The Patient’s Guide to MACRA—and a Healthcare Revolution

MACRA changes how medical care is paid for.



Instead of being paid for delivering a unit of service, the professionals who care for you will be paid by your insurer based on the data they submit.



Data, not care.



What you pay for is what you get.



Insurers want data, they’re going to get data.



The patient wants care; they’re going to get data.



And that mismatch is going cause a lot of angst.



A whole lot.



It’s why the doctor tends the data terminal instead of you.



That’s why his company pays for a data-entry technician (aka a “scribe”)—your privacy and comfort notwithstanding.



And since MACRA takes “data-based payment” for healthcare to a whole other level, all this mismatch of expectations is going to get a whole lot worse.



But fortunately, you can change everything—all by yourself.



By changing the story about how you pay for healthcare.



We get through life by telling ourselves stories. They help us make sense of the world.  When the stories do a poor job of predicting actions and outcomes, we feel the stress.



Like when you come to the office expecting medical care and end up on the giving end of a data submission session.



Chances are the story you’re telling yourself about your healthcare goes something like this:



  • “I pay money to my health insurance company. That gets me the chance to get healthcare.”
  • “I pay some extra of my money—copays and deductibles— when I actually get the healthcare I need.”


The end.



It’s time to tell yourself an exciting, new story:



  • “I pay money to the health insurance company to help me pay for a very expensive illness, like cancer.”
  • “I pay my money when I want my personal healthcare.”


That’s all it takes.



Pay your health insurance like your homeowners insurance—send it in and hope you never need it.



Then pay for your personal healthcare like you do when your screen door needs fixing.   You don’t make an insurance claim, you go down to Home Depot and pay the best price you can find.



How do you find a local Home Depot of healthcare?



Try Or Google your town’s name plus the word “concierge” or “cash pay.”



These clinicians are completely outside of MACRA.



They’ve opted out of all insurances.



Their only customer is you



They may have a computer, but it’s there to serve you—you won’t be there to serve it.



You’ll pay them with your own money, not with your data.



And in return, you’ll get your own personal confidentialist.



Right now you must be thinking, “There’s no way I can afford that.”



But it’ll cost much less than you think. You may even save money on the deal.



Think of the last time you needed to get in to see the doctor and ended up in the urgent care. Or the ER.



How much was your copay?



That will NEVER happen with your own personal confidentialist.



You may end up in the ER, but only if you need it.



That’s what you pay the health insurance for.



But your confidentialist will be there when you need them—no extra payments needed.



And chances are your confidentialist will be able to take care of most of your medical problems.  You won’t be passed off to an expensive specialist with all that additional testing at the drop of a hat because your PCP has to rush to see the next patient.  Your personal clinician will take all the time with you that you need.






Because you’re paying them.  You’re the customer.  You’re the boss.



And that’s how the story of your healthcare will, for once,  have a happy ending.









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