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Dr. Bernard in the media

Saying no to insurance: Some area physicians giving direct primary care a shot

Liz Freeman,, 239-263-47789:58 a.m. EDT July 12, 2016

Dr. Rebekah Bernard has worked for a nonprofit clinic in Immokalee, a physician group affiliated with a hospital chain, and had her own practice within an urgent care center.Now she has a solo direct primary care practice south of Fort Myers and not far from Estero.

She wants simple, low overhead and no red tape. That way, patients pay a low monthly fee of $35 to $75, depending on their age, to be a part of her practice, she said.She opened Gulf Coast Direct Primary Care on July 5 and is enrolling patients."It's really, really ideal for people with high deductible (plans) or no insurance," she said.

Bernard, 42, has been thinking about going into this type of practice for several years. She recognizes there is risk with this type of practice but said it is worth it."I want to take back control. I want to be my own boss," she said. "I'm really interested in helping working people."

The tipping point for her is a new system of merit-based incentive payments to doctors under Medicare that will start 2019 but the federal government will start using performance scoring in 2017 for determining reimbursement, according to the American Medical Association.The new payment system will force many solo or small-group doctors into bigger groups, among other things, she said."It put into law 900-plus pages (of rules) for physicians to follow," Bernard said.

Direct primary care is a form of retainer-based practices which many physicians are turning to out of frustration with insurance regulations, issues with electronic medical records and high overhead.There is no uniform model of a direct primary care practice but doctors typically do not accept insurance. Bernard will not be accepting insurance and will not be participating in Medicare.Still, she recommends her patients have a catastrophic insurance plan or high deductible plan when a hospitalization is necessary.

Dottie Sugarman, of Bonita Springs, first became a patient of Bernard's 10 years ago when she was part of Physicians Regional Medical Group, affiliated with Physicians Regional Healthcare System in Collier County.She has no qualms about paying the $75 a month to be in the doctor's new practice, the 63-year-old said."She's likable, very personal and very computer literate," Sugarman said. "She doesn't make you feel like she's in a hurry to leave the room."

ugarman is retired and her health care coverage is Florida Blue through the Affordable Care Act. Her deductible is $6,700 a year and she pays roughly $1,000 a month in a premium because she doesn't qualify for a subsidy.She intends to submit paperwork to her insurer every time she sees Bernard to have it count toward her deductible, even though she figures she will never reach her deductible."I'm a healthy woman," she said. "I figured why not spend the money with her?"She expects to see Bernard twice a year, for wellness checks, blood work and the like."She will just make sure I'm in good shape," she said.

Patients are not required to sign a contract to be a part of her practice and instead pay monthly, Bernard said.A direct primary care physician typically need 600 patients, but she figures her break even is 100 patients due to minimal overhead with rental space and one employee. She's arranged for discount contracts with a laboratory and radiology practice for imaging, plus she's buying supplies through online retailers.In her previous practice within the Estero Urgent Care Center, she had 3,000 patients.

Eighty percent or more of what patients need to primary care services can be managed in the office, and blood samples can be drawn in the office and sent to the laboratory for the analysis, she said.

For more information about Gulf Coast Direct Primary Care, located at 17595 U.S. 41 South, Suite 227, call 239-322-3860.

For some docs, direct patient care + discounted rad services = freedom

By Dave Pearson

Jul 12, 2016

A Florida primary-care physician who gave up the red tape of reimbursement for the hands-on of monthly retainer payments directly from patients—and for a single, discounted contract with a radiology practice—has gotten her story told in her local newspaper.

“I want to take back control. I want to be my own boss,” Rebekah Bernard, MD, told the Naples Daily News. “I’m really interested in helping working people.”

Click below to read the piece.

Saying no to insurance: Some area physicians giving direct primary care a shot

HISTALK News 7/7/16

Rebekah Bernard, MD cites impending MACRA red tape (not to mention the length of the final rule) as her main reason for opening a direct primary care practice in Naples, FL this week. After working for a nonprofit clinic, hospital-affiliated physician group, and urgent care center, Bernard decided it was time to take back control. “I want to be my own boss,” she says. “I’m really interested in helping working people.”


Jennifer, Mr. H, Lorre, Dr. Jayne, Dr. Gregg


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