I just love when the healthcare industry makes up words to distract you from what they are really doing. I didn’t know what a “Look-Alike” was until I read this called Hospitals Divert Primary Care Patients to Health Center ‘Look-Alikes’ to Boost Finances. It turns out it is just another way to marginalize certain patients:

• A growing number of hospitals are outsourcing often-unprofitable outpatient services for their poorest patients by setting up independent, nonprofit organizations to provide primary care.
• Medicare and Medicaid pay these clinics, known as federally qualified health center look-alikes, significantly more than they would if the sites were owned by hospitals.
• Hospitals are betting that they will come out ahead by spinning off a money-losing service and providing grant funding to the look-alike to keep it solvent, he said. At the same time, hospitals expect many patients from the look-alike clinics who need to be admitted for services or require specialized care to be routed to their hospitals, he said.
• The look-alike status also allows the clinics to participate in the National Health Service Corps, a federal program that pays the student loans of clinicians who agree to work in an area with a shortage of health care providers, he said. “It’s a great way for us to hang on to providers,” Johns said.

I worked in an FQHC for 15 years. I know this world. I also know how the administrators work it. Let’s read between the lines:

• It’s a money game.
• The “routing” of these patients to their hospitals is the crucial part.
• They can trap doctors by paying their loans off.
• Primary care, to these hospitals, is a MONEY loser.

I can almost guarantee that the doctors working there aren’t happy. The non-doctor admin work is ridiculous (EHR, metrics, etc.). The patients feel it is a mill. And the staff turnover is insane.

What’s the answer?

Give the same Medicaid patients a card that enables them to pay their DPC doc $80 a month. No strings attached. No questions asked. It would be like an EBT card. You would need an oversight committee to make sure the DPC docs are legit and then let the market do the rest. Enough of these “look-alikes”. It’s time for the real thing for everybody.