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	James L. Holly, M.D.

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Facebook - Who started HMO-care with no copay for primary care?

Untitled Document

Who started HMO-care with no copay for primary care?

Tonight Carolyn and I were watching a Hallmark Christmas movie. Even though they all have the same story, we are addicted. An advertisement for a Medicare Advantage plan said, “Zero copay in most places.”

I asked Carolyn if she knew who started a zero copay for HMO patients. She did not.

I told her, “We did and really I did,”. Through SETMA’s analytics, we had found that patients with a low or no copay had better outcomes than traditional Medicare beneficiaries.”

I told our HMO that I wanted to have a zero copay. They said with a zero copay, you will be inundated with patients abusing the ability to see s doctor with no cost.

I responded that I knew how to deal with abusive patients. The results of zero copays?

1. Better out comes than traditional Medicare,

2. Better control of diabetes, Hypertension and cholesterol.

3. Patients had no barriers to getting care.

And, as for the concern that patients with zero copays would abuse the clinic? It happened zero times.

SETMA has made a difference in patients, illnesses and communities. We have been innovative and transformative and the interest of the patient always came first. Thus our motto: Health Care Where Your Health is the Only Care.

James L. Holly, M.D.
CEO, SETMA

Adjunct Professor
Department of Family and Community Medicine
UT Health San Antonio
Joe R. and Teresa Lozano Long School of Medicine

Associate Professor
Department of Internal Medicine
Texas A&M University
School of Medicine

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