There is increasing discussion regarding “Direct Primary Care,” otherwise known as DPC or “membership medicine.” The basic premise of Direct Primary Care is a subscription model where an individual can have unlimited access to a primary care provider in exchange for a monthly fee ($60 to $150 according to Employee Benefit Advisor). Part of the rationale behind DPC is that improved access to, and use of, primary care services may produce better population health as well as lower overall healthcare expenditures.
Employers are curious about DPC as a means to reduce overall healthcare costs. Would the use of a subscription model that operates separately from their primary insurance encourage doctors to:
- Deepen relationships with patients and be more pro-active in the health of DPC customers
- Improve their communications with patient’s to expand beyond immediate symptoms and complaints to long-term health strategies
- Use lower cost delivery channels (such as email, internet video, or phone) to deliver care more efficiently given that insurer channel-specific reimbursement considerations are removed
On paper, the answers seem positive. However, one of the unanswered issues for employers concerns the prospect that DPC may have the same success challenges that attend health & wellness programs. For both DPC and health & wellness, there is an important dependency on the patients’ implementation of medical guidance and the significance of this dependency overshadows improved access to that guidance. With respect to health & wellness programs, they have struggled to demonstrate consistent financial returns and improved population health. The degree to which this ROI challenge will face Direct Primary Care is still unknown at this point given the relative newness of the model, its small degree of adoption, and the scarcity of broad-based data. While few people would argue against the value of increased primary care access, there are honest questions about how this model could meaningfully reduce costs for the segment of the population that drives the largest portion of healthcare spending. Such questions, in and of themselves, do not invalidate the initiative but rather invite advocates and critics to review data collaboratively.