How DPC Can Lead to Cost Savings and Better Health

HOW DPC CAN LEAD TO COST-SAVINGS AND BETTER HEALTH

Healthcare costs are rising and making it difficult for patients to receive the care they need – even with insurance. Physicians are growing frustrated with the restrictions that private insurance companies are imposing on care and the administrative burden of bureaucratic red tape. With no obvious solutions in the conventional healthcare system, an increasing number of medical providers are looking into innovative alternatives to traditional practices.

A newer trend emerging in the field of patient care, direct primary care, also known as direct pay care or DPC, is a form of health coverage that does not rely on health insurance. In a typical contract with a DPC practice, a patient agrees to a flat monthly or yearly fee, in lieu of insurance and in exchange for enhanced access to medical services. The lack of insurance eliminates the need for third-party billing, fee-for-service payments, and insurer relationships. The cost of the DPC payment model is more transparent for patients, and it allows them more freedom in their healthcare choices.

According to the Direct Primary Care Coalition (DPCC), the DPC model has grown in the last decade from just 21 practices to over 1,000 practices in 49 states that care for an estimated 500,000 patients.  While the name implies the payment model is used for primary care physicians only, that’s not the case. Specialty practices are also beginning to recognize the benefits as well. In fact, Be Mobile Neurology is taking the DPC trend to even newer frontiers, as the only mobile neurology practice in the nation using the payment model.

The Frustration of Conventional Healthcare

Getting an appointment for a specialty service, like neurology, can be a difficult and time-consuming process in a traditional healthcare setting. After waiting weeks (or months) for your initial appointment, you then have to spend additional time in the waiting room and again in the exam room before you’re finally seen. When you eventually meet with your physician, the visit may feel short or rushed, leaving you without adequate time to explain your healthcare concerns. After all, you’re only one of the dozens of patients your doctor must see in a day. This impersonal environment and lack of attention can lead to frustration for patients. Compounding those feelings is the fear that insurance may not cover the visit, resulting in unexpected (and often expensive bills) for medical services. These issues are causing people with serious health issues to avoid medical care altogether, despite the risk of declining health.

And, the traditional healthcare system also presents significant challenges for the physician. In taking care of the patients in conventional healthcare, the well-being of the physician has been compromised. According to research, data entry and other administrative tasks accounts for 43 percent of a physician’s time every day. In a survey of physicians, 87 percent reported that these administration demands were the leading cause of stress and professional burnout.

DPC as the Answer

Through DPC, physicians like Dr. Deborah Boland of Be Mobile Neurology can offer a more customized and personalized service, without the restrictions, limitations, and administrative headaches that insurance companies impose.  The goal of the practice has been coined as “The Quadruple Aim” and is defined as “affordable care, better patient experiences, better patient outcomes, and better physician well-being.”  At Be Mobile Neurology, patients have direct access to Dr. Boland through calls, texts, emails, video conferencing, and in-home, in-person visits for a flat, affordable monthly membership fee.  Dr. Boland has a passion for improving every patient’s quality of life, and her goal is to lead the movement back to patient-centered, individualized care.

This personal attention is specifically beneficial to people living with chronic illness. A 2017 RAND study found 60 percent of Americans live with at least one chronic condition, accounting for hundreds of billions of dollars in healthcare spending annually. Because DPC physicians have more time and fewer patients, they can better treat and monitor their patients with chronic conditions – keeping them out of the emergency room and hospital.

A Closer Look at the Advantages of DPC

  • More access to care, regardless of age, pre-existing conditions, insurance coverage, or nature of the illness
  • Increased dedicated time with the physician
  • No insurance hassle or denials for physician care
  • More transparent cost of physician care with the monthly membership
  • Reduced cost of care overall
  • More efficiency and convenience in scheduling appointments
  • Better health outcomes through better access to physicians
  • Better overall quality of care
  • Emphasis on patient choice

Physicians at a DPC practice typically see less than 10 patients per day, instead of the 30 plus patients since at a traditional practice. Because there is no third party billing and no claims are sent to insurance companies, there is less administrative burden on the physician, which allows for more time treating patients.

The use of telemedicine like telephone and video visits also enhances the efficiency and effectiveness of the DPC model. Patients are able to able schedule more timely appointments – often even-same day – to address their health concerns before they get worse.

The longer appointments and greater access made possible by DPC allow time for more in-depth discussions between doctor and patient, with more emphasis on enhancing long-term health and well-being. This priority on preventative medicine also helps to eliminate some medical emergencies and to avoid hospital stays. Consider this: A single emergency department visit for a fall and broken hip can amount to $100,000 in total costs. A monthly membership fee of less than $200 to Be Mobile Neurology, by comparison, may prevent that ER visit entirely.

Compared to traditional fee-for-service insurance billing, the DPC model provides patients with cost savings and the freedom to visit their healthcare provider as needed. A traditional medical practice charges fee-for-service payments, which can add up fast. With a DPC provider, the monthly membership fee covers doctor visits and any services that were rendered. This fee is transparent with no hidden costs and remains the same every month, no matter the number of visits with the physician – resulting in significant savings for patients. It can also lessen stress for patients, eliminating the threat of insurance denials for much-needed medical services and reducing worry about inability to pay for healthcare needs.

Some patients may initially consider a DPC practice’s refusal of private insurance as a negative, but the opposite is actually true. One of the greatest benefits of DPC for patients is the freedom of choice offered by the model. Patients in DPC are able to pick the appropriate physician for them, without the limitations of insurance providers, and are fully involved in making their own medical and financial choices. Healthcare’s conventional system of insurance demands and limited patient interaction stands in sharp contrast to DPC.

In a time of rising healthcare costs and frustrations with the traditional system, DPC is emerging as an innovative option for patients seeking individualized, quality care. If the DPC payment model for neurology services sounds like a solution for you, please call (813) 981-4403 or contact us online to learn more.