Source: (Workforce.com) While accountable care organizations have been in the spotlight since the concept was highlighted in President Barack Obama’s 2010 health care reform law, direct primary care is another health care delivery model that is generating buzz among employers looking for a way to better manage their medical costs.
Direct primary care is a twist on “concierge medicine,” a trend that emerged 10 years ago as a way to serve wealthy patients willing to pay hefty fees for unlimited access to medical care. Proponents see the plan as a way to make health care more affordable and accessible to everyone.
For less than $100 a month, patients get unlimited doctor’s visits for routine services and same-day or next-day appointments with no insurance claim forms or deductibles to worry about. Some practices also cover lab fees and basic X-rays. Patients are encouraged to purchase a basic health insurance plan to cover emergency services and specialized care, which is not offered through direct primary care.
“Primary care is very expensive and insurance is all-inclusive, from $4 Advil to major heart surgery, and that’s just not necessary,” says Dr. M. Samir Qamar, founder and CEO of MedLion Inc., a direct primary care provider based in Monterey, California. He says that the purpose of most types of insurance should be to cover unexpected or catastrophic events, not predictable routine services such as wellness checkups. “We’re saying, let’s split it down the middle.”
Critics, however, say that eliminating insurance from primary care would exclude patients who can’t afford the monthly fee. And others point out that direct primary care doesn’t make economic sense for healthy patients who could end up paying a monthly fee for services they don’t use, much like an underutilized gym membership.
But physician and health care consultant Dr. Zubin Damania, who is based in Las Vegas, says direct primary care makes sense for both patient and doctor. Damania is working with online retailer Zappos, which is considering offering a direct primary care clinic to employees at its Las Vegas headquarters.