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One Medical’s Response to CareFirst’s Response to One Medical’s Response about Coverage

by Prince Of Petworth October 25, 2017 at 11:15 am 0

Thanks to Scott sending:

“I just asked One Medical to respond to the Carefirst claims and this is what I got back:

Unlike larger health systems, One Medical is focused exclusively on primary care because we know it is an essential part of bringing down overall healthcare costs.

Because they treat many of their needs in the primary care setting, One Medical patients save more than the average patient by reducing unnecessary emergency room or specialty visits.

Even a meaningful increase to our reimbursement rates does not bring us into the top percentage of medical practices in the DC area.

Our goal is to build a practice that is sustainable and strong. We cannot do this without fair and equitable payment rates from our insurance partners. We believe that the rates we seek will simply get us to a fair rate for the quality, service-oriented care we provide–nothing more.

Our goal remains, as always, to focus on the best possible service experience for our members. Primary care is critically important, yet it is historically one of the lowest reimbursed medical services by insurance companies. This situation is even more significant in constrained markets like DC. We are in no way in the category of the highest paid independent primary care practice in DC.

The bigger mission of One Medical is to provide broadly-accessible, high-quality primary care, in a way that drives down unnecessary expense in the healthcare system. Everywhere we practice, we strive to partner with insurance providers to find ways to make our business strong and sustainable.

To Your Health!

My two cents (as a one member) — I am disappointed that they want such a large increase in reimbursements, but I do understand their desire to have the membership fee. That is something they have had since I joined and I do find that you get a better level of service and added conveniences, compared to a traditional medical practice. I feel like carefirst should let their members make the decision about if they want to pay a membership fee, not make the decision for us…”

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