No matter how you slice it, today’s version of Direct Primary Care (PCP) is Virtual Primary Care with a little bit of Brick & Mortar added in.
We have seen Direct Primary Care organizations realize exponential growth in the past several years with the prospect of growing even larger, quicker, in the coming months and years.
Traditional fee-for-service primary care physicians are beginning to realize there are opportunities to embrace the strategy on a hybrid basis to start. Virtual Direct Primary Care vendors partner with Brick & Mortar PCPs to satisfy instances where a patient needs to be seen in person by a local primary care physician.
Direct Primary Care organizations have found virtual care satisfies 80-90% of patient needs. That’s the reason DPC Brick & Mortar clinics are never busy, with no patients in a small office in front of an empty parking lot. Instead doctors and their medical assistants spend most of their valuable time interacting with patients through computers.
Incorporating Direct Primary Care into a group medical plan has been proven to reduce overall medical spend while at the same time improving member experience.
The key to success is two fold:
First, Direct Primary Care is focused on well care. 80-90% of one’s health care needs can be treated by a primary care physician. Plan savings are realized through reduced specialty referrals, ER visits, hospital admissions and prescription drugs. DPC can pay for itself through these savings.
Second, the referral process can be controlled. (He who controls referrals wins – the primary reason hospitals buy up PCP clinics every chance they can). The primary care physician is taken out of the referral business. Rather, referrals are made to the plan. The plan manager identifies high quality, low cost providers, makes all the appointments, providing personal concierge services to plan members needing secondary care.
Average capitated cost of Direct Primary Care is $60-100 per member per month or more. A hybrid model cost basis is divided into two parts; (1) Virtual Care averaging $15 – $30 per member and (2) Fee-for-Service Brick & Mortar PCP referrals averaging 150% of Medicare allowable (As a point of reference, the BUCAs punish PCPs with low reimbursement rates which can be less than Medicare allowable rates).
A few examples of the explosive growth of Direct Primary Care include Frontier DPC in the Lower Rio Grande Valley, Texas and First Primary Care in Houston.
Revive Health, in partnership with local Brick & Mortar PCPs offers a comprehensive hybrid DPC model. All data is tracked and shared with plan sponsors. Dedicated physicians and their medical assistants are assigned to each member. Added value benefits include free prescription drugs, urgent care, mental health and more
Investors see opportunities in Direct Primary Care. We do too.
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