Direct Primary Care covers 85% or more of a patient’s healthcare needs, with no deductible, no copays, no insurance claims. This is great for the patients, who often pay less than insurance premiums would cost, and don’t have to worry about getting a surprise bill in the mail when a claim was denied.
Personalized Care
DPC doctors spend more time with their patients, which enables them to get to know their health history in detail and provide more personalized care. These in-depth visits help address not only acute problems, but also smaller issues that, if taken care of early, help prevent bigger problems in the future.
With fewer patients, DPC practices can treat patients like individuals, rather than just a number, and provide more attention and care. The patient feels better taken care of, the doctor is more satisfied with the progress.
Flexibility
Patients can choose their own healthcare provider and have more control over their healthcare decisions. The doctors are free to choose the treatment that is best for the patients, and is not limited by insurance approved treatments. The clinic does not have to submit claims to insurance. This is not just a lot of paperwork, but also some insurance claims get denied, and the ones that don’t often take months to get paid out. With DPC, the clinic has a constant stream of income from the membership payments that they can depend on, without that hassle.
No Intrusion by Insurance
Patients can focus on their health goals, rather than being limited by insurance coverage and restrictions. This can make a huge difference especially with chronic illnesses.
No Surprise Bills
With DPC, patients know exactly what they will pay upfront, eliminating surprise bills and financial stress.
This also helps employers who only pay for actual health coverage, not for insurance premiums. Healthier employees make for happier workers with less downtime.
Simplified Healthcare
DPC greatly benefits clinics by eliminating the need for insurance claims, paperwork, and administrative tasks, allowing doctors more time with their patients, and patients the freedom to focus on their health and well-being.
DPC practices can be more cost-effective for patients, particularly those without insurance or with High Deductible Health Plans (HDHPs). Combining DPC with a HDHP gives patients the best possible health coverage with the DPC taking care of the majority of health needs, while the HDHP is there for bigger and unexpected health expenses like hospital stays or surgery.
Further Reading
Direct Primary Care: A Successful Financial Model for the Clinical Practice of Lifestyle Medicine by Amy R. Mechley, MD, DipABLM, DipABFM, FACLM
https://www.ncbi.nlm.nih.gov/
Employer-Sponsored Health Insurance 101
https://www.kff.org/health-policy-101-employer-sponsored-health-insurance/
Direct Primary Care (DPC): A Consumer’s Guide to This Payment Model, written by Gina Roberts-Grey, reviewed by Karla Robinson, MD
www.goodrx.com/insurance/alternative/direct-primary-care