A More Direct Future for Primary Healthcare?

August 28, 2019
By Naomi Lopez

Imagine being able to access your healthcare provider in minutes or hours instead of days, being able to visit for a half-hour or more without the pressure of knowing that there is a roomful of patients outside still waiting to be seen, and paying less than you would for a single urgent care visit. Fortunately, this approach is a reality in many areas across the country.

I recently joined Tony Mazzaferro for the latest episode of the Benjamin Rush Institute‘s Next Generation Medicine podcast to talk about Direct Primary Care (DPC), what it is, and whether it will be an important part of the future of healthcare. 

DPC allows patients or their employers to directly contract with a provider for primary care medical services. This allows patients to directly and more immediately access non-emergency care and, under many arrangements, allows them to do so as many times as needed at no additional cost. 

Much of my discussion centered on my personal experience with Redefine HC,  a DPC provider that operates in my hometown of Springfield, Illinois. Unlike a typical healthcare arrangement, DPC operates independently of traditional health insurance. But in some states, decades-old regulations originally designed to govern the health-insurance market are being imposed on these arrangements, stifling the potential growth of this new healthcare option. 

By contracting directly with primary care providers, patients and providers can avoid many of the administrative costs that come with traditional health-insurance arrangements. This can also allow for more a more direct relationship between the patient and provider—eliminating the middleman. Most DPC providers are available via email, phone, and text 24/7. Some, including mine, will even make house calls. 

As the success and popularity of the DPC model grows, so will the evolution of the model. Take, for example, Dr. Ray Altamirano, a DPC provider in San Antonio who has partnered with a restaurant owner: 

“…[E]very employee contributes seven dollars a week and the employer will contribute the same amount per employee. This will allow them to visit Altamirano, as well as other medical professionals like dentists and eye doctors part of the doctor’s network who have agreed to charge for services given and not the large bill handed down by insurance companies.” 

Bills defining and protecting this healthcare model have passed in more than a dozen states and other states are poised to follow suit. By passing laws that define DPC as a medical service rather than insurance, state lawmakers can ensure that this arrangement will not be squelched by state insurance regulators. 

I also discussed how DPC promotes drug price transparency. Many practices offer prescriptions at wholesale cost, while a small handful include generic prescriptions as part of the membership fee. This transparency and added value are just one more reason why DPC is here to stay. 

You can listen to the full podcast here. 

Naomi Lopez is the director of healthcare policy at the Goldwater Institute.