The trustees of the Hidalgo County self-funded health plan providing healthcare benefits for the county’s +4,000 employees administered by Aetna believes there may be a better solution than traditional fee-for-service primary care.
Is this a recognition that things could be better? The answer is obviously “Yes.”
The county has solicited proposals for direct primary care services. The goal is “to improve employee health and education which leads to positively impacting employee health and engagement. The clinic will provide quality care at a lower cost to the county’s employees, reducing costs to our self-insured plan. Additionally, other expected savings may include employee productivity impact, reduced absenteeism impact, recruitment and retention impact, and improved management/quicker return to work for workplace injuries.
Will local fee-for-service primary care physicians take this lying down? Their income, as skinny as it is for most primary care physicians, is threatened.
Not to worry. They can’t compete with a direct primary model because they typically earn less than Medicare rates through managed care contracts. In order to survive financially they must maintain a panel of patients four and five times larger than a direct primary care panel. Spending more than 5 or 10 minutes with a patient reduces their income so they necessarily have to maintain a fast moving patient conveyor belt backed by standing room only waiting rooms of sick people sitting well past their appointment time with hope based on the lying promise of “the doctor will see you shortly.”
There is no doubt Hidalgo County will adopt the direct primary care model. We believe that decision has already been made. The next logical step is plan managed referrals for upstream, cash paid care at the point of service. Aetna won’t like that but that’s ok because at that point they won’t relevant anymore.
Smart money favors Frontier Direct Primary Care with 5 to 1 odds. Frontier DPC Blitzkreig In Deep South Texas Liberates 10,000 Fee-For-Service Consumers From Managed Care Hell
