Balancing employer patients and individual patients

September 10, 2021

Leona Rajaee

As healthcare costs continue to rise for employers, a growing number are investigating the possibilities of the direct primary care (DPC) model for their employees. As a direct primary care doctor you may be expanding your practice to include these employer patients, as a strategic move to grow your practice. The question of balancing employer patients and individual patients comes down to the needs, goals, and capabilities of your particular practice.

When considering how to balance your patient load, think about these questions:

What are your goals for your practice? Do you want to expand with additional locations or by adding providers within your independent practice?
Do you want to remain loyal to individual patients? Did you convert from a traditional practice to a DPC model and, if so, did you bring along loyal patients who are counting on you for continuing relationship-based healthcare?
How large a patient panel can your practice handle while still providing quality care? What is your ideal patient load?

An informal poll of direct primary care doctors in 2019 found that:

In response to a question about how many additional patients the practice needed to reach maximum capacity, more than 74% responded that they need more than 200-500+ patients to have a full patient panel.
In response to the question, “how many is too many patients,” 77% of polling respondents indicated that between 700-1,1100 is too many patients for one DPC physician patient panel.

According to a 2018 Direct Primary Care (DPC) Study, 57% of DPC practices participate in employer-based contracts. Among those not currently participating in employer-based contracts:

25% are currently in negotiation
29% are looking to pursue contracts in the next 1-3 years.

As a direct primary care doctor, you can benefit from a captured patient panel by partnering with employer groups so that your practice is virtually guaranteed a certain amount of patient membership. It is possible to maintain the sanctity of the DPC model while also enjoying that solid, predictable income that comes from employer patients.

You can also provide more benefit to those patients by becoming their advocate for quality healthcare within their population. When you provide more personalized care, tracking each patient’s medical progress and spending more time with each patient on preventive care, your DPC practice can benefit the employee, the employer, your practice, and the community as a whole.

On the employer side, they are starting to embrace direct primary care as a viable alternative to traditional insurance plans. Employers are attracted to the idea of an independent physician who is compensated in a way that delivers quality care and lowers costs.

The DPC model is also cost-effective for employer patients. It can complement an existing group health insurance plan, and employers bypass insurance companies to pay for care directly. In addition to managing potential catastrophic claims in the future, employers can achieve up to a 20% reduction in total healthcare costs.

Balancing employer patients and individual patients is primarily a matter of determining what your practice can handle, what it needs to grow, and how you can maintain the benefits of the DPC model for yourself and for your patients. Keep in mind those benefits include: