While the Affordable Care Act may help many consumers get health insurance, most are finding that their new insurance comes with high deductibles, as well as substantial co-pays. This is a difficult situation for providers, many of whom may find that patients can't pay their bills.
There's a new treatment model emerging, however, which might absorb some of the heavy financial burdens on patients and get doctors paid.The model is known as direct primary care. In direct primary care, patients pay a flat fee per month to their primary care doctor, and in return, get unlimited visits per month to the PCP. It's also common for direct primary care practices to offer 24/7 physician access via e-mail, phone and even Skype video calls.
While prices vary, they're typically under $100 per month, with specific dollar amounts dependent on the patient's age. By the way, proponents note that this is decidedly different than concierge care, in which patients pay a fee for greater access to their physician but continue to use insurance to cover the PCP's services.
Though, in theory, any PCP practice could set up a direct primary care arrangement on their own, it's proving more common for physicians to work with vendors that handle the logistics and marketing. That's the case, in part, because DPC vendors are selling services not only to individuals, but also to employers, who buy DPC to buttress the high-deductible plans they're forced to offer their employees.
What these new models provide
DPC is also evolving into a basis for new form of health insurance. According to Forbes, the first health plan to build around a DPC core was launched in Seattle last month. The Employer Health Ownership plan starts with DPC but adds wrap-around coverage for specialty and in-patient care.
Wondering if this can work? Well, you may be in the minority. The idea has attracted some big dollars and influential investors to the table. For example, DPC vendor Qliance, which is participating in the Employer Health Ownership plan, has raised more than $8.6 million in funding to expand its model beyond Washington state. Qliance investors include Michael Dell and Jeff Bezos. Another DPC player, MedLion, has bootstrapped its way across the U.S, rolling out DPC practices in Los Angeles, Denver, Phoenix and Philadelphia. And there's dozens of smaller players on their tail.
Bottom line: The DPC movement is gathering steam and seems likely to be capable of disruptive innovations in healthcare delivery. Keep your eye on this sector, folks.
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