Direct Primary Care

EXPLORING DIRECT PRIMARY CARE:

A MODERN APPROACH TO PATIENT-FIRST MEDICINE

DPC: one of the fastest-growing models of primary care

Through the Direct Primary Care Model (DPC) patients or their employers pay doctors directly instead of working through insurance companies. There is no third-party billing. Patients typically enjoy benefits such as unlimited access to primary care services, easier and more immediate appointments, longer consultations, and a range of primary care procedures covered by the membership fee.

Learn more: Access podcasts from ACOFP's DO.fm podcast

HOW TO START A DPC PRACTICE AND WHAT TO EXPECT

This podcast is a “tell all” about starting and maintaining a successful Direct Primary Care (DPC) practice; an interesting and less complex environment for family physicians. Chris Larson, DO, is the CEO of Austin, Texas-based Euphoria Health DPC, which he founded three years ago. Dr. Larson provides answers to common DPC questions about start-up costs, the number of patients in a typical practice, potential income, overhead costs, marketing a DPC practice, and contracting with labs and imaging facilities to get the best rates.

A DAY IN THE LIFE OF A DPC PHYSICIAN

Anastasia Benson, DO, is a family physician and owner of Paradigm Family Health, a direct primary care practice (DPC) in Dallas, Texas. In this episode, she shares learnings about the inner workings of her DPC practice. She reviews start-up costs, and how to set pricing for patients for office visits, tests, and screening. Dr. Benson actively recruits her patients from various civic activities and lots of networking. Her enthusiasm for DPC shows!

Frequently Asked Questions:

In a DPC model, patients pay what’s called a periodic fee, which is usually on a monthly basis, but some physicians employ quarterly or yearly plans.

For that fee, patients have access to a full range of comprehensive primary care services. The fee is designed to pay physicians for the range of duties that are involved with taking care of patients, including communications and administrative tasks.

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 such as telephone and electronic visits, forms of patient care that are faster and more convenient for established 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 or catastrophic coverage that takes care of emergency and hospital care.

DPC practices often negotiate contracts with pharmacies, laboratories, and imaging service providers that give patients significant discounts, saving patients money compared to what insurance companies charge for the same services. The DPC model does not aim to make a profit off these services, because the payment comes from the monthly fees.

Under the DPC model, patients are given more individualized care through ongoing follow-ups and spend more time with their doctors, who now have a small set number of patients.

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, such as same-day appointments and 24-hour 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, decreasing physician overhead.

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, but this is rarely necessary due to the low cost of the DPC monthly fee.

The first step in transforming a practice to a DPC is to conduct a practice evaluation to determine whether the 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 the current patient population may respond to the new model.

Attend the Annual DPC Summit

ACOFP collaborates annually with the American Academy of Family Physicians (AAFP), the DPC Alliance, and the Family Medicine Education Consortium (FMEC) to cohost the Direct Primary Care (DPC) Summit.

The DPC Summit serves as a crucial platform for physicians to learn about the latest trends, share best practices, and engage with thought leaders in the field.