AtlasMD

Direct Primary Care means Evidence Based Medicine

@LighthouseDPC I think it’s doable

Oncologists: I'm a direct primary care Family Physician and bill a monthly fee. Direct especially care Physicians can bill for a 30 minute or an hour fee. Why can't an Oncologist bill cash for their time then let the patient bill insurance for the chemotherapy? Or send the patient to a hospital IV clinic for chemo administration? I had a discussion with oncologist who refused to give up his chemo clinic. The Oncologist did not administer XRT, but insisted on delivering his own chemo.

@NeilFlochMD Is the stethoscope in the room with you? Haha that’s a cheap one ;-)

I’m a Surgeon who wears a stethoscope. How many other surgeons listen to lungs 🫁 and wear a stethoscope?

I stopped asking healthcare executives what they believe. I ask what gets bonused. The second question answers the first.

Will they be using the #DirectCare model? Northwestern Medicine’s new institute aims to become ‘the best place for primary care in the country’... ? beckershospitalreview.com/finance/northw…

Great question - #DirectCare more than 10x's the purchasing power of HSA dollars when it comes to wholesale meds, labs, imaging and more. When patients are empowered to use free market based solutions for the majority of medical needs, then we can decrease the cost of health insurance by 50-75% or more.

Wholesale access is exactly where this gets complicated. The $4,300 income-targeted boost (for individuals earning under $75,000) is real, but the purchasing mechanism matters as much as the dollar amount. HSA funds flowing into pharmaceutical wholesale arrangements still have to clear the qualified medical expense standard, and that's a structural friction most of the "new HSA math" takes get quiet about. What I'd add is the DPC angle. The mechanism I've been tracking is how Sec. 110205 of the reconciliation bill explicitly removes DPC arrangements from health plan classification, which is what makes the pharmaceutical access story actually executable at scale. Direct primary care memberships (capped at $150/month for HSA eligibility) are already the distribution layer for wholesale drug purchasing in most direct care models. And that cap creates pricing discipline that'll favor operators who've already built the pharmacy integration before the rule takes effect. But the Senate hasn't touched the HSA provisions yet. So the 450,000-pill math assumes a bill that's still structurally incomplete on one side of Congress. The arbitrage is real. The timeline is the variable that'll separate the operators who positioned early from the ones doing the math after the fact. onhealthcare.tech/p/the-great-hs…

New HSA math for 2027: $4,500 individual limit ÷ $0.01 per pill = 450,000 pills The IRS just funded your entire pharmaceutical life. You just have to buy at wholesale. #DirectCare

Live look at relationship between Medicare and Physicians.

The traditional employer health insurance model is crumbling.

@rshawnm hahah -

@AtlasMD You were w/in margin of error

I'm wrong. For over 16 years i've been telling people that #DirectCare saves 90-95% on medications...and thats just not the case. Sometimes its a 98% savings or a $7838 :) dpcnews.com/patient-inform…

Everyone's talking about the new $10,000 HSA limit for families 55+. Here's what nobody's saying: it matters WAY more if you spend it in the right system. $172,500 = what Fidelity says a 65-year-old will spend on healthcare in retirement. At DPC wholesale prices? Membership + meds + labs for a couple runs ~$2,500/year. That $172,500 lasts nearly 70 years. You can't out-save a broken system. But you can opt out of it.

Time for physicians to...shrug? dpcnews.com/dpc-motivation…

Imagine if healthcare was this open and transparent...

@DrDiGiorgio Seth says while talking on a free world wide communication platform with real time AI translation, fact checking, etc being streamed to our devices from a blanket of satelites that didn't exist a few years ago....sure, nothing has been invented.

Tell that to someone with melanoma in remission.

@robt_heartdoc Yep, safe to assume 80%-90% discounts on most care is very doable. Which means health ins premiums can be cut in half or more.

@AtlasMD Agree. And this is just the baseline. Generic meds and routine labs. The middleman problem gets worse from here.

IRS increases HSA limits by $100 for 2027 What does $100 buys at #DirectCarew wholesale prices? Lisinopril, 1 year supply............$3.65 Metformin, 1 year supply.............$7.30 CBC..................................$2.19 CMP..................................$3.74 A1c..................................$2.88 TSH..................................$2.23 Lipid panel..........................$4.50 PSA..................................$2.88 TOTAL: $29.37 CHANGE FROM YOUR HSA RAISE: $70.63 Healthcare isn't expensive. Middlemen are.

@WinstonTech1 @Tesla That’s what #DirectCare offers

@AtlasMD @Tesla We should demand pricing for primary and secondary care at market rates not the inflated rates our system currently gives us when we pay for higher premiums and deductibles.

Health insurance now costs as much as a @Tesla "$37,824 a year" — that's what employer-sponsored healthcare costs for a family of 4 on a typical employer plan in 2026. The article drives this home with a comparison: "$37,824 buys you a Tesla Model Y. Every year." (and you never get the car) boardroom.hospitalogy.com/library/607c14… @Hospitalogy_HC #DirectCare

@WinstonTech1 @Tesla Liran Einav and Amy Finkelstein have an excellent book on the subject - based on the worlds best healthcare systems like Sinapore - We've Got You Covered - a.co/d/07u7T0ZD

@AtlasMD @Tesla We need a universal 3-tier safety net system. Govt funding for emergency/catastrophic primarily, but cash market/HSA for routine/primary care, then an auction bidding system for secondary care specialists. We need both equity and efficiency in healthcare.

The 2025 340B data is out. Yes this is what excites me. We surpassed $100B last year. And, again, about 80% goes to the hospitals.

@Badsaltydog In. Deed. Let’s fix that.

In. Sane.