November 2, 2021

How Direct Primary Care Reduces Health Insurance Costs

Discover how direct primary care removes traditional healthcare roadblocks and can greatly impact health insurance costs for your organization.

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Traditional primary care aims to be accessible to almost anybody who needs to see a doctor. However, it’s not always easy for individuals to obtain quality, timely care with a primary care physician. Usually, primary care doctors are required to see thousands of patients. Meaning, when most people need access to a doctor, there are obstacles from overcapacity that they’ll have to face – before and during their appointment.

For example, appointments are often scheduled weeks – sometimes months in advance due to limited availability. Once patients arrive, their time spent waiting with a nurse or lab technician will most likely far exceed the time spent with the doctor. Along with the unpredictability of total time spent at an appointment, the cost of each visit is also unknown until patients receive their bill.

All of these unknowns cost money, time and create unnecessary frustrations for patients. In hopes of bypassing some of these variables, patients might avoid the doctor entirely or seek more immediate, expensive care at the emergency room instead.

For businesses, the inaccessibility of quality primary care not only impacts the patients who make up your workforce but also negatively impacts your business with health insurance cost increases, time away from work, and less healthy and productive employees.

The adverse side effects from primary care’s shortcomings have led employers to look to direct primary care (DPC) as a solution.

How Direct Primary Care Changes the Patient Experience

One key difference between direct primary care and traditional primary care is the involvement of insurance. Traditional primary care requires significant overhead investment to manage all the complexities associated with insurance carriers. Additional staff, paperwork, documentation, and more are necessary for traditional primary care practices to manage their interactions with insurance carriers. This added layer of complication requires doctors to increase their visits, patients, and services to financially support the required overhead.

True direct primary care functions 100% outside of health insurance. Instead, employers pay a monthly membership fee for employees to access a dedicated doctor. DPC’s subscription-like model allows employees the ability to spend quality time with their doctor as often as they need to, with no out-of-pocket costs. Additionally, DPC practices are much smaller, limiting the number of patients per physician, allowing DPC clinics to offer no wait times, same-day appointments, and no copays. It’s a style of primary care that removes middlemen, conflicts of interest, and waste. Insurance is still necessary for higher-cost treatments not available in the DPC clinic, at which point the DPC doctor would refer your employees to the appropriate providers. DPC ultimately leads to improved health for your workforce, lower healthcare costs for your business, and a decreased risk of future high claims.


How Direct Primary Care Impacts Health Insurance Costs

Direct primary care can offer businesses immediate savings in areas like:

– Increased primary care compliance

– Reduced specialist and ER visits

– Referrals to high-value facilities

Those efforts help to minimize health insurance costs and prevent future high claims. Employees receive care as often as they need it, reducing their health risks and ultimately improving the performance of your health plan.

Healthgram’s direct primary care solution allows companies to offer a dedicated doctor to their workforce while removing traditional healthcare roadblocks. Learn more about our clinics and how your employees can experience the personal care they deserve while improving your bottom line.