Key values
Subscription-based
Direct Primary Care is based on a subscription model. Members pay a monthly fee to gain access to pre-defined primary care services. Payment may be made monthly, quarterly or annually depending on the vendors.
Payment
Depending on the size of the DPC, patients may pay their physician directly. However, for nationwide services there may be vendors that manage the membership where the cost of service is covered and managed by the service and the patient only pays the visit fee to the physician.
Not Insurance
DPC practices may work only on the new model. If it is only DPC it is NOT insurance. The patients pay an upfront visit fee that may be as low as $10 per visit-no limit to the visit.
Hybrid model
Some DPC may still accept insurance through a hybrid model. Here if the patient decides to pay with insurance, they still have to deal with insurance claims, deductibles, or copays.
Compassionate care
Since DPC does not deal with traditional insurance, physicians have more time to create better relationships with their patients providing more compassionate care.
Decreased wait times
DPC practices offer both virtual and in person care, both of which are unlimited. This allows patients to have decreased wait times and more personalized care.
No hidden costs
The beauty of DPC is that there are no hidden costs or complex billing. You pay for the subscription you set up and then per visit both of which are affordable and transparent.
DPC Services
DPC is a cost effective new model for primary care. It mostly covers manageable chronic conditions and also annual physicals. However, it will not cover hospital care or specialist care. There are third party companies that are now partnering with DPC offices to create cost-effective comprehensive alternatives to traditional insurance. Patients must ensure they have all the necessary information before they opt to supplement or switch from traditional insurance.
Defining Direct Primary Care
Direct Primary Care (DPC) is a subscription based healthcare model in which patients pay a monthly fee directly to the vendor or physician to access primary care services. This is not an insurance based model and is focused on more compassionate care.
Advantages of DPC
Easy billing made directly to the physician or an online third party vendor
Low cost per visit as low as $10
Monthly subscription fee can also be as low as $50 depending on the physicians and type of membership
Unlimited visits
Reduced wait times
Compassionate care
Disadvantages of DPC
There are no deductibles so you pay the subscription fee and the visit fee without anything being contributed to the deductibles
Hospitals, urgent care and specialists fees are not covered so additional insurance may be needed
Depending on how it is set up the membership fees may not qualify for Health Savings Accounts (HSAs)
No searchable databases of available DPC providers by name or location, making it hard to confirm if a specific doctor participates
Lack of education on what DPC is and the difference between insurance and DPC
The value of DPC
The value of DPC may essentially be for those who cannot afford traditional insurance and have the need for more visits due to chronic conditions that are manageable but do not require specialist care. You can see a primary care physician as many times as needed with worrying about hidden costs or extra charges you cannot afford
Difference between DPC and Concierge Medicine
Concierge medicine is a form of direct primary care. Like DPC it does not accept healthcare insurance and comes at a monthly subscription fee. It is a hybrid that allows members to call a direct line and choose the medical care they require with white glove service.
Members pay an average of $135 a month and this covers the office visit and any procedures that may occur.
Adoption of DPC
One of the biggest blockers to adopting DPC as a new model of healthcare is that it is different from traditional health insurance. The onboarding is different, payment structure and even services may differ.
Users not used to the process consider it hard to understand and need more education to adopt it.