How Direct Primary Care Can Improve Quality of Healthcare

What is direct primary care?

Direct primary care was yet another entrant into the world of healthcare in the mid-2000s. This healthcare model emerged against the backdrop of crazy expensive healthcare insurance, which is also confusing and frustrating to navigate. To get stuck in the loopholes of healthcare insurance is one of the worst nightmares of the average American citizen, as it is a cause for unnecessary stress with no end. Enter direct primary care, a model of healthcare that offers basic medical healthcare through a straightforward financial arrangement – without the complex mediator of insurance companies between the healthcare provider and recipient.

How does direct primary care work?

The financial arrangement between the patient and the healthcare provider is direct, as it leaves third-party insurance providers out of the process. Since the interaction is direct, it also nullifies the need for either party to file health insurance claims. People that enter this arrangement do not pay copays or monthly installments of health insurance premiums. This is swapped out for a monthly fee that goes to direct primary care providers who do not bill insurance companies. However, it must be noted that while direct primary care providers do not accept any kind of insurance, their recipients also opt for a high deductible health plan.

In terms of family physicians, this revenue model is beneficial as it stabilizes practice finances. It frees up the physician and other staff at the hospital from coding and billing and allows them to streamline their focus onto the patients, their needs and the improvement of their health outcomes. Similarly, the patient benefits from having a direct primary care service not only because healthcare becomes much more holistic but also because the contract fee covers basic medical aid without any biases.

Why is Direct Primary care better?

There are several reasons why direct primary care is better than other models of healthcare. The arrangement affords patients a better quality of services in comparison to models which operate according to a fee-for-service model. Services may expand to cover real-time access to their direct primary care physician using modern-day communication technology, create room for longer visits or out-of-station home visits if need be.

It also removes long waiting periods for quick and short visits in an environment that is cold and sterile. More often than not, patients in these models may see many different doctors at the same time or are sent off to specialists, which creates confusion as a result of different diagnoses and prescriptions. Health outcomes in such a model tend to be poor as there is no element of uniformity and efficiency at play here.

In direct primary care, the environment of healthcare becomes increasingly personalized as it revolves around you, the patient. Similarly, the administration is coordinated around these values to the finest detail. The structure of the model is such that it places the relationship between the patient and his or her family physician at the forefront.

The model recognizes the importance of the relationship in improving health outcomes and lowering healthcare costs overall. The financial arrangement allows the family physicians to expend more time during their patient visits, whether they are in person at the clinic or organized via an online platform. This is possible because insurance reimbursement restrictions are not at play here, freeing up the family physician to go with his or her gut and take their time getting to the heart of the health issue.

Benefits of Direct Primary Healthcare

There are several benefits of direct primary care:

1. Better, well-rounded health care as a result of more time: direct primary care providers are able to offer more in-depth consultations to their patients because they do not have to spend time filling and prepping insurance paperwork. Also, it is worthy of note that these practices tend to have lesser volumes of patients than other models that accept insurance. This aids in retaining a personal touch, as lower patient volume means that providers can get to know their patient’s medical history and story in vivid detail. It also becomes easier to forge relationships with people that you see when they aren’t part of a massive client base which is hard to track.
2. Pricing is upfront: In this model, patients know beforehand the exact cost of monthly membership and flat fees, if there are any. This removes the likelihood of confusion commonly associated with traditional health insurance plans, where billing is not as transparent. Patients do not know how much they will be billed when they leave the office and are informed after deductibles and copays have been negotiated between the other two parties.
3. Ease of access: Patients can opt for same-day or next-day visits on short notice, request long visits between 30 and 60 minutes, and email, text, or chat with the provider 24/7. This is not possible in traditional healthcare models, which are usually overwhelmed.