Writing in Forbes today, Microsoft veteran and now health care-themed tech startup founder Dave Chase waxes poetic about Direct Primary Care (DPC), something he calls concierge medicine for the masses. More like a gym membership than an insurance plan, its boosters describe it as the antidote to what they consider to be a system that currently overinsures people:
Chase obviously is a firm believer in the notion that most health insurance plans pay for too much, like car insurance covering your gas (in the past he's compared it to a hypothetical homeowner's insurance policy that covers the routine servicing of household appliances). Given his faith in this DPC approach, he apparently sees a light at the end of the tunnel: "What looks like a very minor part of Obamacare may prove to be the most important clause to slaying the healthcare cost giant that has crushed family, business and government budgets."
His piece is: "David Clause" in Obamacare Ready to Slay the Healthcare Cost Beast:
I'm not convinced his argument is particularly strong, but it's an interesting perspective. I suppose we'll see if those arrangements take off.
Direct primary care practices offer a membership-based approach to routine and preventive care that can dramatically reduce health care costs for individuals, families and businesses.
Direct primary care practices serve as a patient's "primary care medical home" (D-PCMH) where they go for all routine primary, preventive and chronic care management types of care. Patients pay one low monthly fee-sometimes as low as $49-directly to their direct primary care facility for all of their everyday health needs. Like a health club membership, this fee gives patients unrestricted access for visits and care, so patients can use the services as much or as little as they want. Many direct primary care practices are open seven days per week and offer same-day or next-day appointments. At many clinics, physicians are on call 24/7.
There is none of the paperwork and expense required today by insurance reimbursement - no procedure or billing approval, deductibles or co-payments. With a lower business overhead and dramatically less paperwork, primary care providers are no longer forced to squeeze in an unmanageable number of patients and can instead take the time necessary with each patient to deliver high-quality, personalized care.
Accidents and the unexpected do happen, so the typical patient in a direct primary care practice keeps an insurance plan to cover emergencies and serious illnesses. Because this insurance doesn't need to cover routine care, many patients choose a less comprehensive plan with a higher deductible and lower premium.
Chase obviously is a firm believer in the notion that most health insurance plans pay for too much, like car insurance covering your gas (in the past he's compared it to a hypothetical homeowner's insurance policy that covers the routine servicing of household appliances). Given his faith in this DPC approach, he apparently sees a light at the end of the tunnel: "What looks like a very minor part of Obamacare may prove to be the most important clause to slaying the healthcare cost giant that has crushed family, business and government budgets."
His piece is: "David Clause" in Obamacare Ready to Slay the Healthcare Cost Beast:
Proponents of DPC state that the best way to pay for healthcare is to pair DPC with a high-deductible wraparound policy. The idea is you use insurance what its best for rare items (house fires, cancer, major car accident). For day-to-day healthcare, DPC is paid for in a model that is akin to a gym membership a flat monthly fee regardless of how much one uses it (though some have co-pays mainly due to state insurance regulations).
As an observer of the evolution of health plans, Ive been stunned by how slow insurance companies have been to capitalize on the DPC opportunity. Perhaps they were waiting for the Supreme Court ruling. For several months, Ive said that its clear how the insurance exchange marketplace will play out. Before long, insurance companies will realize a key way to win in the insurance exchanges is price. Low price wins. Theres no better path to a lower price than pairing a DPC model with a high deductible wraparound policy which is explicitly what Section 1301 (a)(3) of Obamacare allows. Given how game-changing this is, surprisingly few insurance companies even know about this clause given the threat and opportunity it poses. DPCs other notable advantage for insurance companies is the Medical Loss Ratio requirements (read the bunker buster article for more). In a nutshell, insurance companies have to keep overhead low and DPC allows them to eliminate most of the bureaucracy associated with day-to-day healthcare that would be like getting an EOB for your visit to Jiffy Lube.
I'm not convinced his argument is particularly strong, but it's an interesting perspective. I suppose we'll see if those arrangements take off.