Traditional medical practices have had to change their healthcare delivery approach in recent months, given the restrictions and safety guidelines imposed in response to COVID-19. In-person office visits have transitioned to telehealth sessions. Adherence to new Medicare regulations for reimbursement for these services has required adjusting billing codes and practice strategies. During all of these changes, one group of providers has been able to transition more smoothly and more effectively.
Direct primary care (DPC) providers are well-positioned to respond to the necessary changes in healthcare delivery during COVID-19. DPC’s strengths include:
- Virtual office visits
- Financial stability
- Doctor-patient relationship
Most DPC providers are available for telephone and video consults, outside of practice hours, during “normal” times. As healthcare providers move toward telehealth during the coronavirus outbreak, these DPC providers are well-positioned to make those adjustments for all of their patients.
Given orders for staying at home and maintaining social distances, many traditional healthcare providers have shifted their delivery method to virtual visits, using telehealth options. The Centers for Medicare and Medicaid Services (CMS) has also adjusted, enabling physicians to bill for these services. However, providers are finding that they still have to follow “a slew of rules,” such as regulations regarding audio and video components of these patient encounters.
DPC providers do not rely on billing and reimbursement from third parties such as Medicare and so have much greater flexibility as to how they provide care for their patients. In addition, many DPC practices are already set up to provide web-based video consults, often embedded into their electronic health systems.
Telehealth provisions and the innate structure of the DPC practice is also better designed for keeping physicians, their staff, and their patients safe during COVID-19. Jeanette Williams, MD, a California-based DPC physician, says that “while many of my friends, family, and colleagues are worried about me as a ‘front-liner,’ the truth is that my system of practice with virtual communication and built-in care keeps everyone safer.”
DPC providers encourage their patients to contact them via email, text, or patient portal message between visits, to clarify diagnoses or to ask questions about treatment plans. Dr. Jacqueline Slakoper, a Board-certified Family Medicine physician and DPC provider, says “Secure text messages enable my patients to reach me directly during and after hours, including weekends. In traditional primary care, they would go through an answering service or an on-call physician who might not know their medical history.”
Dr. Slakoper adds that these communication strategies have benefited her patients in many ways. “Constant and easy access to my patients has allowed me to be able to talk them through their concerns with the advantage of knowing them and their medical history. I am therefore able to ease anxieties and help reduce the over-burdening of ERs with patients who are not truly a risk.”
The DPC model is based on monthly membership fees, rather than fees for each visit. DPCs, for the most part, do not accept insurance, including Medicare. The model enables DPC practices to continue functioning through the coronavirus outbreak, providing care to their patients virtually, not stressing over properly coding telehealth services or waiting for fee reimbursements.
DPC practices also have lower overhead, with fewer employees, improving their ability to be financially prepared for the current crisis and financially stable on an ongoing basis. Deborah Sutcliffe, MD, a DPC physician in California, is treating most of her patients using telehealth options during COVID-19. Dr. Sutcliffe says, “Knowing that my practice is financially secure is something that would not have been possible four years ago. Now I can assure my medical assistant that she will be paid regardless of how many hours we keep the office physically open.”
DPC providers have always enjoyed a close relationship with their patients. During the coronavirus pandemic, that relationship is increasingly important for the patients.
Dr. Slakoper explains that “Having the access to and the relationship with your personal primary care provider leads to better outcomes and healthier lifestyles. No one could have imagined that our commitment to delivering the right care, at the right time, in the right setting would show its value in a situation like COVID-19.” She adds, “We are thankful to be able to provide our patients with some level of consistency and reliability amid a worldwide health crisis.”