Why benefit advisers should consider direct primary care for clients
Direct primary care is an innovative alternative payment model for primary healthcare being embraced by patients, physicians, employers, payers and policymakers across the United States.
DPC doctors typically charge a monthly subscription fee. However, they don’t bill insurance or even accept insurance payments.
The patient and doctor both win in DPC because the physician is able to deliver a more customized and personalized service while spending more time with each patient.
It is great for those with diabetes or high blood pressure who take daily meds and need to be coached and monitored to improve their health conditions.
The employer can pay for the DPC monthly subscription cost for employees and it is treated as health insurance and available for the tax exclusion for health insurance to employers provided under ERISA.
Certainly, DPC needs to be accompanied by a high-deductible health plan for catastrophic care.
And when the patient needs to go to a specialist or a hospital facility, the DPC will provide the referral and oversee the care while sending the patient to the lowest cost, highest quality care provider. The DPC provider partners with the employee in all of their healthcare decisions.
Medicine for everyone
DPC offices are popping up all across America. Doctors starting their DPC businesses are receptive to working with health benefit advisers who have clients interested in paying subscription fees for their employees for care.
DPC is often much less expensive than building a free-standing healthcare clinic onsite at company and delivers similar results.
Paired with a reference-based pricing health plan for catastrophic care, the employer will gain control of their healthcare spend and improve the quality of care for employees.
Don’t confuse DPC with concierge medicine, where an annual fee is paid and the providers still bill your insurance plan. The level of service can be comparable, but DPC providers don’t bill insurance — ever.
DPC is concierge medicine for everyone and it is a solution employers can embrace to lower the costs of providing healthcare while improving the quality and experience for the employee.
A DPC relationship can result in better health outcomes and significantly lower costs for both the employer and the employee.