WHY THE WEDGE?

The Wedge of Health Freedom (“The Wedge”) is a nationwide disruptive innovation for health care launched by Citizens’ Council for Health Freedom The WEDGE will restore the caring heart, ethical principles, affordability and patient-centered focus of medicine in America. Our vision is patient-friendly, price-friendly and privacy-friendly medical care. The eight principles of The WEDGE are:

• Transparent, Affordable Pricing
• Freedom to Choose
• True Patient Privacy
• No Government Reporting
• No Outside Interference
• Cash-Based Pricing
• Protected Patient-Doctor Relationship
• All Patients Welcome

The WEDGE is a free-trade zone for health care – a legally-protected zone of deregulation into which patients and doctors can escape from government and health plan controls over medical care — and find each other.

As we grow participation in The WEDGE, we expect other physicians, practitioners, pharmacies, and facilities to feel comfortable moving away from health plan and government contracts and into private contracts with patients.

Patients can help us grow The WEDGE by sending their doctors a “Join the Wedge” message (click on SHARE). Joining The WEDGE is a voluntary collaborative venture between independent third-party-free practices and the non-profit CCHF.

The WEDGE was launched at a press conference at the National Press Club in Washington, D.C. on June 28, 2016. The first wave of Wedge practice sign-ups was announced on August 31, 2016.

Within the circle of health care, there is a pie-shaped space—a WEDGE—where health freedom exists today. These practices are independent. They do not accept third-party payments from government, employers, or health plans. They accept payments only from patients, regardless of the patient’s coverage status.

Our aim is to protect and grow that space of freedom so that patients and doctors will always have a place to escape from the current system of corporate and government control. We branded that place The Wedge of Health Freedom. We want this interference-free zone to be: 1) identified and recognized as a space of freedom, 2) made visible to the American public, 3) legally-protected and 4) greatly expanded for the sake of personalized patient care, medical excellence and health freedom for all.

No. However, you can ask your health plan or government program to reimburse YOU for the cost. Neither is obligated to do so.  Wedge doctors practice independently and contract directly with you, the patient. They have no relationship and do not contract with any insurers. Patients pay by cash, check or charge according to the transparent pricing structure of the independently-operated practice.

If you have out-of-network coverage, you may choose to seek reimbursement from your health plan for out-of-network care as allowed under the contract you have with your health plan. If you have a Health Savings Account (HSA), you may be able to use it to cover your costs or get reimbursed for care.  However, some health plans require a medical code for reimbursement. Patients using a Wedge practice may ask the Wedge practice to provide a billing code but should not expect the practice to do so. Part of being an affordable, interference-free, cash-based practice is not participating in the insurance coding system or acquiring the expense or expertise necessary to find the billing codes or use the coding system.

NOTE: Many people will never reach the high deductibles now imposed under the unaffordable Affordable Care Act. Wedge practices often offer patients a more affordable option for care. In short, you will likely get more care for your dollar and have more money left over in your pocket despite no reimbursement from your health plan or government agency.

Wedge practices welcome all patients, but they do not participate in Medicare or Medicaid programs. Thus, these practices are not subject to the government’s treatment controls, reporting requirements, or penalties and fines. Notably, cash practices report seeing both Medicare and Medicaid patients.

Wedge practices can offer prices closer to the actual cost of doing business because these practices do not sign restrictive contracts with health plan corporations and do not participate in Medicare or Medicaid. As a result, they are not strapped with time-consuming and costly corporate and government regulatory and reporting requirements (e.g. 132,000+ pages of Medicare regulations, 20,000+ pages of ACA regulations). They are also not required to spend $32,500/doctor/year (for government-mandated electronic medical records) or the staff, lawyers, coders, scribes, data reporters, data systems, IT staff and administrators needed to comply with them.

Therefore, the cost of operating a Wedge practice is significantly reduced and those savings can be passed onto patients in lower prices, individualized care, high-quality time with the doctor — including time to get your questions answered — and true patient privacy.

That said, given the often lower costs and the higher-quality benefits of Wedge practices, you may find the insurer’s or government’s lack of payment an increasingly insubstantial consideration when deciding whether to choose a Wedge practice. As Brenda Jones, a patient of Dr. Brenda Arnett, M.D. in West Virginia, told Scripps Howard News Service:

“Paying her up front doesn’t matter to me at all. The level of care that I get is worth twice what she’s charging.”

NOTE: Although health plans and other insurers cannot prevent you from paying an out-of-network Wedge practice for care, few patients realize that contracts between network practices and insurance companies often prohibit doctors from accepting payments from patients for care that is denied by the insurer. This troubling restriction, typically called a “hold harmless” provision, may discourage contracted doctors from disclosing and discussing all possible treatment options with patients. Wedge practices are free from these hidden contractual impediments to physician-ordered patient care.

Examples include: internist Brenda Arnett, M.D. (Virginia), Robb Oto-Neurology Clinic (Arizona), and Empower Family Medicine (Georgia). Wedge-like practices are located in all 50 states. Some practices are nearly Wedge-ready. For example, Davis Orthopedics (Alabama) has opted out of Medicare, provides cash-based prices for all, and only accepts Blue Cross Blue Shield insurance. We strive to invite all cash-based practices into The Wedge so patients can easily locate them…and so doctors who want to escape into freedom will realize that it’s possible to do so.

Thousands. As more cash-based practices emerge online nationwide — and as patients discover and use them — we look forward to the day when the current small but growing “wedge” of health freedom becomes a hemisphere of health freedom and then eventually a full circle of freedom for patients and doctors. In the future, we also envision affordable, confidential cash-based hospitals in The Wedge, free of costly third-party-payer restrictions and onerous reporting requirements. Check out the affordable Surgery Center of Oklahoma to see how low prices could go free from the costly bureaucracy of health plan contracts, government regulations, and mandated electronic health records.

Ask the doctor. The best way to discover how your date is protected is to ask the practitioner and clinic staff. Specifically, ask if medical records data is behind a firewall, protected from outside access. Ask how the practice makes sure the data stays within the four walls of the practice. Ask whether there are any exceptions to patient consent requirements in their office. Because the doctor’s office has a direct contractual private relationship with you—the patient—your health information should not be shared without your express, voluntary, written consent.

The practice may or may not have an electronic health record, however, in a Wedge practice, under the principle of “True Patient Privacy,” the practice should understand that the patient’s record should not be hooked up to a state health information exchange (HIE), corporate health information exchange (e.g. Carequality) or the federal national medical records exchange system called eHealth Exchange. Notably, clinics are on an honor system, as it’s impossible to know or track how clinics handle the confidential medical records of patients.

We allow practices that respond yes to the following seven questions to join the Wedge.:

1. Have you opted out of the Medicare program?
2. Have you dropped all contracts with health insurance companies?
3. Have you opted out of Medicaid and ACA coverage programs?
4. Do you have an EHR (Electronic Health Record)?
5. Is your EHR interoperable?
6. Do you have a firewall that prevents outside access to patient data?
7. Do you have a separate patient consent form for sharing of patient data?

First, practices should look at our list of eight Wedge Principles:

• Transparent, Affordable Pricing
• Freedom to Choose
• True Patient Privacy
• No Government Reporting
• No Outside Interference
• Cash-Based Pricing
• Protected Patient-Doctor Relationship
• All Patients Welcome

Second, if the practice follows these principles, simply use the website form for doctors to request that your practice be added to our online map of Wedge practices. As our disclaimer notes, CCHF does not make any claims about the practices that request us to add them to our map. We seek to validate that they are licensed to practice, have opted out of Medicare, and do not have contracts with health plans or insurers. This list is a voluntary collaboration with interference-free practices nationwide that want to participate in the movement back to health freedom. NOTE: We reserve the right to limit the map to third-party-free practices and to de-list a practice for any reason at any time.

Encourage your patients to visit JoinTheWedge.com and to discuss the benefits that come from having a doctor or using a practice that is free from outside controls on the practice of medicine; a practice that is free to work with the patient as an individual. These benefits include lower costs, more time with you, a trusted confidential patient-doctor relationship, an advocate when they cannot advocate for themselves, and privacy of confidential medical records.