BUFFALO, N.Y. (WKBW) — A new medical practice is set to open in Western New York this fall and it will be a first-of-its-kind for the area.
Latus Medical Care will serve members of BlueCross BlueShield exclusively.
Having one “payer” is a practice that is both common and growing across the country, but it’s never been done before in our area because of the state’s strict prohibitions on corporate medical practice.
7 Eyewitness News legal expert Florina Altshiler says there are a few things that Latus Medical Care will need to be aware of to not violate the state’s laws.
- BlueCross BlueShield can’t profit from the practice, meaning no revenue sharing,
- Latus cannot be marketed under the BCBS trademark
- BCBS cannot be extensively involved int the operations of the practice — influencing physician recommendations or practices.
These restrictions are the reason some other medial practitioners have concerns about the structure of the new venture.
Dr. Nancy Nielsen is the Senior Associate Dean for Health Policy at the University at Buffalo, and she says physicians need to ask many questions before joining a practice like this.
“Be careful what you’re signing up for. Be very careful about who is going to tell you how to practice medicine,” she said. “Are you going to be able to exercise your best judgement for the needs of the patient, or are you going to be following the dictates of the insurer?”
Dr. Thomas Schenk ran a pediatric practice for years before joining BlueCross BlueShield in 2014. He is now stepping out as the president and owner of Latus Medical Care
.
Schenk says LMC will be privately owned by him, and BlueCross BlueShield will only be involved as the sole “insurance payer” to the company.
He says this is a first of it’s kind practice in Western New York, but not across the nation.
The structure of the practice is still being looked at - Schenk hopes to model it after corporate medical best practices that are up and running in other states, although his practice is not corporately owned.
“We’re only going to worry about one kind of insurance company’s panel, we’re going to build a system that is just embedded right in it.”
This practice will help address what Schenk calls a primary care problem in the area.
“Just for BlueCross BlueShield, there are tens of thousands of people who have not seen a primary care doctor in the last three years,” he said.
Latus will help patients with a special advisor who understands the networks. It will focus on primary and adult care and help patients understand their benefit structure as well as book appointments with other specialists as needed.
This specialist will also be responsible for making sure the patient actually gets to that appointment by following up with them…bringing healthcare full circle.
Dr. Nielsen says a practice with this structure is attractive to physicians because it cuts out a lot of the paperwork that many complain was not a part of their doctoral training in school and bogs down their ability to care for patients.
“It’s really attractive, all the back office stuff is taken care of, you get to practice medicine, you don’t have to worry about the business,” she said.
“But, what are the unwritten things?”
Schenk says with any new structure physicians will and should have questions — but in a follow up call with 7 Eyewitness News, Schenk assures us he is working closely with the state to make sure LMC is compliant with state regulations. It is independently run and operated by him, a board certified physician.
The provider plan is currently being reviewed by the state and if LMC gets approval, it will open it’s doors by the end of this year at 2350 Maple Road, near the intersection of Maple and Transit roads.
