Current State of Primary Care
The current state of primary care delivery in our country is dire. The current model of care demands that more physician time be spent on compliance with an increasing number of insurance coding and regulatory requirements instead of prioritizing care for patients. This coupled with the fact that physicians are being forced to see upwards of 20-25 patients/day (15 minute apt slots with 8 minutes of face to face time) is leading to physician burnout, adding to the increasing physician shortage in our country, and is leading to increased “downstream care” (expensive referrals, ER visits, urgent care visits, hospitalization, etc) that could be minimized or prevented if primary care physicians had more quality face to face time with each patient. The ensuing increased number of claims leads to higher premiums and deductibles for employers and employees. This trend is likely to continue in the existing primary care model but for employers, employees and individuals who are looking for change, the Direct Primary Care Membership model (which operates outside the insurance system) can provide a lower cost, high quality care option which restores the patient-doctor relationship to the way it was years ago.
Direct Primary Care, when coupled with a lower premium High Deductible Health Plan (HDHP) or a Health Care Sharing Ministry can produce significant savings for the employer while at the same time improving access and reducing out of pocket costs to their employees. Bringing together the "Buyers" (employers) and "Sellers" (doctors) of healthcare creates a win-win-win relationship for the employer, employee and the primary care physician.
Fully insured employers who choose higher deductible policies (HDHP) will save money on premiums (as will their employees) effectively lowering costs. The HDHP will provide catastrophic coverage and PMPdirect will provide the primary care at a much lower out of pocket cost to the employee. Smaller employers may even consider not purchasing a corporate policy and instead provide increased payment to employees to purchase either their own individual plan (often cheaper than a corporate based policy) or to purchase a Health Care Sharing Ministry Policy which can provide excellent coverage for a fraction of the price of an insurance policy. Health Care Sharing Ministries work very well with DPC often providing individuals considerable cost savings.
Self-funded (Self-insured) employers can benefit greatly by working together with a DPC practice. Our bundled and transparent pricing provides employers with a "fixed" amount as to what it will cost each employee for their primary care for the year which helps employers budget accordingly. Self-funded employers pay claims directly (unlike fully insured employers where the claim risk is the responsibility of the third party insurer) and therefore would see a significant cost savings when paying DPC rates instead of traditional insurance based rates since DPC provides a low cost primary care option at a fraction of the price that would typically accrue in an insurance based system for similar services. Self-funded employers will often incorporate a DPC option within their plan documents (along with their existing network) and incentivize their employees to use DPC which can lower costs for both the employee and the employer while providing high quality care. DPC doctors also refer employees to direct pay free market specialists, direct pay radiology facilities and direct pay ambulatory surgery centers to provide ever greater cost savings to employers.
Dave Chase's new book, CEO's Guide to Restoring the American Dream - How to Deliver World Class Healthcare to Your Employees at Half the Cost is a MUST READ for CEO's, CFO's and HR Managers who are looking to lower the cost of health benefits but have been led to believe that controlling corporate health care costs isn't achievable. This book not only lists the current dysfunction in our healthcare system, it provides solutions to achieve lower cost, high quality care, something our country and future generations desperately need.
Here is a link to an article titled "Qliance study shows monthly-fee primary care model saves 20 percent on claims" which shows that Direct Primary Care can reduce employer healthcare costs.
Insurance premiums for your business too high? If you would like to learn more about self funding or self insuring your business please visit the following links: Self Funding Success and Employers Weigh In: 10 Main Benefits of Self-Funding by Jay Kempton of The Kempton Group.