How a Direct Care Practice Can Save Money While Improving Medical Care

Open Enrollment for medical insurance this year started November 1st and lasts through December 15th.  During this time, each of us looks at our medical coverage and decides whether we will continue with our current policy through the next calendar year, or make the necessary changes to better fit our current life circumstances.  We are required by the Affordable Care Act (ACA) to have either health insurance or be a member of a health care sharing ministry (HCSM).  If not, we face a fine from the IRS.  Most of us by now have received our insurance renewal notification for 2017, and many of us are quite shocked at how our premiums continue to rise at a double digit clip, well ahead of the pace of inflation.

In this setting of ever-increasing health costs and decreasing access to medical care comes a relatively new movement, one which promises to once again make health care more affordable and more accessible.  Direct primary care practices are springing up all across the country and becoming wildly popular with the savvy health care consumer (see What is Direct Primary Care (Concierge) Medicine?).  These membership practices, when paired with a lower cost catastrophic medical insurance policy or a health care sharing ministry plan, ultimately decrease costs while simultaneously improving care in the following ways:

1. Lower office overhead means lower charges.  Membership prices are typically less than a monthly cable bill or a daily latte, and are clearly posted, with special discounts for larger families and small businesses.  North Idaho Direct Primary Care has not raised its fees for most age groups since its inception in 2013.
2. Member patients that call the office during weekdays with immediate medical needs are usually seen the same day, and always within 24 hours.
3. Member patients can phone, text or email their physician after-hours and on the weekend for urgent matters that cannot wait, potentially saving the cost and inconvenience of an emergency room or urgent care visit.  The physician will then see the patient in the office or make a home visit after-hours if the problem cannot be satisfactorily addressed by phone, text or email.
4. Expanded visit time.  The average face-to-face time with a member patient in a direct care practice is 30 minutes, compared to a rushed 7 to 10 minutes in a typical insurance-billing office.  More time with each member patient ultimately translates into better medical care.
5. Waiting rooms are uncrowded in these small practices, with minimal wait-times to see the physician (see Four Advantages of a Small Medical Practice).
6. Medical care is comprehensive, meaning that approximately 90% of the routine and urgent care a member patient needs is provided solely by the direct care physician.  Seeing the same provider consistently improves the quality of the medical care rendered.
7. Member patients save a substantial amount of money through significant in-office discounts for labs and imaging as well as with most medications (see Three Ways a Direct Care Practice Saves Patients Money).

As mentioned above, a lower cost, higher deductible medical insurance policy or a health care sharing ministry plan should be paired with a direct care membership in order to provide comprehensive medical coverage.  (Please see Blue Cross Decision Further Erodes Patient Choice as a local exception to this recommendation).  Insurance and health care sharing ministry products are used for catastrophic, expensive events only, such as those requiring surgery or hospitalization, or for outpatient specialty visits, addressing problems that are well beyond the scope of a primary care practice.  Ultimately, the direct care physician manages most medical problems, saving his/her member patients substantial money and time, while at the same time improving the quality of the care they receive.  Call our office at (208) 295-5772, or email us at of****@*************md.com today and find out how North Idaho Direct Primary Care can provide you, your family and your employees quality medical care at a substantial savings over what you are currently paying.  If you found this article helpful, you may click here to sign up for our monthly newsletter.