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SEAN HANNITY INTERVIEWS DR. ROBERT HAAR OF REGENCY HEALTHCARE

Manhattan based orthopedic surgeon Dr. Haar discusses free market medicine and the problems with Obamacare with Sean Hannity. Dr. Robert Haar has founded an orthopedic surgery practice that does not participate with third party or government insurances and instead offers transparent cash pricing to individuals and small businesses. Dr. Haar is on the forefront of direct access medicine and is a thought leader in the field.

THE SELF PAY PATIENT FEATURE

For the past several months I’ve cited the Surgery Center of Oklahoma several times as a place where self-pay patients can go to get real prices that are ‘all-inclusive,’ meaning the fee listed covers the entire procedure, and patients don’t have to worry about added feesof $550 for a couple of bags of saline solution or any of the other countless charges that hospital patients often wind up having to pay on top of the surgical, anesthesiologist, and facility fee.

The reason I’ve pointed people to the Surgery Center of Oklahoma is pretty simple – there haven’t been many other places I knew of that offered the same type of transparent, package pricing. There are a few other facilities as well, like Daytime Outpatient Surgical Center in Fort Worth, Texas, and Good Shepard Medical Center in Longview, Texas.

A few other places come close, not listing their cash prices online but giving patients the opportunity to call and talk with a financial representative and get package pricing, places like the Tucson Medical Center in Arizona and Henry Ford Hospital in Detroit, Michigan (Henry Ford’s program is largely aimed at Canadians coming south seeking treatment, but they work with U.S. self-pay patients too).

Up until now, that’s been it, at least that I knew of. Many other hospitals offer some sort of discount off of their fees, or will negotiate with patients, but there aren’t a lot of other options for self-pay patients to get real, up-front package pricing for hospital and surgical care.

But yesterday someone pointed me in the direction of Regency Healthcare in New York City, a surgery center that performs orthopedic procedures like a partial knee replacement, arthroscopic rotator cuff repair, and Achilles tendon repair, all at a single, transparent price.

The center, owned and operated by Dr. Robert Haar, explains their decision to offer real prices this way:

Regency Healthcare’s Transparent Pricing Model was born out of simplicity. Too often procedure costs are rife with hidden fees and extra costs. These additional costs often add thousands of dollars to already overpriced procedures and the patient is responsible to bear this financial burden. Even those who are insured often find themselves surprised by the final costs of their procedures. Our cash pay model allows those who are uninsured or members of self-funded plans to control costs and still benefit from the highest caliber medical care.
Regency Healthcare has opted to include all costs into its Transparent Pricing Model. This means no extra costs for anesthesia and facility fees. Because all of Regency Healthcare’s procedures are performed on an outpatient basis there is no need for overnight hospital stays. These hospital stays often contribute to the thousands of extra dollars added on to the final costs.
Regency Healthcare’s surgical facility is physician owned and operated and as a result is able to dictate the costs of procedures. This eliminates the bureaucracy that is often involved with determining medical costs. Also, because Regency Healthcare is physician owned and operated we are able to control our overhead costs, a cost that is often passed on to the patient.
The prices listed on the site are not introductory prices or discount specials. These prices reflect the entire cost of each procedure with no ancillary charges.
The prices listed appear to be in line with what insurers pay, according to Health Care Blue Book. An ACL repair surgery generally costs $10,105 in the same area, compared to $9,900 at Regency Health, while a rotator cuff repair surgery usually runs $8,263 in local hospitals compared to $9,500 at the surgical center.

Perhaps the most important thing about Regency’s prices are that they are all-inclusive, meaning no surprises when the bill comes. Regency’s price for the rotator cuff repair is also for outpatient surgery, compared to a two day stay in the hospital elsewhere. I suspect that’s because Regency performs arthroscopic surgery for this procedure, which is minimally invasive and allows more rapid recovery and discharge compared to full surgery. So the prices on rotator cuff repair may not be fully comparable.

It’s great to see another cash-friendly surgical facility open anywhere, but in this case it’s especially nice to see one open on the East Coast, giving self-pay patients in this part of the country what may be a more convenient and accessible place to get procedures done.

DR. ROBERT HAAR’S DECLARATION OF INDEPENDENCE

“Let me just tell you something. Insurance companies aren’t watching your back, the hospitals aren’t watching your back, and the government is certainly not watching your back. Guess what: us docs are not sheep in the headlamp. We’re not powerless to do anything or to change anything. We’re going to take this health care mess into our own hands and we’re going to fix it.” – Dr. Robert Haar, Orthopedist to the Upper East Side of New York.

After about three decades of fencing with insurers, reading The New York Times accused physicians of putting personal gains ahead of patient welfare and working more as an administrator than as a physician, Dr. Robert Haar has had enough.

He’s chucking insurance over the side.

Effective this year, Dr. Haar’s Regency Healthcare Clinic is going all cash, all transparent, and all patient-focused.
No more army of administrative assistants filling out forms and fighting with insurance companies to get paid. Enough is enough.

In the Patient’s Best Interest

Dr. Haar’s decision to go the all cash route is fairly recent, but the stimulus behind it was a long time in coming. We caught Dr. Haar after a long day in the clinic and he was very candid about this move. In his view, going all cash, all transparent was really in the best interests of his patients.

As Dr. Haar sees it, “When a patient looks online or tries to call a hospital purchase center and ask ‘what’s the charge’ they’ll find that a lot of these hospital staff don’t know. They don’t know what they’d charge for cash, they don’t know what the surgeon’s going to charge and they don’t even know what the anesthesiologist would charge. When a patient calls the average surgery center or hospital, they find that the staff is clueless. The patient hears ‘we’ll get back to you’. And when they get back to the patient, it’s always sticker shock.”

Indeed. We’re reminded of the recent New York Times article which told the story of a patient in Washington State who’d been told that a knee replacement operation would cost about $65,000, not including the $13,000 implant.

We at OTW knew that the New York Times article was way off base because not two weeks earlier we’d published our ranking of the top hospitals in the U.S. for total knee operations (TKA). These were not only the hospitals with the lowest complication rates in the country but also had the highest volumes in the country (those attributes are often found working hand in hand). Not a single one of the hospitals in our survey charged anywhere near $65,000 for a TKA. In fact, the range of charges was closer to $17,000 – $30,000.

Wal-Mart and Lowe’s

And, it seems, the larger companies are also looking at more direct payments to providers like Dr. Haar.

Wal-Mart and Lowe’s have decided to offer free hip and knee replacement surgeries to their employees. They launched a program called the Employers Centers of Excellence Network (ECEN) and are starting to offer no-cost (to the patient) knee and hip replacement surgeries for their employees.

The two companies negotiated directly with four orthopedic centers:

  • Johns Hopkins Bayview Medical Center in Baltimore, Maryland
  • Kaiser Permanente Orange County Irvine Medical Center in Irvine, California
  • Mercy Hospital in Springfield, Missouri
  • Virginia Mason Medical Center in Seattle, Washington

In exchange for a flat cash fee for both surgeries (no hidden costs, no extra charges for the anesthesiologist or rehabilitation and no co-pay) Wal-Mart and Lowe’s are offering to pay 100% of a hip or knee replacement where everything is covered including travel, lodging and living expenses for the patient and a caregiver. This program covers 1.5 million employees!

Could Dr. Haar be onto something?

“As we all know, un-insured,” said Dr. Haar, “there are millions of people uninsured or work for self-funded companies. There is a growing need for providers and facilities that provide transparent pricing where patients know what exactly a price for a procedure is. And that is a global or bundled payment. There are no hidden fees. No surprises at the end of the episode of care. They know exactly what they are paying for up front. Without the administrative hassle, overhead and layers of bureaucracy that are usually commensurate with insurance based care.”

Dr. Haar’s Practice

Dr. Haar received his medical degree from Tufts University School of Medicine and completed his residency at Montefiore/Albert Einstein. He’s been treating patients for nearly 30 years.

In line with his new emphasis on cash and transparency, Dr. Haar renamed his clinic Regency Healthcare (www.regencyhealthnyc.com) and revamped his website. Physically, he is located at roughly 90th Street and York just off the FDR Drive across from a beautiful park. Regency offers a full range of orthopedic procedures including knee, shoulder, foot and ankle, spine, hand, and arm.

In fact, here’s a selection from his price list which he posts on his website:

 

 

“The bread and butter of my practice are knee and shoulders. The most commonly performed procedure is knee arthroscopy. Certainly, we expect that to be our most common procedure and that is priced the lowest given the rest of the procedures that we offer our patients. I think that is very fair and very attractive approach.”

In terms of pricing, Dr. Haar is competitive with his nearby hospitals (which includes Hospital for Special Surgery). In fact, says Dr. Haar, “We’re more competitive than the average ambulatory surgery center because our costs are lower! We don’t have the administrative load that these other providers do. We don’t have all these administrators in $4,000 suits in burled wood offices. I never saw a CEO from Aetna or Cigna or UnitedHealth[care] who wasn’t running around in custom tailored, thousand dollar suits.”

On Dr. Haar’s website is the following statement: “We make every effort to decrease the cost of your medical care. Therefore, we request payment arrangements for all office services at the time they are rendered unless prior arrangements have been made. We accept cash, checks, MasterCard, and American Express for your convenience.”

Regulatory Issues

We asked Dr. Haar about any regulatory issues and he said: “From a regulatory, from a compliance or from any other vantage point, this is clean, this is transparent, this is a free market, this is an alternative to having to deal with insurance companies.

“Patients generally know what they need, what they want and if they’re not sure then they would see their local physician, they might have imaging studies, they may have conservative care. This is an a la carte surgical procedure menu for patients who know they need certain surgical procedures and can select those procedures that they may need and know exactly what they’re paying for.

All cash, all transparent approach “really doesn’t change the type of patients I’m seeing although a sizeable number are uninsured for whatever reason. Either their employers don’t offer insurance or they are self-employed or they are small businesses or they can’t or don’t want to buy insurance. Often they think they’re healthy but all of a sudden they have an injury or a condition develops where they need a procedure. So there are very few alternative for these sorts of individuals.”

After 30 Years…

“When you’ve been in the trenches as long as I have, you get sick and tired of having to hire an army of people to collect your money.”

And from the perspective of the patient and companies who are taking a more active role in funding their employee’s healthcare needs, Dr. Haar’s leap into a cash-based practice may well be the trend of the future. Notably, it is being driven by the physician.

As Dr. Haar told us: “This is just the tip of the iceberg.”

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Meet Founder: Dr. Robert Haar

Board Certified Orthopedic Surgeon
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