The healthcare landscape continues to change rapidly. Recently the 21st Century Cures Act was signed into effect. The Cures Act is making significant provisions to health reimbursement arrangements (HRA’s) for employers with 50 or less employees. Changes to the Affordable Care Act will likely be announced in 2017. Regardless of whether the ACA is repealed or withheld, the US will continue to face the challenge of overpriced healthcare with inadequate quality. (Despite spending more per capita on healthcare than any other country in the world, the life expectancy of U.S. citizens ranks only 26th out of the 36 member countries of the Organization for Economic Cooperation and Development.)
Employers are faced with the burden of how to manage the never-ending price increase. The reluctant solution for many employers has been to shift the costs on to their employees. The high deductible, high premium health care plan has been the normal benefit offering. Cost shifting onto employees has proved to be inefficient, and often incurs additional costs for employers. Due to the high the high deductibles, many employees are reluctant to seek preventive care leading to increases in urgent care and emergency room utilization rates.
There is a solution and a growing trend in the US to improve health outcomes, quality and allow employers to take control of the healthcare system, the solution is Direct Primary Care. Direct Primary Care (DPC) is an affordable membership based healthcare model. Direct Primary Care does not bill through insurance, which reduces the practices overhead costs by 60% or more. The cost savings is passed on to the patients who are able to have 24/7 access through telemedicine, and same/next day appointments with their doctor for often less than a monthly cell phone bill.
Here are 3 significant ways Direct Primary Care helps employers reduce costs, improve quality and take control of the healthcare system.
- Improved Access since direct primary care reduces patient panel size to typically no more than 500-600 patients per physician versus traditional fee-for-service primary care practices in which the patient panel size is typically 2,500 to 4,000 patients per physician. DPC patients are able to have 24/7 access to their primary care physician, and same or next day appointments. Instead of the average 7 minutes spent with each patient in traditional fee-for-service primary care practices.
- Quality Improvement is often tied to improvement in access. DPC physicians have the ability to block hour-long intervals to ensure they have enough time for a more comprehensive patient history, the ability to perform a through exam and time for critical thinking. When paired with 24/7 telemedicine to provide immediate access to your own primary care provider who knows you and your health history on weekends and evenings results in more appropriate care, and a reduction in ancillary services such as the ER or additional specialty care. There are multiple studies that confirm Direct Primary Care does translate into improved quality of care.
- Cost Reduction occurs through a variety of channels when utilizing Direct Primary Care. First, DPC reduces overall healthcare costs by reducing unnecessary healthcare utilization. Data from Qliance, One of the US largest direct primary care practice, shows the DPC savings vs. fee for service primary care had:
- 14% decrease in ER visits
- 60% decrease in the number of days admitted to the hospital
- 14% decrease in specialty referrals
- 29% decrease in radiology exams
- 58% increase in primary care visits
Yielding a $679.00 savings per patient per year compared to traditional fee-for-service practices.
Local Governments are utilizing Direct Primary Care for significant cost savings. In 2015, Union County North Carolina expanded its health benefits to include a Direct Primary Care (DPC) option for employees. It is the first county in the state to offer such a plan, and its experience offers valuable lessons to other counties. Direct Primary Care in comparison to their CDHP (Consumer Driven Health Plan) and in the first year has saved over 1.28 million in healthcare claims for Union County.
As health care costs continue to rise faster than the rate of general inflation, employers must necessarily consider new and innovative ideas. Direct Primary Care has the potential to effectively transform our healthcare system in the United States.
If you are an individual or employer group, Solstice Health has Direct Primary Care solutions to fit your budget and company needs. Solstice Health provides Direct Primary Care services in 3 clinic locations throughout Southeastern Wisconsin and through on-site and near-site clinics for employers. Contact the Solstice Health team today to learn more about our Employer Direct Primary Care Solutions.
Solstice Health provides direct primary care at 3 convenient locations throughout southeastern Wisconsin.
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