A healthcare option that improves access for patients and reduces burnout for physicians: that’s the conclusion of a study on direct primary care (DPC) conducted by the Pioneer Institute, published in January 2021. The researchers found that DPC increases patient-centered care access by its very structure, which not only enables but encourages patient engagement.
The DPC model is growing among independent physicians who are eager to provide quality care for their patients without the administrative burden of insurance reimbursements. The model is also enticing to more patients who appreciate its simplicity and affordability. The study found that in 2018, almost 80% of DPC membership fees fell between $51 and $99 a month, a healthcare cost that is affordable to the majority of members (60%) who have an annual household income of $95,000 or less.
For their monthly membership fee, DPC patients have unrestricted access to a specific set of healthcare services offered by the DPC physician. Patients have no deductibles or co-pays and neither patient nor provider has to bill a third party payer for the services. There are no surprise expenses for DPC patients. In addition, many DPC practices offer their patients access to prescription medications that can be 70-90% less costly than if they were to use a traditional insurance plan for their drugs.
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Patient-centered access is key to the DPC model, for the patient and for the provider. The study found that, on average, DPC patients visit their provider four times a year, for 35 minutes each visit. In a traditional model practice, patients see their doctor an average of 1.66 times each year, for about 15 minutes each visit.
Patients have shorter wait times in a DPC practice, on average less than 10 minutes. They usually also have access to same-day and next-day office visits. Adding to the patient-centered care access is the fact that most DPC physicians provide patients with a way to communicate with them directly, such as a cell number for calls or texts.
In the age of increasing virtual care, DPC practices have the advantage as well, as they have typically been using telehealth as a care option for years. DPC providers are generally skilled with diagnosing a patient over a video call or still image and can then prescribe the appropriate medication for their patient’s injury or illness.
The study found that most DPC agreements with patients include:
- Unlimited office visits
- Home visits
- Same-day or next-day appointment availability
- Immediate rooming (no stops in traditional waiting rooms)
- Extended visit durations
- Access to telemedicine visits, email, and text messages
- Annual physical examinations
- Routine laboratory tests
- Stitches; splinting or casting of fractured or broken bones
- Help navigating the rest of the health care system if additional care is needed
- 24/7 emergency triage support.
The researchers also found that DPC agreements could provide convenience and patient-centered care for Medicare beneficiaries. Since older adults are more challenged with finding transportation to office visits, so the home visits that are usually included in DPC memberships could lessen the impact of this particular social determinant of health. The longer and more frequent appointments are beneficial to this population as well, as they allow for more patient-centered management of chronic illnesses.
The DPC model also results in less burnout among physicians, according to the researchers. Since they typically do not accept insurance, providers can spend more time focused on providing quality care to their patients and less time on administrative tasks such as completing paperwork for third-party payers.
There are currently about 1200 DPC practices across the US. The Pioneer Institute’s study concluded that DPCs deliver more patient-centered care at affordable prices and serve as an effective model to increase access to care for those who are uninsured, underinsured, and even those on public programs who have access issues.