How does the DPC model work?

In an environment of uncertainty around healthcare coverage and insurance plans, many physicians and patients are taking advantage of a different option. Direct primary care (DPC) offers benefits to independent physicians and their patients, mostly without involving insurance companies.

Business Insider says the DPC model “could be the future of medicine.” DPC physicians are able to see fewer patients during the day and spend more time with each patient. However, the Wall Street Journal says the model “could exacerbate the shortage of primary-care doctors.”

How does the DPC model work? Essentially patients pay a membership or retainer fee, on a monthly, quarterly, or yearly basis. The fee covers almost all primary care services including clinical, laboratory, consultative services, care coordination and comprehensive care management. In addition to direct care, many patients elect to acquire a high-deductible wraparound policy to cover the emergency care that is not covered under direct care.

The Wall Street Journal adds that “proponents say the direct-primary-care model may work particularly well for patients with complex medical conditions who need careful monitoring and help coordinating multiple specialists.” Patients are not charged a per-visit fee or co-pay and are able to communicate with their physician whenever they have questions beyond the visit.

Elation’s Direct Care Playbook offers helpful information and guidance for those independent physicians interested in pursuing the DPC model option. Physicians and patients are discovering the benefits of the model in increasing numbers. In 2005, there were fewer than 150 physicians practicing in direct primary care, concierge, and other direct care models.  This number grew 5x in the next five years, to 756 in 2010, and then even more rapidly to an estimated 6,500 direct care physicians across the country by the end of 2015.

Patients in a DPC practice benefit from longer visit times with their physician. DPC physicians tout the model as providing them the opportunity to do what they went into medicine to do, to focus more on their patients’ health and less on administrative burdens.