Physicians News May/June 2013 : Page 5Transform from Page 1 that reports a patient’s weight di-rectly from home to the clinic, and reminders to patients of routine di-abetes or cancer screenings. The Heights Medical Center, as the practice is called, has also expanded from two to five doctors and nurses, and hired a patient coordinator who organizes doctor visits, referrals and prescriptions. With a medical home accredita-tion from the nonprofit National Committee for Quality Assurance, the Heights receives higher reim-bursement payments per patient from insurance companies like Horizon Blue Cross Blue Shield of New Jersey and Aetna. "It was all experimental," Bellavia said. "I had to transform my staff and the way I practice. But it has paid me back considerably." While Bellavia figured out how to increase his insurance reimburse-ments, doctors like Holthouse are trying to insulate themselves from the insurance system and govern-ment budget cuts. In 2005, Holthouse started what is sometimes called a functional medical practice – a setup that in-corporates acupuncture, herbal medicines and a nutrition and exer-cise program. He soon found that the only way to remain profitable was to increase the number of pa-tients treated at the practice, now called the n1Health Center for Functional Medicine --something he thought would compromise the quality of care. "We couldn't deliver the kind of care we wanted to with regular in-surance," he said. With the subscription, or concierge, model that he introduced in January, Holthouse will treat about eight to 10 patients a day who pay about $2,600, in addition to the reimbursements paid by their in-surance plans. By contrast, each provider at Heights Medical Center treats up to four patients per hour. Holthouse also has an herbal phar-macy with supplements and nontra-an and remedies, ditional acupuncturist on staff as part of his effort to offer alternative treatments along with traditional medicine. Patients at Holthouse’s practice are still responsible for an insur-ance copayment for medical services that aren’t covered under the monthly fee, which accounts for basic diagnostic tests, physicals and screening. Despite the monthly costs, Holthouse said his patients supported the changes after the practice held 15 “town hall” meet-ings to explain the new model. "By the time we did the conver-sion, one hundred percent under-stood why we were doing it," he said. "They feel like they're getting time and quality care." He also said that patients were spending less on medications and hospital fees, making the subscrip-tion a worthwhile investment. Holthouse, like Bellavia, does not accept patients with Medicaid, the state-federal program for low-income people, because of the low reimbursement rates. He puts little confidence in the federal govern-ment when it comes to paying physicians fairly or streamlining the high cost of health care– one im-petus for choosing the subscription-based model. But James Doulgeris, a health care strategist at research and mar-keting firm HCP, said physicians who adopt innovative practices will benefit from the federal health law, because it gives financial incentives to doctors and hospitals that hold down costs while improving quality. "It's a 180-degree change, but physicians will have a great incen-tive to provide optimal care and focus on wellness," he said. Holthouse, however, is not con-vinced. "Unless you remain inde-pendent, you will have no say in what kind of medicine you practice," he said. Kaiser Health News is an editori-ally independent program of the Henry J. 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