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Chad Savage, MD: Innovative Payment Model for Primary Care

He knew he'd be pushing the boundaries of traditional practice in 2017, but after hearing the struggles of patients, as well as having his own frustrations, Chad Savage, MD, ventured out on a fairly new idea: direct primary care.

With 12 years of experience under his belt, Doctor Savage is making waves not only in Michigan but across the nation; he's been featured on the Heartland Daily Podcast, Watchdog.org, Chicago's Morning Answer, The Hill and much more. He's advised legislators, giving powerful testimonials and speaking at forums to better educate those drafting health policy. All while giving his patients high quality, focused care.

His practice runs a bit differently than your standard third party system -- and it's meant to be that way. No insurance is accepted and patients pay a monthly membership fee for care. Some labs and in office procedures are included, in addition to a standard wellness exam. Any remaining costs are billed directly to the patient in a "Costco-like" model at wholesale. His theory is to decrease the influence of the middle man, namely insurance companies and the government, leading to lower overall costs for patients and providers.

While Doctor Savage has experience in traditional health systems, the inspiration for going off on his own came from the need he saw throughout his community. Many of the patients he was seeing had high deductibles and were paying their premiums but couldn't actually afford care.

This, coupled with increasing levels of his own dissatisfaction both personally and professionally, motivated him to start his own practice. After watching the direct care scene for a few years and learning more about the process, Your Choice Direct Care opened its doors in 2015. His Brighton-based practice was a new way of practicing medicine, both for Doctor Savage and his patients.

Two years later, he now has fellow practitioner, Naomi Pearsall-Cook, MD, on his team, as well as an impressive success rate. He positions himself as a patient advocate and has definitely met expectations.

"Patients themselves are our biggest advocates," says Doctor Savage.

One of the most challenging aspects of the business is simply explaining the method to prospective patients, many of whom are skeptical of the legitimacy of his services. However, after hearing patient testimonials and going through the process themselves, once unsure patients see the benefits first-hand.

"We've seen a lot of success with this model for the 'working poor' demographic -- those who have been priced out of the insurance market but don't qualify for government assistance," Doctor Savage explains. "The costs are predictable, which is very important for families who are budgeting."

Looking to maximize the utility of his medical degree, Doctor Savage also implemented a pharmaceutical component at Your Choice Direct Care. His office has a specific license that allows him to dispense some prescription drugs directly to patients -- again, at a lower, wholesale price.

While this on-call lifestyle is not for everyone, Doctor Savage says his patients are, for the most part, respectful of his time. His work-life balance hasn't necessarily changed, but the work he's doing is more fulfilling. Days he previously spent doing paperwork and bureaucratic tasks are now spent directly interacting with patients.

He's also able to focus on providing better quality care due to the smaller number of patients he is actually responsible for. Previously, he was seeing about 3,000 patients, a historic number in terms of workload. His current patient count at Your Choice Direct Care? Approximately 600 patients -- an 80 percent cut to his workload. This smaller number allows Doctor Savage to give greater focus and personalized attention to those he sees, a benefit for both physician and patient.

Direct primary care is just one of the options physicians are exploring to better patient care and physician practices here in Michigan. To learn more about direct primary care and Doctor Savage's office, visit http://yourchoicedirectcare.com.

Over the next year, Medigram, the Michigan State Medical Society's e-newsletter, will highlight a series of leading, innovative physicians in Michigan. For more information on Medigram, contact Kevin McFatridge.

 

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