What Is Direct Primary Care?
How Direct Primary Care Works For You.
Traditional Primary Care is a “fee for service” arrangement (“plan”) between patient, physician, and insurance company, and we all know the frustration caused by confusing insurance rules, unclear benefits, premiums, copays and coinsurance costs, prior authorizations, denials, retroactive changes, nickel and diming, and other headaches. It is not an exaggeration to suggest that this approach can do more harm than good.
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Why DPC?
DPC benefits patients by providing substantial savings and a greater degree of access to, and time with, physicians.
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DPC allows family physicians to care for the whole person while reducing the overhead and negative incentives associated with fee-for-service third-party-payer billing. Benefits of DPC to physicians include:
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More time with patients
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Simplified revenue structure
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Decreased practice overhead
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Reduced adminstrative burden
Direct Primary Care is a rapidly (re)emerging alternative to the traditional practice model that removes health insurance hassles and red tape so patients can receive better medical care based on a more genuine and less complicated patient/physician relationship, at a price that is less than a typical monthly cell phone bill. In other words DPC mirrors the way primary care functioned before health insurance, with modern advantages and access to the Physician via text, phone call, telemedicine, and office visits.
DPC is not a gimmick or a fad; it is a growing trend that is established throughout the US since its origins about 20 years ago. In 2014 there were 125 DPC offices in the US, in 2018 there were 840, and in 2021 there were 1500, and DPC was a recognized entity in the ACA 2010 (Section 1301). The DPC model is ideally paired with a High Deductible Health Plan to cover catastrophic illnesses, injuries, accidents, surgeries, or other needs that DPC cannot meet.
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Concierge Medicine is confused with DPC, but typically this practice will bill to insurance with the traditional fee for service model, but also charge a retainer fee for non-covered services and/or VIP service. It almost always caters to the upper end of the financial spectrum and has no legal definition or established parameters as opposed to DPC, which was defined in the Affordable Care Act (ACA; 2012).
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Have a question about how Direct Primary Care can fit into your lifestyle? Contact us today!