This installment of CenterStage dives into the world of Direct Primary Care Clinics. Your expert insight this month will be from Douglas (Doug) Johnson, a Partner and CEO at JA Benefits, and Greg Ransom, an Account Executive at JA Benefits. Together, they have provided insightful knowledge on Direct Primary Care (DPC) Clinics – what their purpose is, how costly they are, and some pros and cons.

An Introduction to DPC

Around 2010, JA Benefits noticed a considerable lack of primary care physicians in our community and nationwide. They knew this shortage would lead to a strong demand and persisted to establish access to primary care physicians with as few barriers as possible. Why? JA saw an opportunity for employers to pay less and employees to gain more personalized care.

[At JA], our role is to identify a situation where [DPC] will be beneficial for an employer…There’s not a lot of circumstances where it doesn’t make sense, although it depends on how you fund your health benefits. We take all your information into account, and then we help assess whether DPC might be the right choice for you.

-Greg Ransom

Pros & Cons

There are many reasons why DPC is preferred over traditional care, but here are our top five:

  1. It’s less of a waiting game. In a traditional care facility, patients often wait a good 20 minutes before being assisted by a nurse, sometimes longer. DPC Clinics work on a 30-minute schedule, so they only have two to three appointments per hour versus 10-12 appointments per hour at a traditional clinic.
  2. DPC is a more personal, patient-centered experience. Since doctors have fewer patients to see and the environments are often more informal, the doctors can establish a customized level of care.
  3. Employers pay less. With DPC Clinics, an employer pays a flat fee on a per-member, per-month basis, so the employee has no out-of-pocket cost, no copay and can gain access to generic drugs and basic lab tests at virtually no cost.
  4. The option for shared clinics. Shared clinics provide client’s that otherwise wouldn’t have been able to participate in something like this the opportunity to go in together on a shared clinic. With 2,000-2,500 members necessary for a full-time clinic and 1,200-1,500 members necessary for a part-time clinic, shared clinics offer new ways to save.
  5. Early detection and ongoing care management. Two of the great promises of Direct Primary Care are managing lower costs on a long-term basis and focusing on managing a person’s chronic conditions. The success stories JA has encountered relate to early detection of cancers or heart disease – due to DPC’s quick and personal nature.

That is not to say there are no cons to choosing DPC over traditional care:

  • If you are covered under a qualified High Deductible health plan and contribute to a Health Savings Account you may be required to pay a small amount to access DPC for acute services. However, Congress is considering a bill called the Primary Care Enhancement Act which would fix this issue.
  • There are not a lot of DPC doctors to go around. Because DPC is a smaller facet of the United States Healthcare System and a relatively new alternative to traditional care, there are fewer DPC doctors than traditional doctors. Per the DPC Coalition, “…there are just over 500 physicians using this approach across the country.” However, this number continues to grow as DPC becomes a more affordable option for employers.

Conclusion

With every healthcare option, there can be drawbacks. With DPC, those drawbacks are minimal and are continuing to be fought against. JA Benefits is unique in that they are successful at creating and implementing Shared DPC Clinic Models. Historically, only large employers could sponsor these clinics, but with the shared clinic model, several small and or mid-size employers can offer access to these clinics at an affordable cost.

If you believe offering Direct Primary Care to your employees could be a cost-effective option for you or would like to learn more about this option, contact Doug Johnson or Greg Ransom at JA Benefits for more information.

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