The Affordable Care Act (ACA) allows Direct Primary Care (DPC) providers to compete with traditional health insurance options when combined with a low cost high deductible plan in the health insurance exchange.
The DPC provider may only see 50 patients, allowing thorough conversations and building trust, which helps identify problems earlier and avoid illnesses. The traditional primary care provider could have 2,500 patients and 10-12 minute visits. The DPC also cuts 10-20% off the cost of healthcare simply by not billing insurance companies.
A monthly fee covers your primary healthcare needs, including the extended office visits, follow-ups on treatment plans, and in-house services such as basic lab work, x-rays, splints and vaccinations. Providers are a mix of physicians, nurse practitioners and physician assistants. The DPC will also recommend and coordinate services with specialists and acute care providers when applicable.
Direct Primary Care (DPC) has had many names, including direct care, direct practice medicine, concierge medicine, concierge health care, boutique medicine, retainer-based medicine, innovative medical practice design, membership medicine, and cash-only practice. With the ACA penalizing readmissions, and unnecessary admissions, you would think DPCs would be very popular in Washington, DC. The Direct M.D. Care Act (H.R. 3315) had many sponsors last year, but it’s currently stuck in committee. Reimbursements for Medicare patients, and particularly those who are dual eligible in Medicare and Medicaid are, once again, part of the problem.
- Healthcare Costs: Low-Hanging Fruit (Forbes, 4/04/2014)
- Direct Primary Care Puts Financial Control Back in Physicians’ Hands (Physician’s Money Digest, 10/21/2013)
- H.R. 3315 Direct M.D. Care Act (Direct Primary Care)