Patient privacy advocate Citizens' Council for Health Freedom (CCHF) has spoken out about the Centers for Medicare & Medicaid Services' (CMS) potential plan to wrap direct primary care contracting (DPC) clinics back into the government.
CMS took public comments through Friday about direct provider contracting between payers and primary care or multi-specialty group practices for "potential testing" within the Medicare fee-for-service (FFS) program, Medicare Advantage HMO program and Medicaid.
One of the main problems with this approach, said CCHF president and co-founder Twila Brase, is that mixing direct provider contracting (DPC) with direct primary care (also DPC) will be confusing to patients and may be seeking to strip true direct primary care practices of their independence, and the freedom and cost savings they and their patients enjoy.
"This request for information from the federal government on direct provider contracting looks like CMS is searching for a way to define it, asking how this model can be described for a wide variety of practices, and looking for a direct-pay arrangement between the practices and the federal government," Brase said. "Is this an attempt to commandeer and entice independent practices to come back into government control? Those who are in direct-pay practices are now free, but if they enter back into the proposed version of a capitated relationship with CMS, their freedom would be gone. This is the wrong direction. Rather than finding ways for CMS to contract with independent practices, CMS should come up with ways for patients to enter into direct-pay relationships with their doctors."
Brase added that independent practices can say no to the government relationship and intrusion, and so far, they have. For a long time, the acronym "DPC" has meant direct primary care, where practices charge patients a certain amount of money per month for a roster of services.
"These government DPCs, if that happens, wouldn't be independent anymore," Brase said. "They'd be under a government contract and all its costly and restrictive regulations and rules. This terminology will also confuse the public."
In the request for information, CMS asked several questions, including a query about what features should it require practices to demonstrate in order for them to be able to participate in a DPC model. Brase notes that examples include the use of certified electronic health record (EHR) technology, organizational structure requirements, safeguards, a minimum percent of revenue and a level of risk assumption, among other things. If these were adopted by an existing direct primary care (DPC) practice, especially a government-certified EHR, the freedom and independence from the government is lost.
"At a time when 48 percent of doctors are thinking of how they can leave the practice of medicine, and as 10,000 Baby Boomers are entering Medicare, the government should be encouraging true DPCs and other direct-pay-by-patient models," Brase said. "Doctors who are free will no doubt try to stay free. However, if the government bestows the title of DPC on non-DPC clinics, it will make it more difficult for real DPC practices to be found by patients who want these independent practices. These practices will also have to spend more money trying to differentiate themselves from government DPCs. This proposal is misguided and uninformed."
Brase will soon release a groundbreaking book exposing how electronic health records (EHRs) have negatively affected both doctors and patients. Available this summer and published by Beaver's Pond Press, "Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records" will show how Congress forced doctors to install a data-collecting surveillance system in the exam room. It includes hard facts from over 125 studies and reports about the impact of EHRs on privacy, patient care, costs and patient safety. Brase's extensive work also exposes how patient treatment decisions are controlled and tracked by the EHR; shares specific steps back to freedom, privacy and patient safety; and communicates why Americans must act now.
For more information about CCHF, visit www.cchfreedom.org, its Facebook page or its Twitter feed @CCHFreedom. Also view the media page for CCHF here. For more about CCHF's initiative The Wedge of Health Freedom, visit www.JointheWedge.com, The Wedge Facebook page or follow The Wedge on Twitter @wedgeoffreedom.