Direct Primary Care: Quality Care that Cuts Costs

Steve Zivich of Boston Direct Health - Primary Care doctor Boston Massachusetts
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Direct Primary Care (DPC) is an innovative medical philosophy that completely eliminates third party insurance, allowing patients to directly contact their physicians for their health care needs. According toQliance Medical Management, Inc., patients enrolled in a Direct Primary Care program have on average:

  • 80% fewer surgeries,
  • 62% fewer references to specialists,
  • 59% fewer ER visits, and
  • Spend 30% fewer days admitted in a hospital.

They are also saving money in the process.

DPC’s model is simple: for a monthly membership fee—usually between $75-$125—you have immediate access to a private physician. Boston Direct Health’s (BDH) membership covers ingrown toenail removal, bio-identical hormone replacement therapy, and many services in between.

Rising Healthcare Costs

A Health System Tracker study found that the US spent $10,224 per person on health in 2017, about half the average spend of most countries. From 2015-2025, health spending is project to grow at an average rate of 5.8% per year or 4.8% on a per capita basis. It’s growing 1.3% faster than the Gross Domestic Product (GDP) per year during this period.

Overall health spending growth is expected to accelerate by an average of 6% from 2020-2025. Even if you’re currently spending less per year on healthcare than the average American, your spending is likely to climb significantly as you get older and as new treatments become available.

Not only is this costly for individuals, it’s even more expensive if you work at a firm that have fewer than 200 employees. A Kaiser Family Foundation 2017 Employer Health Benefits Survey revealed that the average worker’s contribution to a premium for family coverage was $6,814 compared to just $5,264 for larger companies. The average general deductible for smaller firm employees was $2,120, compared to $1,276 for employees of larger companies. The cost of deductibles alone tends to be higher than year-long Direct Primary Care membership with none of the perks.

Direct Primary Care can reduce your firm’s healthcare spend by 15%-20% in a single year when combined with a transparent Rx program. Meanwhile, self-insured employers who implement a DPC program have saved as much as $260 per member per month.

Boston Direct Health offers special discounts for both families and businesses. With DPC, you save money by having direct access to your primary care physician, enjoy reduced costs of procedures, and get extra time with a private physician who helps you navigate away from your potential health risks.

Wait Times and Urgent Care

A study conducted by Merritt Hawkins, an AMN Healthcare company, found that the average wait time for a new patient to see a physician was 18.5 days. Among the largest US cities, Boston ended up having the longest wait time. To see a specialist, Boston residents have to wait an average of 45 days. To see their family doctors, the residents have to wait an average of 66 days.

One main problem here is that not all patients have 1.5-2 months to wait for their appointment. Many will instead go to the emergency room or urgent care to seek a faster solution. This results in expensive and needless bills for the patient.

A simple visit to urgent care without any sort of vaccination, procedure, or medication can range anywhere from $75 to $250 without health insurance. With insurance, copayment for urgent care is usually between $50-$150. If you haven’t met your deductible, it may cost more. ER visits tend to be even more financially damaging. Some insurance companies have estimated that an in-network urgent care visit can cost up to 80% less than an ER visit!

Members a DPC program enjoy same day/next availability, evading the process of waiting for their appointment entirely. Patients also enjoy unlimited office visits, no co-pays, and direct, unlimited communication via text, phone, email, or video chat. Outside of some procedures, medications, or labs, the only cost you incur by being a DPC patient is your membership fee.

Additional Savings

The CDC found that roughly 60% of US adults have a chronic disease and that 40% of them have two or more. Chronic medical condition management for common illnesses such as hypertension, asthma, diabetes, depression, and anxiety are covered in most DPC memberships, including at Boston Direct Health.

BDH members also save an average of 90% on labs. Routine diabetes lab work costs $37 as opposed to $200-$300. Typical labs ordered for a 40-year-old cost approximately $1,500 every year. At BDH, the amount is reduced to $137, with the difference being around the cost of a one-year membership.

Consultations for functional medicine, a systems biology-based approach that focuses on addressing and identifying the root cause of a disease, can cost $300 or more. It’s free with a DPC membership at Boston Direct Health.

Other membership benefits include (but are not limited to):

  • Sutures and stitches
  • Vaccines (provided at cost)
  • Lab draws (phlebotomy)
  • EKGs
  • Skin lesion removal/destruction (warts, skin tags, sun spots)
  • Skin lesion excision and biopsy (lab tests not included; provided at cost)
  • Incision and drainage of abscess (lab tests not included; provided at cost)
  • Ear wax removal
  • Breathing treatments (nebulizers)
  • Pap smears (lab costs not included; provided at cost)
  • Thrombosed hemorrhoid – removal of blood clots
  • Botox and facial fillers (provided at 20% off for members)

Redefining the Physician-Patient Relationship

Traditional doctors spend an average of 15 minutes or less with their patients. One of the key ingredients of quality care is the physician-patient relationship. It’s difficult to develop one when you spend 45 or 66 days waiting to tell your physician about your medical history in 15 minutes or less. Shorter visits increase the likelihood that patients leave with a prescription as opposed to physicians taking more time to determine the root causes of an illness.

Most traditional doctors dislike abbreviated visits, but they lack other options. A study by the American Medical Association that followed 57 US physicians in internal medicine, family medicine, orthopedics, and cardiology revealed that physicians spent 27% of their time seeing patients can 49.2% of their time doing paperwork for the electric health record. While seeing patients—for 15 minutes or less—they spend approximately 37% of that time doing paperwork for the electric health record as well.

DPC patients get a full hour with their physicians and none of that time is interrupted by insurance paperwork. That time is spent developing the physician-patient relationship. This allows for physicians to firmly understand your medical needs, your passions and goals, and to have a vested interest in your well-being. Having a strong relationship with your physician can allow your doctor to provide more accurate advice on subjects such as nutritional counseling, lifestyle care, preventive care, and your overall medical well-being. There’s no putting a price on that level of care.

Learn More About Your Healthcare Opportunities

Whether you’re an employer, an employee, or somewhere in between, it’s essential to educate yourself about the difference between DPC and traditional health insurance to determine which—or both—best fits your needs.

One popular strategy utilized by members involves having a low-cost insurance plan with a high deductible. These members use DPC as a way to offset the cost that they would be paying via that deductible. DPC provides an innovative option that eases the stresses caused by our inefficient healthcare system. Learn more about how you can benefit from becoming a DPC member

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