Frequently Asked Questions
1. What kind of medical practice is this?
This is a general internal medicine primary care practice that has been influenced by two care models. It is a hybrid of a “concierge” model practice, which limits the size of its practice, allowing patients to purchase amenities to traditional primary care, including more attention and personalized services, and a “Patient-Centered Medical Home” model practice. The Patient-Centered Medical Home serves a patient’s primary care needs by excelling in the integration and coordination of medical care within the healthcare system. The National Committee for Quality Assurance has defined a set of criteria that practices must meet to achieve medical home status. Both models have gained recognition in recent years and there are pilot practices of the “Patient-Centered Medical Home” model being tested in certain states with health insurers, including Medicare. Dr. Mavromatis' goal was to create a hybrid care model, which she calls a “Patient-Sponsored Medical Home Model” practice that delivers high quality, well coordinated and personalized primary care.
To ensure the success of this primary care model, once each physician reaches a 500 patient membership, the practice will close to additional patients. A waiting list will be established to add in new patients as space becomes available.
Dr. Mavromatis became interested in exploring new models of primary care delivery while doing work to improve the care of patients with chronic illness as Director of Clinical Outcomes Improvement in General Medicine at The Emory Clinic.
2. What type of patients does this practice take care of?
This practice cares for a wide range of patients, similar to most primary care practices. While the practice is well-suited to care for complex patients with ongoing health conditions, it is also ideally poised to care for those who are healthy, but seek more efficiency, enhanced communication and personal attention and a very comprehensive annual physical exam that includes additional preventive screenings.
3. What extra services should a patient expect to get for the annual fee?
The annual fee does not cover medical services that are provided by health insurance plans. Rather, the annual fee allows a full time physician within our practice to limit care to 500 patients, instead of the usual 3,000 seen by most primary care physicians. As a result, we will have the ability to provide each patient with more individual attention and time. We feel strongly that by limiting our practice size we can do a better job researching your questions, coordinating your care, and communicating with you.
Our practice will include an annual comprehensive health assessment with an extended preventive laboratory evaluation. The components of this service that are covered by health insurance will be billed to your plan. Our annual health assessment will some more "cutting edge" preventive laboratory screening tests (link to Medical Services) that are not typically covered by health insurance. Our physical exam is similar in scale to an “Executive Physical” exam. However, in contrast to an “Executive Physical” exam, our fee does not purchase a one time exam, many features of which health insurance covers, it changes the longitudinal doctor-patient relationship by drastically reducing the doctor to patient ratio.
With your fee you will also receive extended office visits, allowing us more time to manage your health proactively.
Understanding that questions arise after office hours, and that illness is not confined to weekdays between 9 and 5, We will provide our patients with access to us by cell phone and by secure email. This type of direct communication with one’s physician is not standard practice.
4. What forms of payment will you accept?
For traditional medical services and office visits, we accept Medicare and most managed care insurance plans, with the exception of certain HMOs.
5. Will you accept insurance as full payment, less co-pay from insurance?
Yes. In order to remain in compliance with insurance company policies, the office visit co-pay or co-insurance will be the only additional patient payment. We will accept the contractual rates with the health insurance plans that our practice participates with. Tests, radiology and subspecialty consultation will continue to be billed to insurance in the usual fashion. I will refer to preferred providers for these services to minimize cost.
6. Are you attempting to create a limited patient load and provide more than usual service?
Yes, while medical insurance will still cover medical care, the amenities of direct access, communication, smaller panel size, and time spent with patients will differentiate this practice from other primary care practices.
7. Are you not actually increasing your work load by adding the additional membership benefits?
The additional work per patient will be off-set by the much smaller patient panel.
8. What options are there for first time patients to try out PPC Atlanta ?
We offer several options for first time patients. As we are available we will see patients for an initial problem-focused office visit or urgent visit and bill to insurance in the usual fashion without payment of a membership fee. If you pay cash, our office fee schedule is reasonable. In addition, we are available for an initial Meet and Greet visit free of charge. In this visit you can meet Dr. Mavromatis or Dr. Tong and have the opportunity to learn more about our philosophy as it relates to your individual health needs. Our quarterly payment plan also enables first time patients to test out the practice for several months prior to making a longer-term commitment. Should you decide to transfer your care elsewhere we will work with you to facilitate the transfer of records and provide you with names of primary care practices accepting new patients.
9. How does your practice model relate to national health care reform ?
We see problems in health care both from the perspective of primary care physician, and patient-consumer. We have tried to balance these two perspectives while thinking through this practice model. Studies have shown that high quality primary care delivery can effectively reduce overall healthcare cost, yet in our current system primary care physicians are not adequately supported to achieve this. We are hopeful that health care reform will eventually succeed in creating more equity for basic health care, while still maintaining the ability of consumers of health care, patients, to have choice so that innovation and quality are rewarded.
Health care is certain to change within the next ten years. We have decided to take a proactive role in pushing that change in a direction that we believe will benefit patients who value high quality medical care. We recognize that PPC will need flexibility to adapt to changes in health care and insurance policy in years to come. This will be a forward thinking practice in terms of technology and use of medical information, however it will continue to emphasis traditional aspects of the doctor-patient relationship, including the value of direct and personal communication.
"I have been active as an advocate for the American College of Physicians and with the Society for General Internal Medicine, lobbying for a variety of issues, including health insurance reform. My work leading health care improvement at Emory led me to believe that primary care delivery in this country can be improved, and that by empowering the primary care physician, overall health care cost may be reduced. My belief is that by changing the primary care market, physicians and consumers will exert pressure on insurers to include new options for patients, including models, such as mine, that support a more personal doctor-patient relationship." -Dr. Juliet Mavromatis