Join a Direct Primary Care (DPC) Practice
My family pays $150 a month for an all-access membership for walk-in appointments to our doctor. We love it. It is called a Direct Primary Care (DPC) practice. Your first Bonus Tip in the Ten Free Tips to Spend Less on Healthcare is to join a Direct Primary (DPC) care practice.
Individual who have converted to Direct Primary Care (DPC) plans are reporting much greater satisfaction with DPC than in their traditional PPO or HMO. The primary reason is that doctors are spending two-to-three times longer with patients during office visits than in prior models. It’s the return of the primary care physician, the reinvention of the patient doctor relationship in many cases!
DPC is one of the most rapidly emerging models being employed and is likely to continue gaining momentum for several years to come. It is proving to save money for businesses providing commercial insurance and also improving patient access and satisfaction.
DPC is a value-based primary care model that increases operational efficiency and doctor-patient satisfaction while reducing overhead by cutting out the middleman, insurance, and a lot of the red tape and bureaucracy from healthcare. In short, DPC medical practices do not accept any form of insurance. Employers and employees are enrolled in an exchange that pays the physician a per-patient monthly retainer fee. This retainer fee most often ranges from $50–$100 a month per patient (the employer pays a portion and you pay the rest). In exchange, the individual is entitled to a specified set of services offered by the physician or practice.
How does DPC differ from a concierge practice? Concierge products are more often premium services that are significantly more expensive than $100 a month. Concierge medical practices often accept insurance but also charge a yearly membership for immediate access. Concierge practices are more like VIP or country club medicine, prominent in affluent communities where access to physicians is sparse or long wait times to see a doctor are an issue. This is not the case with the DPC model.
Aside from the financial benefits listed below, DPC has already enhanced access to the diminishing availability of primary care in many affected markets. Further, DPC is restoring the accountability of doctors when it comes to fulfilling the needs of their patients, and it reduces the administrative burden of many traditional insurance policies. DPC doctors claim they spend much more time with patients, often advertising up to thirty minutes of direct physician access per appointment. Because each DPC practice’s entire book of patients is often smaller than those of practices accepting insurance, doctors have more time for patient interaction and involvement in individual care planning. This additional time spent on care planning allows the physician to better communicate and explain why traditionally routine follow-up tests, exams, and referrals are not needed. With the extra time spent with patients, together they can discover ways to live a healthy lifestyle and optimize well-being.
Benefits of the DPC model include a stronger patient-doctor relationship, the reestablishing of the personal family physician, and enhanced access to the services offered by the doctor or medical practice. Since you are paying a retainer fee, the doctor has stronger incentives to shorten wait times, improve customer service, and keep patients satisfied. That kind of sounds like the way things used to be, doesn’t it?
As a matter of fact, Generation Xers were the first to experience the dissipation of the patient-doctor relationship, as the days of the personal family physician started going by the wayside in the 1970s and 1980s. The 1980s brought an expansion of HMOs, and health insurance largely became reactionary and focused more on catastrophic events. Year over year, the routine, annual health physical became less and less of a priority to American citizens.
There are other ways that DPC can save you money as well. DPC doctors minimize ordering unnecessary tests, exams, and specialty referrals and will often only refer patients to specialists who are preferred providers or Centers of Excellence that offer a discounted rate for the initial consult. The model actually puts the primary care doctors to work for you, incentivizing them to assist you in reducing avoidable spending on unnecessary services, which were so often ordered and abused in an FFS model. This additional physician time and access is a critical component of operating a successful DPC model. Each model differs slightly to best meet the specific needs of each community, but enhanced access to physicians, shorter wait times and longer face time with the physician are the common thread.
Employers who have converted to a DPC model—for the most part—have seen overall spending come down twenty to thirty percent on average. Those savings are being passed onto the employee.
Many of the services in the DPC policy are offered at no cost. For example, the savings on routine tests and wellness checks alone ranges from $35 up to $450 per procedure for many of these services including: twenty-four-hour access to physician or NP, allergy injections, annual exam, annual ap test, chronic care management, blood draws, EKGs, flu shots, lab tests, management of hospital and specialist referrals, nebulizer treatments, pregnancy tests, school and youth sports physicals, spirometry, strep tests, urine tests, urgent care and X-rays (imaging).
DPC cuts down your costs by offering each of these services at no cost to members. Further, although not free, the savings offered on routine lab work and prescriptions can be significant, as illustrated by the chart below.
Direct Primary Care is a great complement to cost-sharing plans as well. If you choose to enroll in a DPC practice, once you select a doctor you may qualify for a $100 a month discount off of your cost-sharing premium as a result. Cost sharing plans offer this discount as they have experienced healthier members with a much lower financial risk when their community members are affiliated with a DPC practice.
Once my family signed up, we qualified for and received a $100 discount from our cost-sharing provider for joining a DPC practice, so the total cost of a way better approach to accessing our primary care doctor was only $50 a month! That’s less than what one visit to a Minute Clinic or Urgent Care often costs me.
Also, keep in mind that DPC doctors care for only you, the patient, and your wallet. NOT THE HOSPITAL OR PHARMACY! The business model of pharmacy-based clinics (often hospital or pharmacy owned) and urgent care (usually hospital-owned) is that they make more money when they order more expensive tests, and then refer you to the hospital. That is YOUR money they are spending unnecessarily. Check out Direct Primary Care Frontier: https://mapper.dpcfrontier.com/ for providers.