Revamping the Backbone of The Healthcare System

Primary care is the backbone of healthcare, and the healthcare system, as a whole, can only function as well as the backbone enables it to. Unfortunately, the backbone of the US healthcare system is broken. Primary care doctors are not the ones to blame, though.

A reimbursement model based on quality of care is the obvious solution to the problem, but waiting for the big players to shift the model won’t likely happen anytime soon.

The HealthCare System

The healthcare system has evolved over the years as a natural product of the fee-for-service reimbursement model. Every year, primary care doctors are being reimbursed less and less for their time, and are, thus, being forced to shorten their appointments just to stay afloat. These shortened appointments do not lend enough time for the doctors to address semi-complex issues. Therefore, they’re encouraged to refer their patients to specialists for problems that they are more than capable of addressing themselves.

This issue of time is compounded by the increasing demands on doctors, in terms of documentation and complex billing. The end result is increasing costs, worsened healthcare outcomes, and professionally unfulfilled physicians. It has deteriorated to the point where primary care doctors aren’t even able to sell their practice.

A reimbursement model based on quality of care is the obvious solution to the problem, but waiting for the big players to shift the model won’t likely happen anytime soon. Hail the heroes of the renaissance of primary care like CareMore, ChenMed, Iora Health, MedLion and many others! By using a gym-based subscription model these innovative players are charging patients a monthly fee that allows patients to get coverage of primary care needs without paying co-pays.

In a few short years, this model has shown reduced costs, happier patients, and better overall health outcomes. However, the challenge with this model is that it reduces the patient-to-doctor ratio. There’s already a shortage of physicians, particularly primary care doctors, which has been exacerbated in the post-Obamacare age. Some of these practices alleviate this problem by using mid-level providers and health coaches.

If you’re looking to improve your telehealth offering, this on-demand webinar shares some best practices.

Direct Primary Care

If the success of direct primary care continues, it will need to be scalable. This is where technology comes into play; it can fill the gap! At Luma Health, our first product was created to address the mismatch between patient appointment vacancies and the greater demand that clinics are facing. Helping patients get appointments with their doctors sooner was our first priority, as we are firm believers in the patient-doctor relationship, which has proven to have the best health outcomes over all other solutions.

Our latest focus has been to help clinics bridge the gap between appointments and increasing patient engagement with their own health. Providing appropriate patient reminders and educational resources can have very important (and lasting) effects on lifestyle modification.

Being able to provide resources and Facetime capabilities to patients is vital, although it’s not sufficient. We are very excited to be able to help bridge this gap and develop an assortment of tools that will help physicians improve their overall quality of care. These tools will position physicians for success as the healthcare system slowly makes the transition from the current fee-for-service model to a fee-for-performance based model.


Tashfeen Ekram, MD, is a radiologist, self-taught coder, healthcare innovator and Co-Founder of Luma Health. Contact him on Twitter at @TashfeenEkramMD.

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