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  #46  
Old 02-26-2015, 10:14 PM
NYGUY NYGUY is offline
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Ha! A link? Are you kidding? They are not going public with this if they can help it....I went to a recent lecture and asked the question, and there will be many more lectures to come
Could you please provide the date, place, and lecturer's name and affiliation that told you who pays The Villages Health physicians?
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  #47  
Old 02-27-2015, 09:57 AM
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We are so pleased with Villages Health. Not really into nitty gritty of payment methods. All I know is I am cared for well and promptly. Would never want to go back to old way of long waits in waiting room (often with sick people). So pleased with the docs. And should you not care for a particular doctor just change to another--not a problem!
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  #48  
Old 02-27-2015, 02:23 PM
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Originally Posted by Carla B View Post
Well, I think it makes sense. Someone has to pay the salaries and to me the insurance company would seem to be the most logical party. If not UHC, who else would pay the salaries?
Up until now, most people thought the developer was the most logical party.
  #49  
Old 02-27-2015, 03:09 PM
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A hospital or large private practice would typically employ physicians. If UHC does employ certain physicians that would be an unusual relationship.
It would be unusual because I think it hasn't been done since Humana Gold Plus (HMO) tried it many years ago. I can't give exact dates but I believe it was around the mid to late 80s when I first became aware of it.

I was operating a small business at the time and I kept hearing about it from my customers. They kept saying how great it was so I got my mother interested and she joined.

I'm sure it doesn't work the same today as it did then because, hopefully, they have learned from past mistakes. Back then the doctors were all employed (under contract) by the HMO. The doctors were given a certain amount of money to take care of each patient. The money was supposed to be more than enough to cover all treatment expenses and whatever money was left over the doctor would keep for himself or herself. So less treatment expense would mean a bigger salary, and, conversely, more treatment expense would mean a smaller salary.

Well, it worked fine a long as my mother was in good health. When she started having symptoms, they would say it was just part of the aging process. Failing memory, lack of balance and incontinence etc. was all part of normal aging according to them (at about 81). After about a year they started saying it was congestive heart failure. I asked if she could see a heart specialist and was told it wouldn't be necessary.

We tried changing to another doctor within the same clinic and it only got worse. The new doctor was wise to what was going on and wouldn't even say hello to my mother when she entered the exam room. She knew she would be acquiring a liability that some other doctor no longer wanted.

So I got her back into regular Medicare and took her to a heart specialist. And after the doctor examined her, he said, "she definitely doesn't have congestive heart failure." It took another year before we got an accurate diagnosis for her symptoms. She had fluid pressure on the brain which required a neurologist.
  #50  
Old 02-27-2015, 03:49 PM
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So, if you have no clue & and you were told no amount, why did you post this ? Just askin' .
Maybe you were not around for previous discussions but up until now everyone thought it was the developer who paid the "generous salaries". And, of course, any thinking person could only wonder what his motivation might be for doing so. Why would the developer pay generous salaries?

Well, it was thought that he was doing so because he was simply a generous man who cared about Villagers.

Of course he was generous and of course he cared about villagers but he was also a good business man, and paying all those generous salaries made no economic sense.

Besides, it didn't fit what usually would happen when he was generous. When he donated land for the library and fire stations he got plenty of recognition for it. There was never any recognition for paying "generous salaries".

So now we have another piece of this new healthcare puzzle.

Think about these questions: Medicare money is our money, so why shouldn't we be able to know how the money is being used? Is it working for us, or against us? It might be difficult to decide if we don't know what's going on. If someone doesn't get good results at a clinic, is it because they just happened to get a "bad" doctor or is it the system that's bad? Don't we deserve to know how our money is being used?
  #51  
Old 02-27-2015, 04:05 PM
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Could you please provide the date, place, and lecturer's name and affiliation that told you who pays The Villages Health physicians?
The person who answered my question might not have been authorized to divulge the information, therefore, I don't want to take the chance of puting that person's job at risk.

The person I speak of is affiliated with USF Health. And USF Health has an office in The Villages. That's why I suggested you call that office.
  #52  
Old 02-27-2015, 04:12 PM
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I have seen my primary care doctor a number of times, another doctor once, the radiation tech, a physician's assistant, and several CMA's. All my treatment has been high quality, and I don't give a hoot who signs their paychecks.
  #53  
Old 02-27-2015, 04:26 PM
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The person who answered my question might not have been authorized to divulge the information, therefore, I don't want to take the chance of puting that person's job at risk....
Too Funny!!!
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  #54  
Old 02-27-2015, 04:35 PM
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Too Funny!!!
It's funny how people will put me under pressure for answers but won't dare put anyone else under pressure. You should call them, they won't bite.

  #55  
Old 02-27-2015, 06:07 PM
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I have seen my primary care doctor a number of times, another doctor once, the radiation tech, a physician's assistant, and several CMA's. All my treatment has been high quality, and I don't give a hoot who signs their paychecks.
Exactly the way I feel.
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  #56  
Old 02-27-2015, 09:40 PM
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I suspect that if you have an HMO plan, the center receives a flat monthly fee from the HMO for functioning as PCP. For non-HMO patients, the center receives a fee from the insurance and/or Medicare for each visit. Pretty standard arrangement. Nothing interesting here folks.
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Old 02-27-2015, 09:52 PM
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I suspect that if you have an HMO plan, the center receives a flat monthly fee from the HMO for functioning as PCP. For non-HMO patients, the center receives a fee from the insurance and/or Medicare for each visit. Pretty standard arrangement. Nothing interesting here folks.

Your supposition is quite accurate. For HMO patients the docs typically receive a set amount per patient per month (pppm). PPO patients are paid to the docs on a reduced fee basis, and most others on an insured negotiated basis.
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  #58  
Old 02-28-2015, 03:31 PM
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Your supposition is quite accurate. For HMO patients the docs typically receive a set amount per patient per month (pppm). PPO patients are paid to the docs on a reduced fee basis, and most others on an insured negotiated basis.
The Villages Clinics are NOT typical. It was said over and over that this is a NEW (revolutionary) system of healthcare that would eventually be the model for the rest of the country to follow. There's nothing typical about it according to those who have been promoting it. So we can only imagine what the financial arrangement is between the doctors and the HMO. But we do know that the doctor's salary has been called "generous", whatever that is.
  #59  
Old 02-28-2015, 03:54 PM
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There is nothing revolutionary about TV Clinics. It is a model used by ACOs, hospital systems and specialty physician groups seeking to increase their referral base. For example, a hospital might employ geographically dispersed groups of PCPs to assist in capturing patients for an ACO. St. Vincent's in JAX has employed PCPs in several counties for this purpose.

Carolinas Health System has many located throughout NC to capture patients for its numerous hospitals and specialists. The physician who established TV Clinic system had pretty much done the same thing in PA where he was CEO of the Lehigh Health System.

There are numerous ways physicians can be paid, there are numerous ways to form a model and involve insurance companies.

Little twists and turns create interesting nuances that can be applauded but not regarded as revolutionary.
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  #60  
Old 03-02-2015, 03:18 PM
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Here's the way it was presented to be revolutionary:

1) They (the developer and others) said PCPs have usually been paid for volume. In the case of volume they needed about 2,500+ patients and would have to rush each office visit. It was quantity but not quality, said the developer. In this new (Village Clinics) system each PCP would have no more than 1,250 patients. There would be no waiting, the doctor might spend as much as a half hour with you and you could even drop in without an appointment if you felt the need.

2) So this question followed: How will PCPs make enough money with less than half the patients they would normally have? And the answer to that, given by the developer: They will be paid "generous salaries" so they won't have to rush. Quality will be rewarded rather than quantity.

3) The promotion of "electronic record sharing" between PCPs and specialists was a big part of why federal grant money was given in the first place. Eventually, one's medical records could be shared with any doctor in the U.S., not just locally.

You can look at it from the point of view of certain typical aspects if you like, but it definitely wasn't promoted as typical. The three points above were given as distinguishing features that would make it like nothing ever tried before. Although, they said it would be reminiscent of the TV character, Marcus Welby, M.D. who knew all of his patients well and spent lots of time chatting with them.

Was it all just a slick marketing campaign, in your opinion?

Last edited by Villages PL; 03-03-2015 at 04:23 PM.
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