Rising health costs can make it difficult for patients to receive the care they need, including insurance.
Direct primary care (DPC) is an alternative payment model that offers family physicians the opportunity to charge a weekly, quarterly or annual membership fee for all or most primary care services.
Compared to traditional fee-for-service insurance billing, DPC can provide patients with significant savings and flexibility to access their health care provider as required without fear of their inability to pay. Read more about direct primary care, its costs, and how a premium broker can help you get the coverage you need.
What Is Direct Primary Care?
Direct primary care is a financial arrangement that is made directly between the patient and the healthcare provider. It cuts insurance providers out of the process, eliminating the need for both patients and providers to file health insurance claims. Instead of submitting claims to insurance providers, patients pay certain visit fees or monthly fixed fees that give them access to certain medical services, such as laboratory services, same-day or next-day appointments, and sometimes even house calls.
Direct primary care physicians generally do not accept insurance payments to avoid high overhead fees and a complex relationship with insurers.
Many primary care providers deal with their patients on the individual health market. Others may, however, collaborate with certain insurance companies or employers to give patients the opportunity to receive all-inclusive primary care.
Unlike traditional payment arrangements that require providers to pay for each individual service, physicians in the direct primary care model do not charge for each service that significantly reduces the cost of office staff. However, there are some health services that most providers of direct care do not provide, such as more extensive testing and hospitalization.
What are the benefits of direct primary health care?
Direct primary care is an innovative alternative to healthcare that allows patients and their healthcare providers to establish closer professional relationships.
It can be difficult to get an appointment in a conventional healthcare setting. Once you finally get a chance to see your doctor, you may feel rushed because your physician hurries to see thousands of patients in a short time frame.
It can make it difficult for patients to believe that they are actually getting the quality time they need to understand their health concerns. Having direct primary care will help to eliminate many of these kinds of complaints.
With a conventional health insurance plan, a patient usually leaves the doctor’s office without knowing exactly what— and how much— their insurance is being paid for. When deductibles or copays are added and discounts are negotiated between the doctor and the insurance company, the patient may provide an overview of what they are expected to pay for the visit. Direct primary care removes the ambiguity. Patients are aware of the exact monthly cost of membership as well as the flat fee for appointments. The fee does not vary on the basis of the services provided.
Direct primary care patients usually have access to same-day and next-day visits, 30 to 60-minute appointments, and 24/7 call, email, text or video chat with the provider. With conventional health insurance plans, many physicians don’t make this much easier because it’s hard to charge for phone or video appointments.
More committed primary care services are open to patients each year. If you are interested in this type of plan and already have a primary care physician, you may inquire if they are willing to enter into a direct primary care arrangement. If not, or you do not currently have a primary care provider, the Today Clinic helps you locate a direct primary care practice in your area.