Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

For the Uninsured a Way to Beat the Pain the Doctor. . . but a Maryland Surgeon Shows It Can Be Done for a Flat $1,900 Fee

Newspaper article Pittsburgh Post-Gazette (Pittsburgh, PA)

For the Uninsured a Way to Beat the Pain the Doctor. . . but a Maryland Surgeon Shows It Can Be Done for a Flat $1,900 Fee

Article excerpt

ROCKVILLE, Md.

It began as a kind of experiment, says Alan Kravitz, a board- certified general surgeon with offices in Rockville and nearby Germantown, just outside Washington, D.C.

About five years ago, as the national economic recession was kicking in, Dr. Kravitz's solo practice started seeing fewer patients but more of those patients had no health insurance.

He noticed something else, too: While the insured patients enjoyed steep discounts negotiated through their insurer, the uninsured -- those least likely to be able to afford it -- got charged full freight. His thought: "It's completely upside down."

So Dr. Kravitz set about constructing an Internet-based practice catering to uninsured patients with hernias. Where someone typically might pay $6,000 to $9,000 at a hospital to repair a hernia, he charges a flat $1,900 fee.

His approach is simple, yet it has a revolutionary feel -- after getting a local surgical center and anesthesiologist to buy in on the set-fee idea, he has squeezed every efficiency he can into a procedure that takes about one hour to complete and rarely has complications.

"He's the Henry Ford of medicine," said Brian Friday, an uninsured Monroeville-area handyman who had Dr. Kravitz repair his double hernia last year. "He has an assembly line organization -- a place for everything and everything in its place. And he makes it affordable for everybody who needs it."

The process is simple: Anyone Googling search terms such as "cheap hernia surgery" will bring up ads from different physicians, including Dr. Kravitz. What stands out is his fixed, all-inclusive fee.

Physicians traditionally don't post a price list, he noted, and there's a certain financial risk involved. If the operation takes longer than expected, due to scarring from previous surgeries or some other complication, the price remains the same. But he thought the expected increase in patients would lessen that risk.

"The experiment was to offer heavily discounted hernia surgeries that made money through increased volume."

Once patients contact the office, they get a return call from Dr. Kravitz. Because most of the patients come from out of state, he wants to make sure they actually have a hernia and that there aren't any other medical issues, such as a heart condition or breathing or clotting problems, that would preclude surgery.

Patients typically can get in within two to three weeks and may head home that day.

Today, Dr. Kravitz, 54, can perform eight hernia procedures in a day at a local surgical center. More remarkable has been his reach - - in one 24-hour period last week, his office fielded inquiries from Eastern Pennsylvania, Tennessee, California, Texas, Arizona, Florida and Indiana. After someone called from North Dakota about a month ago, he says, the office has now seen patients from all 50 states. …

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