Private Direct Medicine
How to create and market US concierge, DPC, integrative/Functional Medicine and connected care private fee practice and business models.
Jim Eischen started to lecture on private direct healthcare compliance solutions in 2010, and has since become a featured private direct healthcare conference speaker for a wide range of physician and healthcare innovation topics. Since 2019 Jim has served on the board of WMD Foundation, a San Diego non-profit dedicated to creating community-based and social media projects to provide healing and reconciliation as alternatives to conflict.
Physicians and Entrepreneurs don’t have time to research the ever-changing healthcare systems.
Our current US private direct medicine curriculum is a curated library of webinars that cover literally every aspect of US private direct medicine innovation and business planning. The existing library includes:
1. Private Direct Medicine Models
What is U.S. private direct medicine? Concierge, DPC/direct primary care, integrative, Functional Medicine, hormone treatment, cash practice, connected care solutions with health data tracking & health coaching: they all involve private fees not funded by healthcare insurance plans.
We explore the aspects and attributes of each version of US private direct medicine models.
We discuss the future of US healthcare and how it may involve fitness testing, genomic information, even heart health data from your watch. Healthcare insurance plans won’t reimburse all the aspects of innovated US healthcare and wellness, so innovative businesses and healthcare practices must offer services triggering patient/consumer private fees. We explore how to accomplish US healthcare disruption with compliant private fee offerings. This webinar identifies all existing US private fees innovative practice models.
2. Comparing And Contrasting Private Direct Medicine Models
We compare & contrast all existing versions of US private direct medicine models so subscribers understand each model. We explore each model’s advantages and disadvantages to help viewers discern which model may best meet their needs. Evaluated models include concierge, DPC/Direct Primary Care, connected care, integrative/Functional Medicine, hormone replacement, and cash models. Subscribers struggling to understand the differences between various US brands and models benefit from this webinar’s overview of each model. Businesses looking to connect with private direct medicine gain an understanding of each model’s pros and cons. We identify MSO models that partner business with healthcare care practices and explain how those models function. We also discuss self-employed healthcare professional practice models that avoid the MSO structure. We discuss connected care businesses and practice models that sell services outside the definition of practicing medicine (health coaching, health & wellness products, health data-related services). This and the prior webinar introduce US private direct medicine models so subscribers can then dive deeper into the compliance challenges and solutions of every US model.
3. DPC Deep Dive
We explore specific positive attributes of the DPC or Direct Primary Care model that has excited many US primary care practitioners as a pathway from plan-dominated medicine. We identify DPC compliance and business challenges, and, discuss various solutions. We help subscribers decide whether the DPC model is the right fit for them by describing who are ideal candidates for this model. We reference the orthodox no-plan DPC model, and variations of that model that somewhat integrate plans. We outline how DPC practice/patient interactions (typically 30-minute office visits) along with electronic communication connection options, and various typical pricing. We discuss DPC efforts to change state and federal laws to better enable the DPC model, and, options that subscribers can adopt that can immediately accomplish compliance under existing laws. We want subscribers to understand the benefits and limitations of the DPC model, and to decide whether that model may best fit their needs (or not).
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4. Concierge Private Direct Medicine
We discuss the "concierge" brand of private direct medicine, the history of how this model arose, the diversity of practice structure options that utilize the “concierge” brand. Because concierge-branded practices can be either Medicare participatory or not, and can offer a wide diversity of services, we use this webinar to explore and consider two important forks in the road: 1) whether subscribers should remain Medicare participatory (and private plan participatory), or not; and 2) whether subscribers should sell "healthcare" for private fees, or, sell services outside of the strict definition of practicing medicine (patient education, behavior modification, health coaching, health data analysis). Because so many concierge-branded practices are Medicare participatory and in-network with private plans, we also use this webinar to discuss fundamental private direct compliance solutions that allow subscribers to remain in-plan/Medicare participatory and to lawfully sell services for private fees. We explain that these compliance solutions have allowed US concierge practice models to compliantly thrive from the late 1990s to the present.
5. Connected Care: Private Direct Healthcare That Isn’t Healthcare!
We explore a version of private fee health/wellness services intentionally structured to not constitute the practice of medicine. "Connected Care" describes a variety of services that can support healthcare without actually involving diagnosis and treatment—therefore that are not actually the practice of medicine. These connected care models deliver services outside plan coverage for private fees, and are not branded “concierge” or “DPC.” We do a market survey of several current versions of this model to show how dynamic and diverse these services are, and how this model is ideal for US healthcare device and services disruptive technologies. We identify compliance solutions to enable these innovative models that can include: health coaching, technology services, and online platform/communication system subscription. Market examples discussed include IORA, OneMedical, Oak Street, Omaha, Docent, ChenMed, WellMed, Mosaic, Aledade, and Arivale (not practicing medicine-genomic testing plus health coaching).
6. Integrative Cash Healthcare
The private fee compliance solutions for practices providing integrative/Functional Medicine/alternative/hormone therapy services provide a strong overview of Medicare/plan compliance alternatives. This webinar focuses on various integrative practice offerings that are outside plan coverage, and compliance solutions to enable these practices. Because integrative healthcare is frequently outside plan coverage, we do in-depth analysis of two (2) important decisions for any private direct fee model: whether to stay in-plan or not; and subscription pricing versus menu (fee for service) cash pricing. We close the webinar with best practices for integrative private fee healthcare practice formations.
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7. Private Direct Practice Marketing: A Primer On Messaging & Compliance
Private direct medical practices and related connected care offerings combine two (2) very different worlds: consumer persuasion and healthcare compliance. We identify US healthcare marketing regulation and compliance solutions. Many of the marketing compliance traps specific to healthcare and wellness products/services are counterintuitive, but this webinar dissects what’s so often wrong about healthcare marketing and the elements of strong (and compliant) healthcare marketing. The webinar addresses our current digital age, and the accelerating merger of healthcare with radically updated communication and data sharing technologies. This webinar is ideal for any healthcare professional or businessperson entering into US healthcare and wellness marketing, but is also useful for existing practice and business models looking to improve their marketing program.
8. Data Protection & Compliance Solutions For Private Direct Practice Models
We discuss US health data privacy laws in general, identifying various applicable federal and state agencies and the laws those agencies enforce. The webinar then focuses on HIPAA compliance solutions. We explain why cash practice models (and even businesses that interact with providers) must deal with HIPAA compliance, and we identify the basic compliance solutions for any practice or business model that connects to HIPAA regulations. We discuss Mr. Eischen’s theory of how to improve both practice AND business data security by adopting an outside-in versus inside-out data security approach. The webinar concludes with guidance and best practices on installing cyber liability insurance.
9. Business Regulations Applicable To US Healthcare: Practical Solution
This webinar is a terrific introduction to the often counter-intuitive and unique regulations that apply to US healthcare-related businesses and professionals. We review the basic essential business regulations that impact US healthcare practices and businesses that wish to engage with those practices. We discuss Stark/anti-referral via OIG resources (Issues and Safe Harbors), incentives, and corporate practice of medicine (CPOM) guidance as US healthcare is often improved and disrupted with practice/business partnerships. We engage in some important US healthcare regulation myth-busting, and conclude with outlining best practices for avoiding US healthcare business regulation compliance problems.
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10. Small Business Ownership/Self Employment Versus Employment: What’s Right For You?
Is US small business ownership or self-employment the right fit for you? This webinar explores starting a small business or engaging in self-employment, identifying both the typical challenges and joys of self-employment. The webinar helps subscribers evaluate whether small business ownership will make their dreams come true, or become a nightmare. We also evaluate the challenges and advantages of outside employment and provide guidance on how to rationally determine whether to pursue small business or outside employment. The webinar gets personal, as Mr. Eischen shares his own story that combines the benefits and challenges of small business ownership and outside employment, and how he navigated the decisions involved with both options. The webinar shares several articles by outside authors celebrating self-employment and outside employment benefits. Subscribers are exposed to diverse sources and points of view. The webinar concludes with suggested questions subscribers must answer for themselves when determining whether to pursue self-employment or not.
11. Medicare: Care Coordination, CCM and Telehealth Coverage Expansion
Many US healthcare practitioners and related businesses are unaware of Medicare’s expanded coverage of care coordination, care coordination management, and telehealth. This webinar discusses how these coverage expansions provide opportunities for US private direct medicine models, and create new compliance challenges as well. The webinar identifies updated US federal regulatory priorities as telehealth and care coordination coverage experimentally expands. The webinar identifies specific areas of US healthcare market opportunities created by these Medicare coverage expansions, while also providing best practices on avoiding regulatory issues. Finally, the webinar concludes with how expanded Medicare coverage can be intertwined with compliant private fee US care models to create expanded practice (or business) revenue streams.
12. Private Direct Medicine: Plan Integration Or Disintegration?
US Private direct medicine models are often both fleeing plan reimbursement requirements, and, billing plans for plan-covered services. The diverse US private direct medicine marketplace includes practice models 100% outside of any plan coverage, and models that integrate plan reimbursement with compliant private fee offerings. This webinar explores how subscribers should evaluate whether to integrate plan reimbursement, or not. We explore the benefits and burdens of plan integration, and spend more time on private plan compliance solutions (as other webinars have addressed Medicare/Medicaid compliance solutions). The webinar provides some updated US market information on how various US private direct practice models either integrate plan reimbursement, or avoid plans entirely, and concludes with recommendations on how best to evaluate whether to integrate plans or avoid them. We emphasize there is no one (1) right answer to the question of plan integration, the decision is personal to the healthcare professional (or business) and involves a variety of factors that are discussed.
13. How To Form Your US Private Direct Practice Model
This webinar is intended as a final presentation that integrates all of the prior twelve (12) US private direct webinars into one (1) final outline to help subscribers most effective enter into this dynamic US private healthcare marketplace—a marketplace that is almost certain to be ground zero for US healthcare innovation and disruption.
We explore the algorithm and structural approaches used by national private direct medicine expert Jim Eischen. He’s successfully formed hundreds of diverse US private direct practice models and practice/business models over the last nine (9) years. In this webinar, Mr. Eischen shares his insights and provides specific guidance on how any subscriber should approach the formation of their US private direct practice or business model. Divulging his internal knowledge and processes, he discusses the right questions to ask, and provides a step-by-step approach to forming the right practice model for various healthcare professionals, businesses and patients. This webinar is intended to follow the same approach Mr. Eischen uses when he consults on US private direct practice or business formations, and he fully shares what he has seen as the factors and approaches most likely to succeed and thrive.
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14. Interview with Michael Tetrault of ‘Concierge Medicine Today’
Jim Eischen interviews Michael Tetreault, the Editor-In-Chief of "Concierge Medicine Today" and "The DPC Journal.” Mr. Tetreault is a well known and respected voice, editor, community builder and authority in the concierge medicine and DPC healthcare innovation movements. Sharing his own stories of US healthcare (he is originally from Canada) and how his own health and business journeys led him to wanting to report on and support US private direct care models. You’ll enjoy Mr. Tetreault’s personal observations and anecdotes, in addition to his more detailed marketing and polling data, on why concierge and DPC practice models continue to thrive (and how connected care models are arriving).
15. Equity Incentive Compensation: From Promise to Reality with Guest Speaker Stephen Candelmo
Jim Eischen interviews and co-presents with attorney Stephen Candelmo, who translates his 25 years and US $3 billion of start-up and venture capital/fund raising experience into concrete guidance for anyone (healthcare professional, key employee, founder or start-up owner) on how to create equity incentive models. Mr. Candelmo acknowledges the power and perhaps the hype of stock options and other forms of equity grants, and helps subscribers better understand the business and tax strategies behind these incentive models. If you are a professional recruited to affiliate with start-up or larger enterprises with promised equity as a key inducement, you won’t want to miss this webinar. Mr. Candelmo and Mr. Eischen identify the compensation, grant calculation, tax and healthcare regulatory land mines to avoid. Subscribers will more effectively negotiate and navigate equity grant realities.
16. Dr. Jack Forbush: My Journey to DPC Medical Practice
Lofty Learning presents a live webinar interview with Dr. Jack Forbush. Dr. Forbush describes his journey to med school and into membership medicine, talks about what he learned from his DPC formation process, and conclude with a question and answer session with me (Jim Eischen) on Dr. Forbush’s DPC compliance questions—I provided answers to and described alternative options.
Weekly Webinars with Q&A Sessions
Subscribers to Jim Eischen’s US private direct medicine challenges have the most complete webinar library available in the US on private direct healthcare solutions.