Cashing out

"Cashing out" Continued...

Issue: "Big mouth on campus," March 12, 2005

For example, Medicare prohibits doctors from referring patients for an A1C, a test designed to catch diabetes in its earliest stages, unless the patient is obese, has a family history of diabetes, and is already symptomatic. By then, Ms. Swanz said, the A1C is a moot point.

A SimpleCare patient can have the A1C for only $14-because his doctor decided the test was necessary treatment.

Maybe that's why SimpleCare is adding members at the rate of about a doctor a day. "We're hearing our members say they couldn't sleep at night knowing they didn't treat a patient" because an insurer wouldn't authorize it, Ms. Swanz said. "They don't want to work for insurance companies anymore. They want to work for patients."


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