IPALC Patient Newsletter
October/November 2016 - In This Issue:

Future Events
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Search for a physician in Lee county through our Physician's Directory on IPALC.org

Thank You
Thank you to the community at large, who support the vision of IPALC and the leaders who devote their time, talent and treasure to keep goals in focus.  Without the patients of Lee County, the Physicians of Lee County wouldn't matter!

Raymond Kordonowy, MD

Please click the highlighted links for more detail and information related to the topics mentioned in my message. Most folks don't know it but a law passed two years ago called MACRA is beginning to affect Medicare patients and their physician providers. This law has "set" reimbursement to doctors collectively to a fixed amount of money. The government is requiring doctors to join an Accountable Care Organization. An ACO is effectively an HMO (Health Maintenance Organization). If any of our collective memories are working, we remember this turned out to be a fiasco of gargantuan proportion. The 90's and early 2000's was consumed by a massive consolidation in the health care industry under the modeling of the HMO and it was a big belly flop.

Medicare patients be aware- your doctor may be enrolling you in the ACO experiment and this will affect your care. Under this model the government is providing bonuses to doctors who "save the system money" while penalizing doctors who "spend more money" in their patient group. Doctors will be in a perverse situation of denying some patients into their practice out of fear they will cost them too much in the global budget.

The irony here is that the government took over the insurance market with PPACA due to "cherry picking" that insurance companies were doing but with ACA they will now force your doctor to "cherry pick" their patients. You doctor is supposed to inform you if they are in an ACO program. If they are and you are a Medicare patient, you are also in an ACO program. It is my belief that society made a "deal with the devil" when they allowed the government to provide for their health care. The results of that deal are now coming to full fruition. As voters I would encourage us to strongly advocate for Medicare vouchers so the money you paid in can get paid back to you and you can shop the free market for your care. Free markets ultimately get the best service and the lowest cost-which is efficiency, again ironically what our government claims it wants.

In this month's newsletter we feature Dr. Rebekah Bernard MD of Family Medicine. She has started her Direct Patient Care Practice recently. This is a terrific value for persons with high deductible insurance and for families. As a Family Physician Dr. Bernard is qualified to take care of the whole family- babies, children and their parents. Nationally this method of payment and practice is starting to catch on like wildfire. It is a very good thing and puts the patient and doctor back in charge of their care. Pick a doctor for who they are and their qualifications, not because they are in your insurance network.

IPALC will be advocating for patient's rights during hospitalization by attending a doctors meeting October 6th to review and discuss the hospitalist program. I have penned an offering to the local News Press which I hope will be published this week. It this editorial I inform the public and the hospital board of its authority and charter through what is called the Enabling Act. This document is an eye opener and offers a tremendous opportunity for Lee County citizens to approach the board regarding how the present hospital system is serving the public.

Enjoy the links and "in the news" section and please stay engaged. As the buyer of services IPALC is trying to bring you information to make you a smart consumer. We are continuing to pursue a live operator service on our website and hope to have a solution and active phone line in the next 1-2 months- stay tuned!

Thanks for considering IPALC doctors for your care.

Ray Kordonowy MD President IPALC

Physician Spotlight

IPALC would like to offer you a different feature physician each month to help you learn who our Independent Physicians are in our community. 


As you begin reading our newsletter, if there is a specific group or physician in Lee County you wish to know more about,  send an email to  info@ipalc.org so that we may feature that physician or group.


Rebekah Bernard, MD has worked as a Family Physician for over 15 years. Dr. Bernard graduated from the University of Florida with a degree in Sociology, and received her medical degree from the University of Miami. She completed her residency at Florida Hospital in Orlando. Dr. Bernard has served as an adjunct professor for the Florida State University College of Medicine and Nova Southeastern University College of Osteopathic Medicine.

Dr. Bernard is the author of the book " How to Be a Rock Star Doctor," published in July 2015, and is often asked to give lectures and presentations to physicians, residents, and medical students.  
She is excited to bring a new model of health care to southwest Florida, as one of the first Direct Primary Care practices in the area.  Dr. Bernard believes that Direct Primary Care will restore the physician-patient relationship, and make quality primary care affordable for everyone.

  • Listen to Twila Brase RN's informational interview about what is really happening to our health care system.  Patients and doctors need to demand their relationship be brought back to its sacred position.  Government and Insurance companies- stop treating us like liabilities.
  • Incentives and Price-fixing: Lee Memorials profits drop this year compared to last but still top 70 million.  Read this report to learn that Lee Memorial's growth is coming from the outpatient services side of their organization.  I have maintained for years that the irony of the health care market is that hospitals are becoming a horse and buggy industry.  The government's policies are rewarding hospitals with "better pay per service" which is allowing them higher profits relative to us independent providers.  This policy is shifting hospital incentives away from being hospitals and towards trying to be outpatient service providers- ironic right? 
>> READ PRESIDENT'S MESSAGE << (click here)



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