…is the point that Dave Chase, who founded patient information/engagement portal Avado and sold it to WebMD in 2013 (and with them until last month), is making in this Forbes article. As newspapers found their readership leaving in droves for online websites that delivered ‘news they could use’ faster and more interestingly, healthcare systems are finding that their patients are finding healthcare services outside their bricks-and-mortar:

• Onsite workplace clinics (including telehealth/telemedicine hybrids such as HealthSpot Station–Ed. Donna)
• Direct primary care providers such as Iora Health, Qliance, DaVita’s Paladina Health
• Retail clinics: MinuteClinic, TakeCare Health
• Medicare Advantage-only programs such as CareMore [TTA 5 May] and Healthcare Partners
• Domestic medical tourism by large, self-insured companies for elective surgeries

This Editor would argue that these forces are at work even in (and perhaps because of) centralized payment systems, and are worldwide, not just in the US. Certain communities such as Rochester, NY, Dubuque IA and Seattle are focusing on lower healthcare as attractions to business–and countries such as Costa Rica, Mexico, Brazil, Singapore, Hungary and India are capitalizing on US-quality facilities and doctors to gain medical tourism for elective and self-paid surgery.