7 things to know about the rise of fee-based direct primary care

Direct primary care practices, which charge a monthly membership fee for medical visits and access to wholesale drugs, are cropping up nationwide, according to Business Insider.

Here are seven things to know about direct primary care.

1. The movement toward direct primary care comes as consumers become more attuned to healthcare prices, and primary care physicians seek to alleviate pressure under traditional fee-for-service payment models.

2. Direct primary care practices charge members anywhere from $50 to $150 a month to access checkups, same-day or next-day visits and wholesale- or near wholesale-priced prescriptions. Since there is no insurance, additional copays and fees aren't collected from members, Business Insider reports.

3. As of March, roughly 790 direct primary care practices operate in the U.S., compared to 620 in April 2017. In June 2014, there were 125 direct primary care practices, according to Philip Eskew, DO, founder of Direct Primary Care Frontier

4. Business Insider spoke to 17 direct primary care practices for its article. The practices saw a varying number of insured patients. Some saw nearly only insured patients, while others said only about half of their patients were covered. 

5. The way insurance would work at a direct primary care practice is similar to car insurance. While a car owner wouldn't use insurance to get an oil change — or, in the direct primary care sense, a checkup — a car owner would depend on insurance if he or she was in a car accident. In the same way, direct primary care members would need insurance to treat anything that can't be provided in the primary care setting.

6. Some insurers, including America's Health Insurance Plans affiliates, oppose the growth of direct primary care services. Insurers worry members may be paying double for primary care through their health plan and a monthly membership fee, while others are worried the practices will become overburdened with patients. 

7. However, direct primary care centers continue to grow. As one example, Boston-based Iora Health plans to expand its 24 practices to 36 in the next year, according to the report.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Whitepapers

Featured Webinars

>