Big Idea: Recruit doctors through graduate medical education and retain them through higher wages
“Any great city has medical schools, and there’s a blossoming academic medical infrastructure here in Las Vegas.” That’s Doug Geinzer’s belief, based on his 10 years as CEO of High Performance Providers — a venture Geinzer founded that connects self-insured patients with providers through direct contracting — and as former executive director of Las Vegas HEALS, a nonprofit promoting health education, advocacy, and leadership in Southern Nevada.
Geinzer says graduate medical education (GME) is critical in diversifying a community’s medical offerings, as it attracts “more specialists and subspecialists to teach those areas.” Moreover, he sees medical schools as sites of training and learning for both students and faculty — “the students teaching the teacher and vice versa. When you have a bunch of students going, ‘But, why?’ it forces the senior political leadership to answer with factual information that they know will be fact-checked by the young kids.”
While GME serves as a recruitment tool for medical professionals, Geinzer sees retention as an issue linked to provider reimbursement. “We tackled recruitment with the expansion of GME,” he says. “(Nationally) 57 percent of doctors will stay where they do the residency.” Thus, he believes, keeping medical students and residents in Southern Nevada requires a focus on retention, which is linked to compensation. “What a lot of people don’t realize is that compensation is directly tied to provider reimbursement, how much they’re getting paid to do the work they do, and that comes down to the commercial carriers,” he says.
Direct contracting — which allows “employers to buy (medical services) directly from providers” — is one method that Geinzer sees as benefiting employers, patients, and physicians. Direct contracting “allows the employer, who’s writing the check, to write a smaller check, so the employer is saving a lot of money. In the world of surgery, they save on average, 40 to 50 percent,” he says. This, he explains, would make healthcare more affordable. “We all have these high deductible health plans be cause the employer cost-shifted to us, the workers, and they all have this max out-of-pocket so that we can’t afford the care that we need,” he says.
According to Geinzer, direct contracting benefits employers, who save money on plans; it benefits employees, who save on the actual cost of the service, because, when patients go through a direct contract, there’s no copay; and it benefits providers, who get paid at a higher reimbursement level. All of this, in turn, would increase physicians’ wages, incentivizing them to stay practicing in their communities. ✦