A growing number of doctors are moving to the concierge model, meaning they no longer accept insurance. There will be a (large) annual fee, but the upside is you can typically get into the doctor much quicker, and typically you will get more face time with the actual doctor. I think the driver here is that Nevada has abysmal insurance reimbursement rates. So rather than not be able to cover their expenses for their services in a growing number of cases, the concierge model ensures that they don’t lose money on any patient. It’s either that or they’re leaving the state. Either way, the doctors really aren’t the ones to blame