Direct primary care (DPC) is a medical practice that puts its patients first. This is an exponentially growing model adopted by many healthcare professionals and patients. According to data from the DPCare organization, there are 1600 DPC practices in the US.
With DPC, you can get access to your doctor whenever you need it for less than the cost of traditional health insurance. Provider-led delivery systems have been around for decades but have only recently been gaining popularity in the United States thanks to the increasing cost burden on patients and employers.
What Is Direct Primary Care?
Direct primary care is a new model of primary care in which doctors charge a monthly membership fee instead of charging for each visit. The fee covers all primary care services, including office visits, lab tests, and procedures like physical exams and consultations with specialists.
Direct primary care providers are not insurance companies. They don't bill insurance companies or third parties on behalf of their patients. Instead, they offer lower-cost alternatives to traditional health plans that cover only hospitalizations and other high-cost services.
DPC memberships typically cost less than what people pay now for insurance premiums plus out-of-pocket expenses when they need medical attention outside the network and often much less than an employer's contribution toward an employee's coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act).
The DPC model has become quite successful. However, there is still a lot of space for success. According to Hint Health, which took data from around 3,500 DPC clinicians and 800,000 members, almost 68% of consumers interviewed do not know about DPC.
Why Choose Direct Primary Care?
DPC is a healthcare delivery model that puts the patient at the center of everything, and it's quickly gaining popularity among doctors and patients alike. Here's why:
Better Health Outcomes
DPC membership is an affordable way to get the care you need. The average monthly membership costs vary based on the care, location, services, etc. This amount may seem like a lot compared to what your insurance company pays for health services.
But remember that a DCP member doesn't have copays or deductibles. Their monthly fee covers the cost of every visit and prescription. Plus, customers can see their doctor anytime without worrying about whether or not they're sick enough for an appointment. Data shows that with a membership fee of only as little as $100 per adult per month, you can simply message the doctor and get a same-day appointment.
This means lower costs for everyone involved in DPC. Patients pay less out-of-pocket than they would with traditional insurance plans. On the other hand, doctors make more money because they don't spend as much time dealing with paperwork and fighting claims denials.
Insurers save money on both sides by cutting down on expenses related to reimbursements. And employers save even more because employees aren't taking off days from work due to illness.
Lower Costs
DPC is a lower-cost alternative to traditional healthcare. For example, you can expect to pay $150 for an office visit at a DPC practice versus the average of $240 at an urgent care center or emergency room.
DPC also allows you to bypass expensive prescription drugs by providing prescriptions from doctors who know their patients well and have been trained in pharmacology. This results in fewer side effects and better compliance rates than traditional drug plans provided by insurance companies.
Additionally, lab tests are typically ordered directly through your physician rather than through insurance companies, reducing costs. With DPC comes greater access to physicians when you need them most, during after-hours emergencies like trips to the ER or hospitalization stays that can cost thousands per day, depending on what kind of insurance coverage you have.
According to an article published on the NCBI website 1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504342/, DPC has proven beneficial in tackling financial challenges associated with healthcare. It is a successful financial model for accessing healthcare services at affordable costs.
Enhanced Patient Experience
Besides lowering costs, DPC also helps improve the patient experience. This is natural because the model keeps them at the center. Here are some ways DPC is improving the patient experience:
- Patients can make appointments online, which is convenient and helps them avoid the hassle of having to call and wait on hold.
- Patients have access to a secure messaging system to communicate with their doctors. This allows patients to ask questions or share concerns without waiting for an appointment.
- Because DCPs offer same-day visits, patients don't have to wait days or weeks between visits like in traditional settings where there may be long appointment wait times due to high demand from other patients.
- DCPs can give quick responses when it comes down to clinical issues, such as prescriptions or answers regarding specific health conditions because they've already seen those symptoms before with previous patients.
Who Should Get Direct Primary Care Membership?
DPC membership is for everyone. A DPC membership is suitable if you want more control over your health and to save money on healthcare.
DPC membership is also ideal for the following:
- People looking to get healthier don't want to be stuck with a long wait at the doctor's office or hospital.
- Those who want a more personal relationship with their healthcare provider.
- Those who value affordable access to high-quality medical care without insurance overhead.
- Individuals whose employers offer them company coverage but whose premiums keep increasing year after year, making it difficult for them to make ends meet.
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Will You Still Need Insurance Coverage?
While DPC is an excellent alternative to traditional insurance, it's not for everyone. If you have a pre-existing condition and need coverage or are self-employed and need health insurance, then DPc may not be right for you.
Suppose you have retired early or have no plans on retiring anytime soon but still want some protection against the medical expenses that come with getting older. In that case, traditional health insurance might still be the best option for your situation.
Conclusion
Direct primary care is a great way to get the best medical care possible while saving money and time. It's a perfect fit for most people, but there may be some situations where traditional health insurance still makes sense.
Additional resources and citations
- 1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8504342/
