Producers seen as critical to direct primary care success

About 8,500 benefit brokers, advisers and insurance agents are being tapped to distribute direct primary care (DPC) plans to employer clients through the healthcare supply chain. All of them are, or will be, working with the Clinical Wellness Network (CWN) to scale DPC to employers across 25 states that have granted the emerging concept statutory approval with at least 10 other states expected to follow suit.

Dan Thompson, founder and CEO of CWN, has been busy building a DPC distribution channel that includes national brokerages he cannot name just yet that are deep into pilot programs with their customers.

Describing CWN as a direct-care organization that provides medical groups with programmatic capabilities to administer a DPC, he estimates that 97.5% of the model’s focus is on individuals vs. the group market, though he’s hopeful that producers will help move the needle toward the employer setting.

By the end of this year, Thompson expects about 15,000 people will be enrolled as DPC subscribers through their employers with the help of CWN – an estimate that could balloon to 44,000 at the end of 2020 and 77,000 at the end of 2021.

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The per-employee-per-month membership fees associated with DPC has been touted in recent months as a cheaper and more thoughtful approach than fee-for-service medicine. There are at least 700 DPC practices in 48 states serving more than 250,000 Americans, according to the Direct Primary Care Coalition. Other estimates suggest the number of practices is higher. Prices range from about $60 to $150 a month, depending on location and other factors.

‘Netflix of healthcare’

“It's the Netflix of healthcare that the next millennial generation is looking for,” says Dennis Hartin, president of Hartin Dynamics in Tampa, Fla., a subsidiary of Peel and Holland who’s also a Health Rosetta certified adviser.

In adopting a high-touch boutique approach, he hopes to sell the concept this year to between 20 and 25 employer clients with 500 total employees. If all goes well, he expects to easily double, if not triple, that number.

Howard Shandell, a general partner with Midwest Benefit Advisors, Inc. in Omaha, Neb., describes DPC as “the great differentiator” for brokers, advisers and agents without claims and red tape that cause headaches and slow patient access. It also gives lower-paid workers who cannot afford coverage “a way to access healthcare at a reasonable price,” he adds.

“We have a handful of prospective and interested parties that we've presented it to,” reports Shandell, whose goal is to enroll about 500 new members in DPC plans for 2019.

Hartin likes that DPC offers a service that can be used on a regular without a deductible, copay or balance bill. It’s a solid good standalone solution for his small and midsize employer clients who have few innovative options, which include a level-funded or fully insured community rated plan. When packaged with plans that cover catastrophic expenses, he says some DPC solutions improve care at half of the cost of traditional health insurance.

Apart from being an innovative solution for employers, DPC can provide producers with a competitive leg up. Christine Vago, SVP for OneBeacon Health, believes that benefit brokers and advisers who suggest these plans to self-insured employer clients will be better able to retain business and close new sales.

“Including the DPC physician in client renewal meetings is a priceless resource when determining benefits and setting strategic plans,” she says.

Thompson boldly predicts that primary care eventually will be “completely evacuated from the traditional mindset of healthcare.” Also, if enough brokers understand how impactful DPC is, he believes “it could be largely responsible for preventing us from going to single payer because of the potential savings to the healthcare system.”

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