Direct Primary Care (DPC) is a revolutionary provider-directed model that shifts healthcare decisions away from insurance companies and back to family practitioners and their patients. DPC gives patients 24/7 access to their trusted family practitioners through all forms of technology. With no copays or deductibles to contend with, patients spend less out of pocket. And with a designated medical team to coordinate care and prevent unnecessary duplication of efforts, most employers can expect to save up to 30 percent on their total healthcare costs.
The greatest benefit of organizations like DPC is that they remove the burdensome procedures and restrictions imposed by insurance carriers. This not only supports quality care — it also significantly reduces costs for patients as well as employers.
The current FFS system requires a practitioner to examine each patient in person to file an insurance claim and get paid. Under this model, providers cannot receive compensation when they communicate with patients by text or phone. In addition, primary care providers are trained to perform a number of procedures that insurance companies will not cover unless they are referred out to a specialist. DPC eliminates these and other obstacles by taking insurance companies out of the primary care equation — providing responsive care and proactive wellness management for one monthly subscription fee.
The DPC model bypasses the inefficient, administration-heavy process of claims administration to channel more of your healthcare budget toward actual healthcare. Patient advocacy throughout the continuum of care is another cost-saving measure that also enhances the patient experience. When a patient goes to see a specialist, a member of the DPC team ensures that the appropriate care is provided and guards against unnecessary duplication of tests or procedures.
We are committed to bringing the financial and wellness benefits of direct primary care to as many patients as our resources will allow.
In a word, the main difference is affordability. While concierge doctors focus on a handful of wealthy clients who pay a monthly retainer for their services, plus additional fees for services outside of their baseline structure, DPC is an affordable return to the era of the family practice. In addition to the dramatic cost savings, DPC patients enjoy 24/7 access to their medical team — along with routine laboratory testing services and urgent care.
While other direct primary care groups may have a menu of costs for lab tests and other common services, DPC includes all these in one monthly fee. This is an important difference that should be considered when comparing DPC practices to other groups that charge $20, $30, or 40$ a month — only to add on other fee-for-service costs that may well exceed the DPC bundled price. By leaving the inefficient fee-for-service model behind, we eliminate any motivation to “upsell” our patients.
Depending upon each employer’s agreement, DPC patients may be responsible for a portion of their monthly membership, or none at all. There are no copays or deductibles for any of the services covered under the DPC agreement. In cases that require hospitalization or specialized expertise, testing, or surgical procedures, the financial terms of the patient’s traditional insurance provider will apply.
Direct primary care practices that operate in the United States have demonstrated that employers who adopt a direct primary care model can save up to 30 percent off their traditional insurance bills, while improving employee health and reducing time lost due to illness.
By leaving the time-consuming tasks of insurance management behind, the practitioners of DPC are free to spend more time with their patients and to treat them according to their specific healthcare needs, rather than checking off boxes or second-guessing medical codes to satisfy insurance requirements.
Not at this time. Since the monthly fee cannot be tied to a specific medical service, and since patients may not use any services during some months, current tax codes prohibit the use of HSA funds for this purpose. There is bipartisan support, and multiple bills already exist, for a change in this IRS code that may allow for HSA payments in the future.