Direct Primary Care

Exploring Direct Primary Care and how we can redefine the delivery of healthcare

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Top Five Things Employers Should Look for When Considering DPC Providers

The goal of DPC is to provide patients with convenient primary care in the effort to prevent illness, reduce hospitalization and encourage healthy living.

Over the last decade, prices for healthcare grew faster than the general economy, so it’s no surprise that almost 92 percent of Americans say they have a major or minor problem paying basic healthcare bills. While that percentage is dependent on many factors, it has motivated physicians and employers to move towards practicing and implementing alternative care delivery models that provide patients with affordable access to care.

One of the delivery models that has risen in popularity among employers is direct primary care (DPC). DPC is an alternative to traditional fee-for-service payments which allows physicians to provide access to primary care services by charging a monthly, quarterly or yearly fee. Since DPC is an alternative to fee-for-service billing, it allows physicians to practice medicine without the hassle of insurance billing codes. DPC physicians bypass the administrative elements of insurance filing and billing while adjusting their panel to spend more time with their patients. Service arrangements between DPC practices and employers vary but may include chronic disease management, physicals and routine labs. Often, members have convenient access to their physician through shorter wait times and after-hour call, text or video abilities built into their membership.

The goal of DPC is to provide patients with convenient primary care in the effort to prevent illness, reduce hospitalization and encourage healthy living. By providing basic and convenient access to patients, DPC develops a trusting relationship between doctor and patient, allowing for increased communication and the consistent monitoring of health concerns. Evidence shows that visiting a primary care physician before a specialist is associated with more appropriate, more effective, and less costly care.

There are several variations to the Direct Primary Care model, and each membership may include different features. Because of these variations, it can be difficult to know exactly what to look for. Below are five benefits an employer should look for in a DPC provider to ensure the quality of a membership:

  1. Availability 

    A benefit to paying physicians directly includes their ability to provide care at unconventional hours. When looking for a Direct Primary Care provider, ensure a physician is available for the symptoms that arrive after business hours. This can be in the form of text, phone calls or video. Resources such as telemedicine have been known to save patients anywhere from $309 to more than $1,500 in emergency department visits.

  2. Affordability

    A major differentiator for DPC, in comparison to other health plans, is affordability. Prices within a membership are pre-determined, freeing patients from financial burdens and unexpected bills. Be careful not to mistake DPC plans for Concierge plans which can provide similar benefits but tend to be higher in price. DPC plans are often billed monthly, bi-annually or annually and the monthly membership national average is nearly $80.

  3. Mobility 

    Electronic Health Records contain historical health information about a patient. In traditional DPC models, these EHR systems don’t talk to one another, fragmenting the healthcare system. Mobile Electronic Medical Records (EMR) can increase accuracy and efficiency should a patient need a prescription refill, is prescribed a new medication or need labs reviewed. Consider a DPC plan that provides multiple locations in the event of travel or relocation.

  4. Acute and Chronic Care 

    Patients build a strong, trusting relationship with their physician, encouraging the discovery of illness and disease sooner. By decreasing the barriers to quality primary care, patients and physicians can better detect, treat and manage disease states. Studies have found that employees that use a direct primary care model tend to have fewer recurring issues with chronic conditions, reducing emergency department and urgent care visits. When looking for a DPC make sure that the primary care physician offers a range of services from acute to chronic care.

  5. Patient Navigation  

    The healthcare system can be a confusing place even for educated consumers. With DPC, building a positive relationship with a healthcare provider allows you to contact someone to assist every step of the way. Find a provider that will navigate patients through their healthcare and assist in finding the most affordable and quality care.

The DPC model is gaining momentum within the healthcare industry at a time when many Americans are confused and burdened by health plan options and medical bills. As the price of traditional insurance increases, this cost-transparent solution for quality healthcare can be implemented into employer groups to support their uninsured or underinsured individuals, as well as those employees with high deductible health plans. The benefits of a DPC provider can be rewarding to both employers, physicians and patients. To provide a healthy relationship for everyone, keep these five features in mind when looking for your provider.