Submitted by Colleen McMahon-Ingraham, President, The McMahon Group
In a Direct Primary Care (DPC) medical practice, the physician has chosen to work directly with their patients and eliminate the administrative burden associated with billing insurance. In a traditional medical practice, a physician spends up to 40 percent of their time doing paperwork. By eliminating that burden, they can keep their charges lower, pass those savings along to their patients, and ultimately increase the amount of time spent caring for their patients, which is what physicians were actually trained to do.
Typically, 85 percent–90 percent of your ongoing healthcare needs can be managed by a primary care physician. In a DPC arrangement, you pay a flat monthly ongoing subscription fee for medical services. Typically, you will find that most of your medical needs will be included with your subscription. There are no additional co-pays to be paid at each visit, no co-insurance, no deductibles to be met, and no surprise charges for other services when you visit your DPC. There are also no pre-existing condition limitations, no long waits to get an appointment, no delays in the waiting room, and ample time to spend with your physician talking about your health and not your insurance plan. You’ll often find in the DPC model that there are additional services and procedures included with your membership fee and even more that are provided with significant discounts. Should you need a prescription for something like an antibiotic or need routine lab work, these are additional services that your DPC will provide in the office, often at a lower cost than a co-pay at a traditional medical practice. Say you fall and hit your head, requiring stitches. In a traditional medical office, you would pay a co-pay to see the doctor initially, pay a co-pay for any medication, and then pay a co-pay again when you go back to have the stitches removed—in addition to meeting your deductible and co-insurance, in addition to receiving surprise bills. In a DPC, you don’t have that to worry about.
One of the things that patients appreciate the most about the DPC model is that they don’t feel rushed and there are no limitations on the amount of time their physician can spend with them, developing a more familiar, long-term relationship, dedicated to their health and wellbeing. Along with the longer appointment times, you often have after-hours availability by phone, text, email, or FaceTime—most will even do house calls, if medically necessary. When the barriers of cost, co-pays, scheduling conflicts, and frequency of visits are removed, the DPC model tends to provide the opportunity to visit a trusted physician proactively, leading to generally improved health and a 50 percent–80 percent reduction in the need for hospitalization. As the mother of five, I appreciate the advantage of having all of my children seen in one office visit as opposed to paying a co-pay and co-insurance for each child, as well as a separate appointment. The ease of removing the financial barrier and having the ability to speak with my physician by phone can be revolutionary for the budget and schedule of a busy family.
Employers are also able to offer DPC access as a health benefit to their employees, which benefits the employer and employee alike. By having access to a DPC, employees can receive quick, easy, and high-quality healthcare, which will also lead to sustained, overall wellness and decreased absenteeism for lengthy and frequent office visits. In addition to it being a benefit for the employee, it allows the employer to dramatically decrease their overall cost of healthcare benefits when paired with a medical cost sharing community, such as Sedera, a self-insured health plan, or a high deductible health plan. The DPC relationship is an absolute win for employers, physicians, and families.
The McMahon Group is on a mission to educate and empower the patient, employer, and physician. If you think you cannot afford quality healthcare or you are an employer struggling with the high costs of providing healthcare benefits, please contact The McMahon Group for more information on Direct Primary Care (DPC), Sedera Medical Cost Sharing, direct contracting with physicians. Visit us on the web at themcmahongroup.net, email healthcare@themcmahongroup.net, or call 309-644-4528.