What is Direct Primary Care (DPC)?
Direct Primary Care (DPC) is an innovative healthcare model where physicians partner with their patients to provide primary care services under a flat, periodic membership fee. By moving outside of the administrative burdens of the traditional insurance-based billing system, DPC practices are able to provide a wide spectrum of care in a transparent, affordable manner. DPC practices—now a grassroots movement numbering over 1000 nationwide—are able to do this while offering patients a higher level of service, communication, and relationship, than what is often found in our dysfunctional healthcare system. Philosophically, the model is intended to restore the patient-physician relationship without the intrusion of insurance companies. (Source: DPC Alliance).
Paid by monthly fee directly to physician, insurance is not billed
Monthly fee covers the cost of most medical care provided within the office – same/next day office visits, phone calls/text messages with physician, and available medical procedures
Benefits of Direct Primary Care
Physician panel capped at 500-600 patients, allowing longer visits (40-60 minutes) and availability for convenient care with your physician on your schedule
On-call availability by your physician nearly all the time for emergencies by phone/text
Longer visits allow for larger breadth of treatment, allowing more medical conditions to be treated by your physician and less need for specialty referral (if desired by the patient)
Blood testing offered through the office will be offered at wholesale cash price which is at a steep discount compared to most hospital labs (most labs are in the $2-10 range)
Most generic medications offered for wholesale cash price, at a steep discount compared to pharmacies even sometimes compared to price after insurance payment
Access to significantly discounted cash prices on imaging studies such as CT/MRI
Who could benefit from Direct Primary Care?
1. Multiple medical problems/medications – Someone in this situation could get a lot of value from having a physician with the time to make sure every problem has been fully addressed. The ability to closely follow-up in person or to access your doctor by phone/text could reduce the need to go to the ER or be admitted to the hospital. Additionally, a doctor with enough time to fully address all medical problems can reduce the need for some referrals to specialists, further streamlining care and costs. Also, wholesale medication and lab prices can save a significant amount if needing multiple medications on a daily basis.
2. High Deductible Insurance Plan/Health Share/Uninsured – Someone in this situation can save a lot of money with a DPC membership. By having full access to a physician that can treat 90% of health issues nearly 24/7, it nearly eliminates the need to ever visit an urgent care and can eliminate the need for many ER visits as well as reduce the need for specialist visits. Wholesale labs and medication prices as well as negotiated cash imaging prices can save you up to 10 times compared to the billed price to insurance before your deductible is met (example – Cash price MRI $500 compared to $5000 typically billed to insurance). A single typical ER visit can easily cost over $1000 which would cover the whole cost of a DPC membership for a year.
3. Value Convenience and Access – Nearly 24/7 availability to your personal physician for emergencies, daily availability by phone/e-mail/text message and same/next day appointments upon request
4. Annoyed with Insurance and Medical Industry Complexity – DPC was created to push back against the inefficiencies and frustrations of insurance and healthcare systems. The model is meant to be as simple and transparent as possible. Your physician acts as your navigator through the health care system if you are needing additional services to help decrease the overwhelming complexity and lower the chance of paying way more than you should.
5. Value a relationship with your doctor – The focus in DPC is that your care comes almost entirely from your doctor. This adds convenience as well as quality to the care that can be provided through decreased fragmentation. The development of that physician patient relationship is what this practice is all about.
