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Health Insurance & Healthcare:

A Direct Primary Care Perspective

Most Americans often mistake health insur- companies have less expensive claims to deal with
MEDICAL DIVISION ance for health care. Studies show that most such as ER visits and possible hospitalizations
health care consumers lack the basic under- which ultimately drives down cost and increase
standing of how health insurance works. the quality of care of the beneficiaries in the insur-
Navigating the terms and coverage explana- ance plans. DPC also encourages policymakers to
tions can be very confusing. In addition to not allow health insurers to continue to design poli-
What is Financial Planning
Wha t is Financial Plaanning
understanding how traditional health plans cies that support consumers who seek to enroll in
to Coastal W ealth?
work, and its nomenclatures such as premiums, a DPC program.
Helping you achieve
deductibles, and co-pays; consumers are over-
your goals whelmed with the many choices in the market, DPC's Impact on Hospitals:
with accoun tability! which leads them to make poor decisions. Hospitals would see cost savings as well since
This confusion among consumers is especial- studies have already shown a decrease in the inap-
ly significant as we introduce a new delivery propriate use of emergency rooms and urgent care
model into our nation's healthcare debate. BY DR. SIDNEY COUPET, facilities by uninsured patients. Chronic disease
Direct Primary Care (DPC), is on the list of DO, MPH, MSC management has also improved where there are
health innovations that lead to high-value pri- decreased sentinel events and improper utilization
mary care for consumers around the country. During our of emergency rooms such as readmissions to the hospitals with-
nation's ongoing debate on health care, it will be increasingly in 90 days.
more important for us to make the clear distinction to our con- Hospital systems would have the opportunity to identify
sumers and healthcare professionals that DPC agreements services for their uninsured and underinsured populations.
between healthcare professionals and their patients are mistak- Hospitals would have a place to care for their numerous high-
en for as insurance. The importance is evident with the passing risk underinsured individuals who would have access to a
of the new state legislation (SB 80 and HB 37) on March 2018 provider that would deliver necessary and timely services upon
that specifies that DPC agreements are not insurance. The State discharge.
of Florida has now joined 23 other States in this movement.
The DPC Health Policy Value Proposition:
What Is DPC? The Affordable Care Act has already demonstrated that
(954) 625-1515 DPC is a delivery model that allows patients to manage their increasing insurance coverage to people led to an increase in
WWW . CASEYSJOHNSON C . OM primary and preventative healthcare services outside the tradi- accessing health care which resulted in an improvement of a
tional health insurance model. DPC enables patients to pay an wide range of health outcomes.

affordable membership fee to their primary care professional Although multiple studies have shown the health benefits of
i si (usually on a monthly basis) that allows them complete and merely having insurance coverage, we also know that quality
d
ci al p gr d direct access to their doctor. They can call, text and video chat care does not stop there. There is an opportunity to evaluate the
r a
their doctor at any time while having unlimited office visits impact of DPC coverage +Insurance coverage in our state as a
n o M
f a a dc with no co-pay. Patients can spend significantly more time with way to reduce our cost and increase the quality of the primary
r r r esenntaaattaatn t t t ecuc
ecu
rvivvi vici ice d t u e o their doctor (30-60minutes) that allows them to get their ques- care services provided. It is our responsibility as healthcare pro-
M . S
tions answered while their primary care providers have the time fessionals to make a clear distinction between health care and
to manage their complex conditions. Patients also have access health insurance as they are not synonymous but most impor-
to low-cost lab and radiology tests as well as wholesale pricing tantly to identify permanently that DPC is health care with
on generic medications. Subsequently, this allows patients who multiple benefits. As we work together to achieve High-Value
A Special Thank are enrolled in a DPC practice to have increased satisfaction care in our community, there will be an increasing need for this
distinction as well as innovations such as DPC.
while saving more money in their pockets, specifically those
consumers with a high deductible plan.
You to the March DPC in Our Community:
DPC's Impact on Insurance: DPC coverage + Insurance coverage is a way to increase high-
2018 Host of the DPC coverage is intended to work with insurance coverage value care according to Dr. Sidney Coupet the Founder and CEO
while driving down cost and increasing the quality of care. DPC of SPARK Health Inc., and Coupet Quality Clinic. With offices in
South Florida does not cover catastrophic incidences such as a heart attack or North Lauderdale and Plantation, he is driving cost down further
and supporting local Hospitals in care coordination for high-risk
cancer. DPC coverage allows patients to get services without
using their deductibles on their insurance coverage. Patients populations as well as the uninsured and underinsured patients.
Healthcare save money by using their DPC program. They benefit directly
from the unlimited access to their providers without co-pay, the For more information, call (786) 207-4788 or visit
Networking Group low-cost tests, and the wholesale priced medications. Insurance www.coupetqualityclinic.com.

Time for a Paradigm Shift

in the Classification of Muscle Injuries
VITAS
Current grading systems for muscle injuries
COMMUNITY LIFE may not provide clinicians with enough informa- describe or determine the prognosis of a specific
injury.” Injury classification helps to describe an
& INPATIENT tion to guide athletes on when they can return to injury while a grade indicates the severity of an
their respective sports with minimal risk of re- injury. Most athletes and coaches are concerned
CENTER injury. That’s the finding of an article co-authored with the severity of an injury as it relates to the
by Thomas M. Best, M.D., Ph.D., Research length of time it may take to return to full sports
Director at the University of Miami Sports participation. The use of radiology can quickly
For information about Medicine Institute, and published in the Journal correlate clinical findings with imaging charac-
our next meeting of of Sports and Health Science in 2017. teristics that help establish early categorical radi-
The purpose of this study was to discuss the ological grading systems.
SFHNG, fact that current grading systems for muscle While most sports medicine physicians rely on
injuries provide clinicians with little information MRI to guide athletes when projecting time loss
please email
on which to guide the athlete regarding project- from a sport, this study argues that a new classi-
charles@ ed time loss and return to sport. . The authors Dr. Thomas M. Best fication system of muscle injuries need to be
southfloridahospitalnews.com found that each of the new classification and developed in order to better inform athletes of
grading systems have strengths, but there remains little una- their prognosis, as well as help physicians accurately diagnose,
nimity on a system that is both comprehensive and evidence- manage, and prognosticate.
based. “While the ability to predict return to play is an expectation
“Muscle injuries remain one of the most common injuries in placed upon practitioners working with athletes, there is still
sports,” said Best, who is also a professor of orthopaedics at the incomplete evidence upon which to base decisions,” said Best.
University of Miami Miller School of Medicine. “Yet despite Dr. Best is part of an international consortium leading this
THE REGION’S MONTHLY NEWSPAPER FOR HEALTHCARE PROFESSIONALS & PHYSICIANS
this, there is little consensus on how to either effectively effort.
16 April 2018 southfloridahospitalnews.com South Florida Hospital News