By Charging Up-Front Fees, Florida Company Offers Uninsured ‘Cut-Rate Prices’

A Florida company that charges annual membership fees in exchange for "better access to physicians" is targeting the uninsured and underinsured by setting rates significantly below the normal costs of treatment, the South Florida Sun-Sentinel reports. Founded in 1995 as North American Care, the Ft. Lauderdale-based HealthAccess charges patients a $100 annual membership fee that allows those without insurance to receive the "cut-rate prices that insurance companies typically negotiate, as long as patients pay up front -- a health version of the prepaid calling card" -- and to have their appointments managed by company coordinators. Several other companies in Florida now use a similar business model, but most of those are targeted to a "more affluent" population. For example, the Boca Raton-based MDVIP, whose establishment earlier this year "stirred controversy," charges its members a $1,500 annual fee. In addition to the low rates for services -- mammograms, for instance, cost $50 instead of the usual $200 or more -- HealthAccess members pay a "transaction fee" for doctors' visits ranging from $5 to $15. According to HealthAccess President Carlos Herrera, hospitals are "willing to accept" the lower rates the company pays for services because the payment is up front, precluding any "collection hassles." Herrera said, "We are going to providers and saying, 'Please give us a specific discount and we will guarantee payment within 30 days.' In most cases we make payments within 48 hours." HealthAccess has a network of 18 South Florida hospitals and nearly 2,000 physicians, and its membership rolls "shot up" from 3,000 to nearly 50,000 last year, primarily due to "group agreements with small-employers and self-insured associations." Herrera, looking at the company's target group of the uninsured, says that HealthAccess has "huge potential" for growth. "When you look at Aetna, the nation's largest insurance company, it has 11 million members. Well, there are over 44 million uninsured," he said (Singer, South Florida Sun-Sentinel, 7/19).