How DPC care can segue to direct-to-employer care

Change is generally a challenge, particularly in the workplace. Employees who are told they must change their healthcare plan may not always react positively. In fact, employers may not want to change their company healthcare plan, at least not all at once. One option is to segue to a new plan in small steps, especially when it entails a new concept, as is the case with direct primary care (DPC).

DPC practices are a relatively new breed but are growing in popularity. The DPC model involves patient membership fees rather than insurance reimbursements, as well as more direct involvement by the independent physician. The DPC practice harkens back to the day of the family doctor. House calls, after hours communications, and personalized care are among the benefits cited by DPC physicians and their patients.

Employers have moved slowly toward the DPC trend but are still somewhat hesitant to forego traditional healthcare coverage completely. One option is to offer employees the choice of a health insurance plan such as a PPO product in addition to the DPC practice. That’s exactly what one company – a large healthcare provider itself – has done for its employees.

CHI Health is the Catholic Health Initiatives (CHI) division for Nebraska and southwest Iowa. In 2017, CHI Health launched its own DPC practice to augment its traditional healthcare services. The DPC was designed to care for CHI Health’s own employees primarily. CHI Health employees are given the option of enrolling in traditional PPO coverage or participating in the DPC. Approximately 1,130 of the organization’s 20,000 employees and beneficiaries opted into the DPC model during the first quarter of 2018.

Employees were reassured that if they needed care beyond the basic primary care services provided by the DPC that they could seek out specialty providers and other catastrophic services such as hospitalization for the same deductible costs as the PPO-covered employees. However, according to HealthLeaders, “early results suggest DPC participants use these more-expensive options less.”

In fact, the costs were significantly lower for DPC-covered employees during the first quarter of 2018. Facility and specialist claims were 20% less for those employees in the DPC practice than for those employees enrolled in the traditional PPO plan.

Employers can test the waters by segueing employees to a DPC practice, offering the choice for those who do not readily accept the change. After demonstrating both cost savings and improved outcomes, the DPC may be seen as the preferred choice for all going forward.