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How Employers Can Help Reduce Healthcare Costs by Eliminating Unnecessary Care

Discover how direct primary care can reduce employee healthcare costs and prevented one patient from undergoing unnecessary treatment options.

The U.S. healthcare system is a multi-trillion-dollar industry and highly complex, with an array of moving pieces and stakeholders such as insurance carriers, hospital systems, governmental authorities, employers, PBMs, pharmacies, etc. These entities exist in-between patients accessing healthcare and play a role in the patient’s payment. Medical billing, paperwork, data sharing, administrative staff, and more are all required and necessary for a patient to see their doctor. This exhaustive process continues to build an environment where doctors must treat patients and accommodate the many stakeholders involved.

Due to the high volume of patients and overhead associated with a system of this magnitude, a patient’s quality of care can easily get lost in the shuffle. Sometimes, this results in unnecessary treatments or prescriptions. For example, according to the CDC, 30% of antibiotics were deemed unnecessary. Additionally, government health statistics stated that an estimated 7.5 million unnecessary medical and surgical procedures are performed annually, with needless hospital stays around 8.9 million per year. The most glaring statistic is that the U.S. is the leading nation in high healthcare spending and poor health outcomes.

Fortunately, Americans can save up to $2.5 trillion in healthcare costs with the right interventions, which brings us to an alternative solution: Direct Primary Care (DPC). More specifically, the rise in employers adopting DPC to curb their company’s healthcare costs, as private health plans represent 29% of total U.S. spend.

DPC is the practice of delivering high-quality care to employees independent from employer-sponsored insurance. Because of its self-dependent structure, DPC practices tend to have a limited patient panel, giving physicians the freedom to spend more time with their patients to provide a broad scope of care that focuses on prevention. This type of care requires more time talking to patients and less time checking boxes and filling out insurance forms. For a more in-depth perspective, look at this patient’s experience with one of our DPC physicians:

The patient suffers from Chronic Venous Insufficiency (CVI), which causes a high risk of developing ulcers. The patient visited our clinic with a chronic ulcer of the leg. To monitor the wound and swelling in the patient’s leg, the physician applied an initial dressing and scheduled an immediate follow-up appointment. A few days later, the patient came in for a follow-up, where the physician noticed the wound had improved but needed further care. With the physician’s extensive knowledge of this patient’s history, the physician concluded that this patient could use a more comprehensive dressing, an alternative to a more expensive referral to a wound clinic. The low patient count of this DPC clinic allowed the physician more time to appropriately treat the patient and prevent an unnecessary referral plus cost.

“The physician knew the patient’s history and understood the severity level of the patient’s condition. If the physician had additional patients and no time to get to know the patient, the physician would’ve had to opt for a wound clinic as his time and knowledge of the patient’s individual needs would be limited.” –Dr. Kate Long, Healthgram DPC Physician

Stories like the one above powerfully illustrate the key differences between insurance-based health care and the direct primary care model. DPC is a style of primary care that removes middlemen and conflicts of interest, leaving only the doctor and patient. This gives physicians time to diagnose the patient and determine the proper treatment – which might not include a prescription or procedure.

“Most doctors dealing with insurance hassles and seeing 25-30 patients a day don’t have time to dig deeper into their patients’ symptoms and concerns. With Direct Primary Care, I can get a more detailed history and provide individualized care for each patient, spending more time with them and practicing preventive medicine that can eliminate a problem before it becomes serious or even takes place at all.” – Dr. Kate Long, Healthgram DPC Physician

By taking the time to understand the “why” behind a patient’s problem, doctors can provide a unique treatment plan tailored to the patient’s specific needs, eliminating the universal approach of a prescription or procedure due to limited time and system hurdles.

Direct primary care is the powerful healthcare solution employers have been looking for to reduce healthcare costs and prevent unnecessary treatment options. Learn more about our direct primary care solution and how your employees can experience the personalized care they deserve while improving your bottom line.

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