California practice's direct primary care model lends hand to uninsured

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The St. Luke's Family Practice in the Central Valley of California has a new strategy for providing direct primary healthcare in which patients who can afford it help pay for uninsured patients, Kaiser Health News reported Oct. 26.

In a combination of concierge-style medicine and charity-like work, the practice of four has a unique business model.

The clinic does not accept insurance, but instead charges paying patients an annual fee for 24/7 access to their physician and requires its paying patients to have coverage for major medical expenses outside the practice. These "benefactors" participate in this model, knowing that their annual fees help cover the care for uninsured patients from the local community. By not accepting insurance, the practice has eliminated the need to chase after bills and treatment authorizations.

"Direct primary care is where a physician has a relationship with a patient. We do not have to be accountable to an investor, because our investors are our patients," Maryal Concepcion, MD, who just left a commercial practice to start her own direct health clinic, told Kaiser Health News.

Given its nonprofit, tax-exempt status, St. Luke's can encourage charitable donations and grants. In terms of the care, though, there are some differences, with benefactors getting 24/7 access to the clinic whereas uninsured patients do not. Before the pandemic, the two patient groups had different waiting rooms, and some of the uninsured patients are employees of donor companies.

St. Luke's founder Bob Forester, MD, said the idea for the clinic arose from concern for the uninsured and his disdain for bureaucratic systems.

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