Direct-pay Palmetto Proactive expands to Drayton Mills
When it was all over, Sodfather employees had decided to dump their paid provider insurer in favor of service through a local direct-pay physician practice, Palmetto Proactive.
Sodfather General Manager
"I think the price was rising every single year, and they felt like they were receiving less and less coverage and having to fork out more and more out-of-pocket," Reid said. "For us, going the direct pay route has been a great decision."
Direct-pay practices like Palmetto Proactive removes insurance companies from the patient-provider equation. Instead, patients pay directly for services on a kind of a la carte basis -- similar to how you'd pick and choose menu items at a restaurant -- or by paying a monthly membership that spreads out the cost of care over the course of a year.
Founded by Dr.
McCarthy said the company has long looked to open on the east side of town, and its
After grueling years in medical school, residency and the emergency room, McCarthy said he came around to the idea of the direct-pay model after realizing he spent perhaps a third of his waking hours focused not on patients or his family, but on the paperwork, record keeping and billing tasks required by insurance companies.
"There were so many hoops and hassles," McCarthy said. "You see your patients during the day, come home after
He said he was disappointed with the way the fee-for-service model affected the way he practiced medicine. McCarthy said he had somewhere between 7-10 minutes to speak to and examine his patients before making a determination and sending them on their way.
Looking for a way out, he said he and Aya-Ay researched the direct-pay model and decided to make the jump and open their own practice.
"When we told the banks we weren't going to be working with any insurance companies, they laughed at us," McCarthy said.
The model's simplicity, though, appeals to both patients and the physicians treating them, McCarthy said. The monthly membership fee offers patients quick access to their primary provider and, coupled with a much cheaper, high deductible insurance policy, patients are covered in the event of a catastrophic medical emergency.
Reid said that's the route her team at Sodfather has gone.
"I wish we'd done it from day one," she said. "We keep hoping Proactive is going to expand into
Direct pay also reconnects consumers and physicians with the actual costs that come with treatment and medication. There's no middle man, and McCarthy and Reid said they believe consumers become smarter shoppers over the long term.
Generic blood pressure and diabetes medications can be picked up at steep discounts from store to store, for instance.
"The point is that it pays to be smart about this and shop around," McCarthy said. "But insurance means we don't think about cost as much as maybe we should."
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