A Brief Overview of Direct Primary Care (DPC) Model

In a course of their career, primary care physicians spend 40% of their practice revenue dealing with billing issues and are forced to manage huge patient panels with ever-shorter appointments. It’s not surprising that the Direct Primary Care model is gaining traction slowly. For primary care physician it’s an opportunity to cut the cord on many of the things that are driving their dissatisfaction. In 2014, over 4,400 doctors in the US had taken the plunge– a significant increase from just 146 in 2005.

Direct primary care is a new model in which patients pay their primary care doctor directly, instead of through their insurance company, which means patients pay a monthly fee along with visit fees straight to their doctor instead of paying an insurance company premiums and collecting reimbursement checks. Although, DPC does come with some challenges, research suggests physicians are increasingly demonstrating that the model is manageable. The DPC model gives family physicians a meaningful alternative to fee-for-service insurance billing that covers all or most primary care services including clinical, laboratory, and consultative services, and care coordination and comprehensive care management.

Direct Primary Care is not Concierge Care Model

Remember, DPC bears little resemblance to concierge medicine other than that patients pay fees to doctors. Under concierge care medical practices collect a monthly or annual fee, allowing the practice to see fewer patients and thereby offer greater flexibility in how they deliver care. However, physicians in a concierge care model do accept payment from insurance companies, which forces them to maintain billing and coding staffs, cope with denials of claims and meet the requirements of multiple payers.

Where in direct primary care, although the physicians collect a monthly retainer and in return, patients get unlimited visits to the doctor, along with access to channels (email and phone calls). In addition, DPC practices are also able to offer lower-cost medicine and labs in some cases, though the model for doing so varies. With doctors no longer having to handle health insurance administration their overhead drops substantially in Direct Primary Care.

Are you wondering the viability of direct primary care concept and how it compares and contrasts with a concierge practice? Join our expert consultant Wayne Miller in a power-packed session to address some of the myriad hurdles that can be overcome to proceed with a direct care arrangement.

Leave a Reply

Your email address will not be published. Required fields are marked *