Health care
BY ZACHARIA WASHINGTON
Providers seek different care model
Diving in deeper
The DPC model was introduced to the health care industry about two decades ago as a form of concierge medicine, Euphoria Health Founder and CEO Dr. Chris Larson said. Larson said concierge medicine requires patients to pay a monthly membership fee, while still billing their health insurance companies. This practice is known as “double-dipping,” according to a May 2020 study from the DPC Coalition. Pricing at area DPC clinics ranges from $70- $100 per month for adults, and most clinics have packages for families, according to local providers. This price can cover visits, telehealth services and various treatment options, but it does not include advanced testing, X-rays or specialty care. For these services, patients are often referred out to imaging centers and specialists, and can choose to bill the cost through their insurance or pay an out-of-pocket fee. The fee is often reduced through a partnership the DPC practice has with the referred provider, Miller said. DPC memberships can be a more affordable option for those who are uninsured, said Jamie Keller, a retired nurse and owner of Cornerstone Patient Advocacy. Keller works as a liaison between patients and providers, and helps guide patients toward the best plan for their health care. Miller said a lot of the patients at Premier Health MD do not have health insurance, though several local providers still encourage people to have some form of catastrophic coverage, if they are able to, as DPC cannot cover emergencies. “We can take care of about 80% of your health care needs, but there is a time and a place for traditional insurance,” McKitterick said. “Medical insurance was meant to be like your car insurance where it’s used when things go really bad.”
Direct primary care is a developing model in the health care field that does not require patients to have insurance to receive select primary health care services, said David Miller, practice manager at Premier Health MD, a DPC practice located in Cedar Park. At a typical DPC practice, many services are covered through a subscription-based monthly fee or discounted and paid by cash. DPC patients can receive most of the services offered at a traditional clinic, including chronic disease management, annual physicals, sick visits, treatment for acute injuries, urgent care and lab testing, according to local DPC providers. Miller said the DPC model allows providers more one-on-one time with patients since they aren’t spending several hours a day completing billing paperwork for insurers. In the last five years or so, there has been an increase in the amount of patients purchasing a DPC membership, according to the 2022 Direct Primary Care Trends Report by Hint Health. Per the report, there were 163 DPC members per 100,000 Americans in 2021, a roughly 240% increase compared to 48 per 100,000 Americans in 2017. The number of active DPC providers per 100,000 people grew by 159% between 2017 and 2021, compared to a 6% increase in the number of active primary care providers per 100,000 people, per the report. There are at least 1,600 DPC clinics serving more than 300,000 American patients across 48 states, according to the Direct Primary Care Coalition. “It’s a great option for patients but also a really great option for providers as we get to
Demand for DPCs
240% Roughly
increase in DPC membership in the U.S. from 2017 to 2021
increase from 2017 to 2021 in the number of active DPC clinicians per 100,000 people 159% states where DPC clinics operate as of 2021, up from 20 in 2019 40 DPC practices in the Austin, Liberty Hill, Cedar Park, Lakeway, Round Rock and Hutto areas 12 At least DPC practices nationwide serving more than 300,000 patients 1,600 increase in DPC membership during 2020; fee-for-service adult primary care visits decreased 10% 21%
SOURCES: DIRECT PRIMARY CARE COALITION, HINT HEALTH/ COMMUNITY IMPACT
actually take care of patients instead of doing paperwork all day for insurance companies,” said Monica McKitterick, family nurse practitioner and owner of Impact Family Wellness.
Looking ahead
Factors to consider when choosing a medical provider
“[Insurance companies] have a really expensive product that is incredibly confusing, and no one understands, yet everyone buys it,” she said. “I think if people were more educated on what their insurance actually does and doesn’t do, they would stop buying it.” Specialty doctors such as dermatologists will also likely begin implementing the model at their practices, Keller said.
Area health care providers said the DPC model will likely continue to grow in the coming years. However, Larson said it will be a while until it becomes the main form of primary care. McKitterick said for the model to grow, patients need to be educated on what it is. She said society has made people believe they absolutely need insurance, when that’s not always the case.
Overall status of health Insurance coverage
Satisfaction level with current health care Amount of doctor’s office visits per year Management needed for any chronic conditions
SOURCES: EUPHORIA HEALTH, IMPACT FAMILY WELLNESS, PREMIER HEALTH MD/COMMUNITY IMPACT
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