The Future of Primary Care May Surprise You

We know primary care doctors are being hit hard by all of the changes occurring in medicine. In the following illustration, Dr. Eric Topol demonstrates why doctors are feeling squeezed these days:



Some doctors are joining new networks and practices that promise a way out of the confusion of modern medicine and medical billing. The two models being discussed in this post are "Direct Primary Care" and the "Hybrid Concierge Model."

The first model, direct primary care, is a flat monthly fee charged to patients in exchanged for unlimited access to their doctor. People seeking this model may even switch to higher deductible plans because they know a lot more will be covered by their primary doctor. Primary doctors often choose this route to reduce their patient panel and provide more personalized care to their consumer.

Interestingly, the America Academy of Family Physicians has spoken out in support of this new model.

"The AAFP supports the physician and patient choice to, respectively, provide and receive healthcare in any ethical healthcare delivery system model, including the DPC practice-setting."2

The new health care law also supports DPC model.

"To qualify to offer their products on exchanges, direct primary care practices must provide medical homes and be packaged with wrap-around health plans for noncovered services. Lower-income individuals who choose such combination plans will be eligible for federal subsidies to help cover the cost."3

Hybrid concierge practice models are designed to accommodate for physicians who don't expect to stop billing their patients' insurance, but have decided to charge an extra fee for their care in order to compensate for insufficient insurance compensation. This is essentially operating both a traditional medical practice model (e.g. billing insurance) while also "charging a monthly, quarterly or annual retainer or membership fee for services that Medicare and insurers don’t pay for."4

"A practical reason to go with this approach is that it allows you to determine if eventually going entirely off of a traditional practice model is right for you.  Physicians also like this model because they are able to retain many of their established patients (under the insurance payment side) without have to hand them off to another practice."5

What do you think of these new health care delivery models? Will you change the way you practice in the future or continue with traditional insurance billing?

Works Cited:

1 Doctors Are Getting Squeezed

2 AAFP Statement On Direct Primary Care

3 Direct primary care model: Cutting out the insurer

4 Business Models: A Simple Look at the Best Corporate Structure for Your DPC Practice

5 Physician's Practice: Concierge Medicine vs. Direct Primary Care