percent of physicians reported they wanted to spend more time with patients, making it the top response. The next two largest choices were improving work/life balance (41%) and separating from the insurance payer system (40%). This motivation seems to be born out in fact since the survey found that 75 percent of physicians in conventional fee-for-service practices spend 30 minutes or less with each patient, and nearly 60 percent have a patient panel of over 1,000. On the other hand, nearly all physicians employing concierge medicine membership or direct primary care payment models have a patient panel of less than 1,000, and 79 percent spend an average of 30 to 60 minutes or more on each patient visit.

Dr. Jeff Unger, MD, ABFM, FACE, has shifted his practice model and has realized these benefits. “Prior to transitioning to concierge medicine I was seeing 40 patients a day and unable to get home before 9:00pm each evening. Now, two years into this ‘experiment’ I have never been happier,” said Dr. Unger. “Our patients are thrilled with the care they receive and I look forward to creating health each day I head to the office. I am now seeing 10 to 12 patients each day, which allows me to intensively manage chronic diseases such as diabetes, hypertension, mental illness, and even substance abuse.”

Conventional fee-for-service physicians also work, on average, about six hours more per week than concierge medicine or direct-pay physicians. In addition, conventional physicians spend nearly 12 hours on administrative work, while providers in concierge medicine practices spend 10 hours on administrative tasks.

Of those respondents using some variation of a concierge medicine membership model, 65 percent said the cost for membership was under $2,000 per year. Thirty-two percent of respondents have less than 25 percent of their patients in membership, while almost an equal number of respondents (30%) have all their patients in membership, with the balance somewhere in between. Fifty-seven percent participate in Medicare, 54 percent participate in health plans in network, and 58 percent are out-of-network with health plans. This shows a flexibility that works for both patients and doctors.

At the same time, no specific model appears to be a panacea since 35 percent of conventional practices said their biggest challenge is remaining financially viable, while 38 percent of the direct primary care private practices call recruiting new patients their single biggest hurdle.

Creating a concierge medicine membership or other private pay model seems to encourage innovation in patient care. Twenty-three percent of private practice respondents currently use telemedicine versus only 8 percent of conventional practices. Forty-two percent of private practice respondents plan to grow and expand the use of telemedicine, and 4 percent will switch entirely to telemedicine.

Click HERE to download the concierge medicine and direct primary care survey report and infographic.

To view the original version on PR Newswire, visit here.

Yahoo! Finance Article

PDF of Survey Findings

DPC: An Innovative Alternative

The care we are offering is like nothing being offered in this market today. Buying extensive insurance coverage will not get you the type of services in this new model of care. 24/7 access, home visits, hospital visits, deeply discounted medicines and labs, no co-pay, and pre-existing conditions welcome. Coverage does not equal care! Direct Primary Care has been proven to keep people out of the hospital and to keep people more healthy than fee for service medicine. ..."patients experienced 56 percent fewer non-elective admissions, 49 percent fewer avoidable admissions, and 63 percent fewer non-avoidable admissions than patients of traditional practices." From Daniel McCorry of the Heritage Foundation.

Please take a moment to read the whole article here:

Direct Primary Care: An Innovative Alternative to Conventional Health Insurance