Direct primary care explained and four reasons you need it

May 28, 2020
Josie Rasberry

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Most people know what a primary care physician is, but what exactly is direct primary care (DPC?)DPC is different from the typical fee-for-service, insurance billing model in that DPC operates like a subscription service. Patients pay a monthly, quarterly, or annual fee to have access to their doctor at any time and for almost all services.  

Just as you pay a monthly fee to watch your favorite shows on Hulu or Netflix, you can pay a subscription service to your doctor to cover primary care services such as clinical or laboratory services, consultative services, care coordination, and comprehensive care management. But what are the actual benefits to a direct primary care physician? We’re glad you asked:

You don’t need insurance.

DPCs do not accept health insurance as payment, but even if you do have insurance you can still go to a DPC. Whether you have a plan with a big health insurer, a health sharing community, or something in-between, you can still save money and have a better healthcare experience by using a direct primary physician. In many cases, health sharing communities will offer you a discount on your monthly fee if you have a DPC and some employers offer to pay for a DPC as an alternative to health insurance. For those who are unemployed or work part-time, direct primary care is an affordable way to get quality health care despite job status.

Price transparency.

You rarely know the exact cost of a health care service or appointment before going in, which is why the price transparency that comes with DPC is so great! Since you pay a flat rate, you know exactly how much it costs to receive the services your direct primary care physician offers. This makes it easier to budget for other health care expenses, such as medications or surgeries, and relieves a lot of the stress that comes with going to the doctor. Depending on the DPC, some will even recommend tools and services to help you shop for the best price on your medication, imaging and even surgery centers.

Better health.

Everyone is guilty of putting off making an appointment or ignoring pain because they couldn’t afford the expense. Since you pay every month, quarter, or year for a direct primary care physician, there’s never an excuse to not get care when you need it; you’ve already paid for it! DPCs are also available through online communication portals, which means you can ask your doctor about a medical issue you’ve been having and get a course of treatment over a text. Your doctor can also advise if you need to come in for an appointment or not, or even go see a specialist.

More interaction with your doctor.

One of the best perks of direct primary care is that doctors have more time to spend with patients. Less paperwork and not having to deal with an insurance company frees up DPC doctors to spend enough time with patients to get to the bottom of a problem. In many cases, your initial appointment with a DPC will last an hour so you can build a relationship and your doctor can understand your health needs. It’s also common for DPCs to use online communication platforms, which makes it easy and fast to interact with your doctor for situations where you don’t need to go in for an appointment but do need your doctor’s advice.

Everyone is used to the “standard” system of healthcare: having health insurance with a high deductible (or a low deductible but high monthly payments), busy physicians, and no price transparency. There are solutions to this broken system though, such as direct primary care. As more people use these alternatives, the closer we get to fixing the messy healthcare system in America. At the very least, you get a more affordable healthcare option that improves overall health.

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Download The Limited Benefit Plans’ Guide to Competing On More Than Price

Discover how to stand out based on unique offerings and high member satisfaction, and how to implement these strategies.

Download The Complete Guide to Implementing Price Transparency

Discover how to bring price transparency into your benefit offerings to increase member satisfaction, lower overall costs, stand out from competitors, and improve member retention.

Download Your Roadmap to Creating Engaged Healthcare Consumers

Discover the roadmap unique to your health plan type and start seeing higher member satisfaction, lower overall costs, and healthier members.

Download How to Leverage Ambulatory Surgical Centers for Lower Costs and Higher Satisfaction

Discover how TPAs, health cost sharing groups, and limited benefit medical plans can benefit from the use of ASCs.

Download the Patient Advocacy 2.0 White Paper

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Download the Complete Guide to Retaining Health Plan Members.

Learn the best strategies and tips for retaining your members while keeping costs low.

Download the Complete Guide to Growing Your Health Plan Membership

Learn the best strategies and tips for growing your members while keeping costs low.

Download the Complete Guide to Lowering Member Costs

Discover what health plan members had to say about the value of patient advocacy in our survey.

Download Healthcare Consumerism 101: A Playbook for Health Plans

Learn the best strategies and tips for retaining your members while keeping costs low.

Download Your Guide to the Transparency in Coverage Rule

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Download Your Guide to Unique Benefit Offerings that Don't Break the Bank

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