More doctors offer patients flat-fee option

FORT MYERS, Fla. About three years ago, family physician Dr. H. Lee Adkins noticed an increase in missed appointments at his Fort Myers, Florida practice. When he talked to patients, he found out many had lost their insurance.

Dr. Adkins set up a self-pay, flat-fee option where patients can pay $75 a month. For that, patients get 15 visits a year and access to all services, including blood tests, EKGs and pap smears.

Adkins says 30 percent of his patients are on the self-pay system, and that it's helped his bottom line. According to Dr. Adkins, he's up 30 percent over last year.

While difficult to track exact numbers, an estimate by Kaiser Family Foundation and The Wall Street Journal reveals several hundred primary care physicians have begun to offer pre-paid plans for their patients.

Critics say some doctors who use flat-fee services are operating like insurance companies, without proper licensing. Dr. Adkins says he's just offering a service that benefits patients.

"If the doctors don't get active and do something, we'll have less qualified people making our decisions for us," said Dr. Adkins.

Mike Scott lost his insurance when he lost his job. A diabetic, he found an affordable doctor in Dr. Adkins.

"It offered an opportunity to recheck for my diabetes, to keep it in control, and that's what I wanted to be able to do," said Scott.

Like so many Americans, Kim Turano used to have insurance. When she lost it, her health took a back seat.

"What this program allows is for me to get the care that I had been ignoring in the past," Turano said.

Dr. Adkins says the flat-fee approach saves him money by eliminating administrative costs that come from dealing with insurance companies.

Patients who can't afford the monthly flat-fee instead can pay per visit or per service, Dr. Adkins says.

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