Direct-pay Palmetto Proactive expands to Drayton Mills

July 22--Squeezed by ever-rising health insurance premiums and cuts in services, the team at Spartanburg's Sodfather commercial landscaping company decided last year it was time to vote.

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 Kelly Reid said for her employees, the decision ultimately wasn't a hard one to make.

"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. Christopher McCarthy and Dr. Jerome Aya-Ay, the practice got off the ground in 2010. Since then, Palmetto Proactive has spawned several locations in the Upstate and Columbia, with another practice at Drayton Mills set to open its doors in just a couple weeks.

McCarthy said the company has long looked to open on the east side of town, and its Drayton Mills office -- housed in the space that was once the old mill's infirmary -- is the right step. It'll be the fourth Palmetto Proactive practice opened in the past eight years.

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 6 p.m., eat a little dinner and stay up doing paperwork past midnight. Then get up and do it all again the next day."

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 Charleston so our people there can take advantage of the same setup."

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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