• Chuck Hulse

Pig in a Python

Quite a visual isn’t it? The media coined this phrase a couple decades ago to describe the impact of the Baby Boom Generation on the United States commerce. At a time when the Millennial Generation is getting a lot of attention, I am struck by the reality that the pig has not been digested just yet – at least when it comes to healthcare. The Boomers are still driving healthcare utilization and cost. Care Credit, a company at the 2018 Medical Group Management Association annual conference sponsored research on the generations and healthcare. The data concluded that consumerism is here to stay, and further that the Boomers are the mega consumers – twice as likely to have a procedure, almost twice as likely to visit a primary care provider. What’s more, the research showed that Boomers are much less likely to make a choice about where to get care based on a friend or family member. Medicare coverage allows a member to make choices unconstrained by their employer’s choice of insurance carrier and the limited choice forced by insurance company “narrow networks”.

Why am I thinking about all this? I am approaching an age where I can sign up for Medicare coverage. I lost focus a couple weeks ago, wacked my head and thought I would need stitches. Here is the interesting part, did I think that I was headed to the emergency room, no. My first inclination was Direct Orthopedic Care, a walk in care center for musculoskeletal issues, no referral required. Similarly, a recent MedMan consulting engagement found a family medicine physician who is providing Direct Primary Care. Think of it as a form of concierge medicine, a retainer-based model, where patients pay a monthly fee directly to the practice for a certain set of services. This week, the MedMan corporate team met with a physician interested in starting an Urgent Care Center - no primary care physician required.

Options for care are emerging to fill a void created by the shortage of primary care physicians. Admittedly, I mostly dislike the notion of being of Medicare age, but I am intrigued by the idea that I will have more choices when I need care.


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