Hatch-Paulsen Bills Would Allow Monthly Primary Care Fees to Be Paid With Pre-Tax Funds and Direct IRS to Stop Classifying Direct Primary Care Model as an Insurance Product
SEATTLE, WA, Jun 19, 2013 (Marketwired via COMTEX) — The Direct Primary Care Coalition today announced that it strongly supports the Family and Retirement Health Investment Act of 2013 sponsored by Sen. Orrin Hatch (R-UT) and Rep. Erik Paulsen (R-MN) to promote the growth of direct primary care medical care (DPC) homes and make primary care more accessible, affordable, cost effective and efficient.
“We thank Sen. Hatch and Rep. Paulsen for their continued leadership and commitment to transform and reshape health care,” said Erika Bliss, MD, co-founder of the Direct Primary Care Coalition and President and CEO of Qliance Medical Management Inc., which has pioneered DPC clinics in Washington State since 2007. “They clearly understand that changing how primary care is delivered and paid for, and making it affordable and available to every American, is key to fixing many of the problems arising from a reimbursement system that pays doctors based on volume of services instead of quality and results.”
The proposed legislation includes two critical reforms that have the potential to transform the quality and cost effectiveness of the U.S. health system. One clarifies that the DPC medical home model is to be classified as primary care rather than a health maintenance organization or health insurance product in the Internal Revenue Code (IRC). Under the innovative DPC model, individuals or employers pay physicians a flat monthly fee covering all primary and preventive care, chronic disease management and care coordination throughout the health care system rather than a fee per visit, service or procedure, as is the case under the current volume-based reimbursement system.
Although DPCs do not bear any insurance risk and do not submit fee-for-service bills and claims to insurers and patients, they historically have been lumped together with health plans by the Internal Revenue Service due to their monthly fee structure. The proposed Hatch and Paulsen bill clarifies language in section 223 (c) of the federal tax code that the IRS uses to interpret DPCs as insurance companies or products.
Language in a different provision of the Family and Retirement Health Investment Act of 2013 would treat monthly fees for direct primary care services as “qualified medical expenses” under section 213 (d) of the IRC. It would allow individuals to use pre-tax money in health savings accounts (HSAs) and flexible spending accounts (FSAs) to pay for those costs.
“As the country moves from an uncoordinated fee-for-service delivery of health services to an accountable fee-for-value model, it is imperative that laws be updated to support and keep pace with emerging care models designed to encourage and reward doctors to spend more time with patients, coordinate care across settings, and prevent onset of disease or minimize its impact,” stated Dr. Bliss. “Research has shown that timely and excellent primary care reduces emergency department visits, specialist visits, hospitalizations and surgeries. We applaud Sen. Hatch and Rep. Paulsen and urge Congress to pass this legislation to enhance quality and substantially reduce healthcare costs.”
For more information about the benefits of DPCs for patients, physicians and the U.S. health system visit the Direct Primary Care Coalition at http://www.dpcare.org.
About the Direct Primary Care Coalition The Direct Primary Care Coalition is a growing organization of health care providers, patients, employers, and active citizens united in support of direct primary care. Through awareness campaigns and community outreach, the group works to ensure the availability of quality, affordable, and immediate primary health care for all Americans. Visit dpcare.org to learn how direct primary care makes healthier patients, happier providers, and a stronger America.
Qliance is a growing Direct Primary Care organization pioneering a transformative approach to healthcare. With an uncompromising focus on personalized, high-quality care, Qliance provides convenient access to doctors, nurses, and medical teams who deliver comprehensive services to limited numbers of patients giving them unparalleled attention and care. Patients have unrestricted access to 30-60 minute office appointments, phone and e-visits, extended office and weekend hours, and 24/7 physician coverage. By spending more time with patients, Qliance helps them avoid unnecessary specialist and hospital care, thereby reducing overall healthcare costs. Qliance patients also report increased satisfaction with their care and benefits. Qliance has partnered with more than 200 employers and trusts and serves over 7,500 patients at five locations in the Puget Sound. For more information, visit http://www.Qliance.com.