Direct primary care model is a great concept and is the sign of physicians thinking in the right direction

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healthcare reform

In recent decades there has been a significant movement in our country, especially in the Midwestern states, to create a free-market, cash-for-service system called direct primary care.

Direct primary care (DPC) is a type of primary care medicine where billing and payment arrangements are made between patients and providers, without sending claims to insurance companies. It is an umbrella term incorporating various healthcare delivery systems that involve direct financial relationships between patients and health care providers.

Direct primary care has been promoted by certain groups of physicians as a means for patients to save money on their primary care services, as well as other ancillary-performed services such as laboratory testing, etc. Some call it a match made in healthcare heaven.

Often, there are no insurance co-pays, deductibles or supplementary fees, thus avoiding the overhead and complexity of maintaining relationships with insurers. Because direct primary care payments are typically paid over time, rather than in return for specific services, the economic incentives are such that the long-term health of the patient is the most lucrative outcome for the doctor. As such, preventative care gains greater emphasis under DPC.

Because direct pay members are usually automatically billed, a physicians’ practice cash flow situation can also be improved. An emerging model of direct primary care involves the medical practice contracting with self-insured (or self-funded) employers.

They offer the direct primary care option as a means of accessing care for free or drastically reduced office visit fees. The employer pays the membership fees on behalf of the employee to the DPC practice directly. This option usually provides the employee same or next business day access to care.

This supposedly allows workers to address evolving health concerns rapidly in order that the condition can be treated more quickly and the number of sick days or days of decreased productivity from illness might be reduced.

This model is intended to dissociate independent physicians from big corporate insurance companies as a solution that will satisfy consumer attitude as well as helping physicians to overcome the burden of dealing with insurance bureaucracies.

Direct primary care model is not a new system. Different versions of this model existed in the UK and some European countries decades ago. Wait times for procedures were long, and that’s why people who wanted to get faster treatment would utilize direct primary care or direct care-or-cash for care opportunities.

Direct primary care is the prototype version of that system which is still in its infancy and will get more sophisticated over time. This means that these type of reimbursement systems and models always come in the face of national health system and single payer where there is a clash of consumerism and the utilitarian healthcare model.

This is a great start and an important step closer to an awesome healthcare-delivery model.

The most important thing is that it shows that physicians are starting to become more active and rebellious against the broken system that is today’s healthcare. Kudos to them who are on the front line of this movement.

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