10,000 Pound Gorilla Sees No Value In DPC or Cash Pay Claim Strategies

Trustees give up free babies & other weird things…………..

The Brownsville Independent School District, the largest employer south of San Antonio with more than 10,000 member lives eligible for coverage under the district’s health plan, voted last night to change the logo on their health insurance program as a cost savings measure.

Approval was made to change from one managed care network to another managed care network, neither of which have a proven track record of reducing health care costs. The failure of 40 years of managed care is evident to anyone with half a brain including Mike the Headless Chicken.

Trustees failed to approve proposals incorporating cost saving strategies proven to produce better benefits for plan members while reducing costs to both members and taxpayers. Capitated direct Primary Care would have reduced plan spend, provide better and easier access to care while waiving all patient financial responsibility for primary care services and upstream care referred by direct primary care providers.

Plan financed immediate cash pay claim settlement at the point of service for all upstream care referred by direct primary care providers would have allowed plan members to enjoy free health care including specialty doctor office visits, lab and radiology services, in-patient and out-patient hospital care, and free babies (Yes, all financial barriers to having a baby would have been eliminated).

An independent actuary study indicates Brownsville trustees walked away from a $4,000,000 to $10,000,000 annual savings by failure to adopt these proven strategies. Instead trustees voted to gift taxpayer monies through managed care contracts they can’t see nor audit, believing in magic and hoping for the best.

“You can lead a horse to water but you can’t make them……….”


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