Transforming a practice into a DPC takes time and resources, so many organizations are working to help doctors transition and market their practices. The Direct Primary Care Practice Model is one of the fastest growing models of primary care. Patients or their employers pay doctors directly – hence the name Direct Primary Care – versus working through insurance companies. Also patients have more direct access to doctors through same day appointments, more time with physicians and greater access to procedures, diagnostics and medications.
HOW DOES DPC BENEFIT PRIMARY CARE DOCTORS?
In a DPC model, patients pay what’s called a periodic fee, which is usually on a monthly basis, but some physicians employ monthly, quarterly or yearly plans.
For that fee, patients have access to a full range of comprehensive primary care. The fee is designed to pay physicians for the range of duties that are involved with taking care of patients.
The fee-for-service system only pays physicians for seeing the patient in the office, while DPC physicians are free to spend larger amounts of time with the patients in a variety of settings from telephone visits and electronic visits – forms of patient care that’s faster and more convenient for established patients.
WHAT DOES DPC DO FOR PATIENTS?
By using DPC physicians, patients end up paying less than if they use primary care insurance. In addition to the DPC retainer, patients typically buy what is called “wrap-around coverage” that takes care of emergency and hospital care.
Under the DPC model, patients are given more individualize care through ongoing follow ups and spend more time with their doctors who now have a small set number of patients.
HOW DOES DPC DIFFER FROM CONCIERGE MEDICINE?
Concierge medicine typically charges higher retainer fees for services than DPC. These types of practices also take insurance that covers primary services as the concierge fee is for services like same day appointment and 24-hours access to doctors that aren’t covered in typical insurance plans. DPC retainer fees cover primary care services, so many DPC practices don’t take any insurance, so physician overhead is less.
HOW DOES IT AFFECT INSURANCE COVERAGE FOR PATIENTS?
Physicians in DPC practices can treat patients who have insurance coverage through employer or individual plans. Privately insured patients may receive reimbursement for care through the claims process that they handle themselves instead of physicians’ office, but this is rarely necessary due to the low cost.
HOW DO I TRANSFORM MY PRACTICE INTO A DPC?
The first step in transforming a practice to a DPC is to conduct a practice evaluation to determine whether a practice should take the next step. In that evaluation, physicians should ask how important it is for them to spend more time with patients, how it may affect practice management and operating costs and how current patient population may respond to the new model.