West Virginia doctor's retainer practice under investigation

The physician has stopped signing up new patients to the program that directed patients to an insurer for individual policies for uncovered services.

By Mike Norbut, AMNews staff. April 5, 2004.

A West Virginia physician who has started a retainer practice with a twist he says "will get health insurance out of primary care" is being investigated by the state's insurance commission for possibly selling insurance in violation of state law.

Vic Wood, DO, who specializes in ambulatory medicine and runs Doctors Urgent Care, a clinic in Wheeling, W.Va., offers unlimited appointments and x-ray services to patients for a monthly fee, in typical boutique medicine style. He also directs them to an insurance company that writes individual policies for care he can't offer, including hospitalization, outpatient testing, prescriptions and visits to specialists. He does not collect a commission from the insurance company. The total package, he says, covers the patient without the need for an HMO.

"I estimate about 20% of health care costs come from third-party markups," Dr. Wood said. "Doctors add another five to 10% in billing cost. That's 30% I can cut in administrative fees."

As proof, he points to his own clinic. Rather than offer traditional insurance to his employees, he gives them free primary care as if they were members, and pays for individual policies for those who need it.

Dr. Wood's health care costs for his 12 covered employees dropped from $64,000 last year to $30,000 this year, he said. For a business with 12 employees that actually would pay either $83 per month for an individual or $125 per month for a family for primary care services, Dr. Wood estimated costs would drop from $64,000 to $44,000 per year.