Tips for staffing for DPC practices

Direct primary care (DPC) practices typically see fewer patients than a traditional practice. A DPC usually also opts to not accept patient insurance. As a result, overhead for a DPC is significantly reduced, overhead that includes staff members. When the practice does not bill per visit or bill for insurance reimbursement, there is less need for people to perform these duties. The DPC does bill for monthly membership fees but will generally not require the typical fully staffed office found in an independent physician’s practice. A DPC physician who wants to attract staff to the practice should keep a few things in mind. With a smaller staff, it is even more important that the people working in the practice are able to work as a team. Owen Dahl, writing in Physicians Practice, suggests that potential staff should be evaluated based on three factors: Knowledge. A DPC’s staff must be knowledgeable not only of how the DPC practice operates, but may also need medical knowledge, to be able to assist the primary care provider with patient engagement and care. Skills. Although there is less to do in regard to billing in a DPC practice, there is still a need for effective practice management. Staff members must have the skills to manage appointments as well as patient membership fees. Attitude. In a small office setting, such as that found in a DPC, the staff’s attitude toward the practice, toward the patient, and toward each other can make a significant difference in the patient’s experience. Staff must be able to communicate effectively with everyone involved with the practice, especially the patients. Dahl also writes that by 2020, about half of the workforce will be millennials, those employees currently in their mid to late 20s. When staffing the DPC practice, the independent physician must keep in mind that the “mindset of these employees is built around learning, involvement, and participation in the organization,” so putting a plan into place that enables this new workforce to grow and develop their own skills will prove beneficial as well.

Greg Miller

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Social Media for Direct Primary Care physicians

Direct Primary Care (DPC) physicians can use a number of marketing tools for promoting their practice and for educating patients. DPC is a relatively new concept and a DPC practice may need to clarify some information or provide additional details regarding the way the practice operates, to reassure potential and current patients. Social media can be an effective platform for reaching those patients. Millennials and Gen Zers, those patients in their mid to late 20s and younger, use social media as their primary means of gathering and sharing information. As millennials are approaching their 30s, they are getting married and starting families. A DPC practice that wants to attract this younger and largest generation of patients will need to have a solid social media presence. Care must be taken when implementing a social media strategy. Online posts can take on a life of their own, with shares and reposts. A DPC’s messages must be professional and appropriate. When initiating online communication where patient information may be at risk, physicians should carefully avoid any HIPAA violations. Sensitive situations include posting images of patients without their consent, compromising patient confidentiality by posting identifying information, and communicating with patients via a social media platform. DPC physicians should make use of their electronic health record EHR capabilities when communicating with patients, to ensure that any information transmitted is secure. Social media can reach a large number of people with just one post, but that one post requires careful planning and a bit of effort on the DPC’s part. A staff person may be assigned to post timely, relevant content and to respond to comments. For example, a DPC practice may decide to build a Facebook page that will require timely and consistent monitoring. These social media options do provide the DPC with an effective outlet for education and marketing, as long as they are planned and maintained in a manner that is engaging and professional.

Gabby Marquez

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5 reasons why patients love direct primary care

Direct Primary Care (DPC) is growing in popularity with primary care physicians. Under the DPC model, billing is virtually eliminated as patients pay a monthly membership fee rather than paying per visit. Physicians are also able to spend more time with fewer patients in a day as a DPC, given that their income is based on the monthly fee and not on the number of patients they see. Patients also have a number of reasons they cite as to why they love the DPC model. A recent blog post in Twine Health lists four of those reasons: -Less expensive. Patients pay a monthly fee instead of paying a copay or full fee at each visit. Insurance copays can add up when a patient has multiple primary care visits within a month’s time. With a DPC, there is only one payment per month and that is usually low, typically in the $25-$85 range. -More convenient. A patient can generally make an appointment sooner and receive more services than with the typical primary care physician model. Patients have more access to the physician during the visit as well as through communication in between visits. -More effective. In a DPC model, patients become more engaged in their own healthcare. The primary care physician is not just there to send patients to other providers, but is able to offer more “coordinated and continuous” care, an aspect particularly important to patients with chronic or complex illnesses. -More personal. Primary care physicians who operate under the DPC model see fewer patients per day and so are able to spend much more time with each patient. Their patient engagement increases, as does the patient’s satisfaction with the level of care received. A recent article in the Wall Street Journal adds a fifth reason why patients love direct primary care. In a DPC model, patients “can provide their own quality control.” If the model or the practice does not work for them, they can leave. The WSJ adds that, so far, “satisfaction rates run high.”

Greg Miller

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What the research says about Direct Primary Care

Direct Primary Care (DPC) is an innovative practice model that enables the independent physician to spend more time with patients and less time with billing paperwork. In a DPC practice, patients pay a regular monthly fee for services. The primary care physician does not bill the patient or an insurance company for each visit. While a relatively small percentage of physicians practice as DPCs, the model is growing in popularity and has support from organizations such as the American Academy of Family Physicians (AAFP). The AAFP cites research that shows that “DPC patients have better patient experience of care and improved clinical outcomes as they become more engaged in managing their own health care.” In the DPC model, patients have predictable costs as they pay a monthly membership fee that covers their primary care physician visits, lab tests, and communication with the physician beyond the office visits. The Wall Street Journal reports that physicians who operate as DPCs “say the steady income from membership fees frees them from having to pack patients into 10-minute visits to make ends meet.” They are able to focus more on patient engagement while the patient is in the office as well as “handle many issues via text or email, which are rarely reimbursed in traditional fee-for-service medicine.” According to the WSJ, research also shows that the DPC model “may work particularly well for patients with complex medical conditions who need careful monitoring and help coordinating multiple specialists.” A patient with a chronic or complex illness may need to visit the primary care physician multiple times each month, all of which would be covered under a single membership fee. As there is still a small percentage of physicians operating as DPCs, there is little research available as to whether the model actually helps improve patient outcomes. As DPC grows, however, it's likely that researchers will be more interested in studying how the model impacts access to care, care quality, and healthcare costs.

Gabby Marquez

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Concierge Medicine vs. Direct Primary Care

Healthcare delivery comes in many forms. The traditional independent primary care physician model, in which physicians see a number of patients each day and then bills insurance companies for their services, is somewhat transforming. Over the past couple of decades, two new models have risen in popularity: concierge medicine and direct primary care (DPC). While there are some similarities in the two, there are also a number of differences. Both the concierge and the DPC models have as their core a membership fee paid by the patient, or sometimes the patient’s employer. Concierge practices may also bill the patient’s insurance company for covered services, while the DPC practice usually relies solely on the membership fees to cover costs. Membership fees provide direct access to physicians in both models. When the physician is not relying solely on insurance reimbursements to finance the practice, the number of patients seen each day can be reduced, so the physician has more time to spend with each patient. In the concierge model, the membership fees may be slightly higher and the patients may receive increased access to their physician’s services. A study cited by the AAFP and conducted by the Concierge Medicine Research Collective found that “people age 50 and older make up an increasing share of patients at most concierge practices.” Typically, these concierge services are more concentrated in states such as California and Florida, which have higher populations of patients over age 50. Those concierge practices seeing Medicare patients or that are billing insurance companies in addition to the membership fee are subject to the relevant rules and regulations. DPC models that do not bill insurance are not subject to Medicare or insurance regulations. The DPC model is identified in the Affordable Care Act as an acceptable non-insurance option, but the concierge model is not. In both models, patients enjoy the individual attention and communication they receive from their physicians. Physicians are better able to focus on patient care with fewer worries about practice management issues. An independent physician considering a transition to either model will need to weigh all of the pros and cons for the practice and for the patient before moving forward.

Greg Miller

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Choosing an EHR for DPC practices

Choosing an electronic health record (EHR) system is an important step for Direct Primary Care (DPC) practices. Since a DPC practice usually operates on a “retainer” system, the practice must be managed in a cost-efficient manner while still providing quality patient care. The right EHR can certainly help in making that happen. What are some considerations a DPC should factor into the choice of an EHR? Although DPCs may differ somewhat in their structure, the defining characteristic of a DPC is that the practice offers patients “the full range of comprehensive primary services, including routine care, regular checkups, preventive care, and care coordination in exchange for a flat, recurring retainer fee,” according to an article posted by AAFP. DPC physicians typically see fewer patients during a day and are able to focus more on the quality of their patient’s care. Given this structure, an EHR system must enable the DPC physicians and their patients to communicate with each other using seamless, secure messaging. Elation’s EHR solution provides this capability and more, to support the physician-patient relationship. Patient engagement is a significant contributor to the quality of their healthcare management plan, a primary focus of the DPC practice. A DPC practice must also streamline its overhead, to remain solvent while focusing on patient care. Elation’s Clinical First EHR offers DPCs the tools they need to minimize practice overhead for more efficient practice management. With the right EHR solution, physicians in a DPC practice spend less time on paperwork and more time with the patients themselves. Time wasted searching for information or waiting for information from other providers is virtually eliminated. The AAFP states that given the DPC practice structure, the physicians in the practice “are no longer generating revenue solely on the basis of how many patients they see per day, [and] many report that they have significantly more time to spend with patients in face-to-face visits.” Patient focus is also Elation’s goal and we have designed our EHR solution to help DPC spend more time with their patients and less time with their patient records.

Gabby Marquez

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What is Direct Primary Care?

Direct Primary Care (DPC) is a model of primary care that gives physicians alternatives to traditional fee-for-service insurance billing. Direct primary care physicians charge their patients a retainer, whether it be monthly, quarterly, or annually that is used to cover services. Often supplemental insurance for emergencies situations is suggested. The DPC Model Spending more time with patients is the ultimate goal of DPC. The core principles are patient-centric and prioritize the patient-physician bond. The unique payment structure of direct care eliminates many of the administrative burdens physicians face, freeing up more time to focus on a patient’s care plan. Engaging with patients is another priority for DPC physicians. Patient engagement can include sending and receiving messages with patients, communicating lab results and discussing general health information. Keeping a channel of open communication with patients builds trust and subsequently strengthens the patient-physician relationship. Benefits of DPC for Physicians DPC rewards physicians for treating the whole patient. Because DPC physicians are not as concerned with the number of patients seen per day, physicians can spend more quality, face to face time with patients and can develop stronger relationships with their patient population. DPC physicians also reported reduced overhead costs at their practices compared to traditional primary care practices. Many of the administrative duties are reduced because there is no longer a need to hire staff that handles third-party insurance claims. Simplifying the billing and administrative work for physicians also provides DPC physicians with a better work-life balance. Physicians experiencing burnout might find the schedule of a DPC physician, with a more intimate patient panel, appealing. Benefits of DPC for patients Smaller patient panels for physicians leads to more individualized and personalized care for patients. DPC physicians are easier to access and care is timely and convenient for the patient. Many DPC physicians even offer extended hours and are always available via phone. Beyond the greater access to comprehensive care, patients find that DPC care is oftentimes more affordable and more flexible to their unique needs. Whether you are interested in starting a DPC practice,  just starting out a DPC practice or a DPC veteran, doing your research and staying up to date on the latest on this ever-evolving and innovate model of care can help you achieve your practice goals. Learn more about direct primary care and the greater direct care movement by subscribing to this blog or downloading our recently released DPC playbook! 

Greg Miller

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