Dr. Fernandopulle writes:
“For the past four years we at Iora Health have been building and operating over a dozen primary care practices across the United States that are purely based on a wholly different and simple comprehensive payment model. We start with a risk-adjusted fixed fee per patient for all of our services, and in some cases add additional payment for meeting experience, quality, or utilization targets, and/or some sort of shared savings off expected total health care costs.
“What we do not do is take any sort of fee-for-service payment. Our billing for employers or union trusts are often a one-line monthly email with three numbers: the number of patients we are caring for times the rate we should be paid equals the size of the check to send us. No codes, explanation of benefits, or appeals.”