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What employers should know about direct primary care

We explore the trend of direct primary care by answering employer FAQs.

Direct primary care, also referred to as concierge primary care, is a popular alternative to traditional fee-for-service insurance billing. Most widely adopted in the individual market, the model allows doctors to spend more time with each patient as a result of smaller patient pools and less administrative paperwork. Employers can also take advantage of the benefits of direct primary care by offering access to their employee populations. It’s a convenient way to provide quality care, improve employee health and provide a competitive benefit for recruitment and retention.

In this article our clinical team answers questions commonly asked by employers. To see how direct primary care and near-site clinics could work for your company, access custom checklists, vendor questions, sample ROI reporting and more in our step-by-step clinic planning guide.

 

What is direct primary care?

Direct primary care is the practice of delivering high-quality, physician-led care to employees through near-site, onsite or shared multi-employer clinics independent of traditional employer-sponsored insurance. Compared to traditional primary care, employers find direct primary care offers a better experience, more comprehensive care and lower costs.

 

What would direct primary care mean for my employees?

We often hear patients make stark contrasts between what they are used to and the type of care they receive in a direct primary care setting. Many employees are frustrated with what they’re used to in a traditional setting. For the time and effort employees invest in seeking medical care, they don’t get much in return.

Research published in the American Journal of Managed Care estimates that it takes an average of 121 minutes each time a patient seeks medical care, including 37 minutes of travel time and 87 minutes at the clinic.

Out of those 121 minutes, patients spend 8-12 minutes face-to-face with their doctor. That’s less than 10% of the total time patients invest in seeking care.

Direct primary care flips this narrative. A smaller patient pool (typically 800 depending on membership age) and lower administrative burden allow physicians to spend as much time as necessary with each patient – whether it’s a 45-minute discussion of multiple issues or a quick phone call. Clinics also accept same-day appointments. One of our patients recently remarked:

“My experiences in your office are 500% better than any I’ve had before…especially when I have to wait 45 minutes after my scheduled appointment time to see my doctor. You all have spoiled me, no other doctor’s offices will ever be able to live up!”

This drastic change in experience can have life-changing impacts on patient health. Employees are more willing to seek out care for chronic conditions like diabetes and high blood pressure when they know their doctor will listen to them and work with them to develop a plan of action.

Employees also welcome the immediate financial savings at the point of care: employees pay nothing out-of-pocket to use the clinic.

 

How does direct primary care different from traditional primary care?

Dive into the differences with a side-by-side comparison:

Healthgram Side-By-Side Direct Care Comparison

You’ll see the approaches differ in three significant ways:

 

  1. Emphasis on complete patient care, not volume or paperwork:

To see the 24-30 patients a day in a traditional practice, doctors must limit time spent with each patient. A 2017 survey revealed six out of ten physicians agreed with the following statement: “my visits with patients are often too short for me to answer their questions and treat them effectively.”

In the direct primary care model, smaller patient panels allow physicians to spend as much time as needed with each patient, ensuring no question goes unanswered. The physician operates independently from your traditional insurance, meaning clinic staff is not burdened with claims processing and can focus on delivering patient care.

 

  1. Long-term treatment and management of health conditions versus episodic:

Episodic care, when employees rush to specialists or the ER for escalated health issues, is expensive and fragmented. In contrast, the additional time built into the direct primary care model allows physicians to uncover future potential risks or health issues before they become catastrophic – something that can’t be done in an 8-12 minute visit.

Whether employees are in need of long-term care for chronic conditions or are maintaining their current health status, the clinic becomes their medical home, and the physician their singular point-of-care.

 

  1. A focus on cost-effective referrals and coordination:

Physicians in a direct primary care clinic take the time to provide a broader scope of care, drastically reducing the amount of specialist referrals (1 in 3 patients are referred out in a traditional system). When patients are referred outside of the clinic, care doesn’t end there. The physician coordinates with fair-price providers and advocates for each patient, generating savings for them and for your health plan.

 

Why are employers embracing direct primary care?

Employers embrace direct primary care because it offers a proven alternative to a system that doesn’t work. Employers are attracted to the idea of an independent physician who is compensated in a way that delivers quality care and lowers costs.

The impact expands into the strength of your workforce. Because direct primary care provides a better and more convenient experience, healthcare becomes a recruitment and retention tool. Employees who make use of their clinic spend less time away from work and are more productive.

The direct primary care model is also cost-effective. It complements an existing group health insurance plan, and employers bypass insurance companies to pay for care directly. In addition to managing potential catastrophic claims in the future, employers can achieve up to a 20% reduction in total healthcare costs.

 


Take the next steps in your near-site clinic research with interactive checklists, vendor evaluation questions and an ROI report. Access the guide.

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