BUSINESS: 2 New Infographics Explain SIMPLE Differences/Similarities Bet. DPC and Concierge Care

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By DPC Journal Staff

SEPTEMBER 16, 2015 – Free Market healthcare delivery is alive and well today across America. On one side of the free market umbrella is Membership Medicine models and on the other, Convenient Care Clinics — making this modern-day revolution in healthcare, approximately 12k strong combined. Not only is it [free marketing healthcare options] spreading in consumer awareness, causing more employers to rethink their healthcare benefit package options, it’s also putting more people into the drivers seat and causing them to analyze what options are available to them for healthcare in their local neighborhoods.

As we objectively observe the national marketplace, we see that there is a definite rising trend in consumer cost-shopping going on in healthcare. And now that more and more free market delivery model variations are on the rise, very soon, and particularly among the Millennial patient-base — more people are going to start “clinic-hopping.” Meaning, that these people (typically age 18-45) are shopping around and jumping around from one clinic to the next with no brand or relational loyalty — strictly making what they believe is a good buying decision based on price.

Published and designed by Staff at The Direct Primary Care Journal and its sister publication, Concierge Medicine Today and the Concierge Medicine Research Collective, these organizations have combined interviews, surveys and polling data to help describe the various nuances of each of these growing healthcare sectors in their own right.

Not every physician will choose Ideal Medical Practice environments, Direct Primary Care models or even choose to work within a Concierge Medical program. Over 60% of physicians polled in 2014 were so frustrated with today’s healthcare headaches that they are willing to leave the profession of medicine altogether … and start a new career entirely outside of healthcare, according to The Concierge Medicine Research Collective. Today (2015), there are more and more free market healthcare delivery solutions and buy-out options which physicians are evaluating.

While all Concierge Medicine and Direct Primary Care (DPC) practices do share some similarities, they vary widely in their staff employment, structure, payment requirements, insurance participation and form of operation. Both equally impressive and proven business/practice models, they differ in the level of service provided and the demographic using each. Additional characteristics of DPC include (Source: The DPC Journal):

  • DPC is primary and preventative care, urgent care, chronic disease management and wellness support through a monthly care fee patients (or an employer) pay to cover the specific primary care preventative care services.
  • DPC practices are distinguished from other retainer-based care models, such as concierge care, by lower retainer fees, which cover at least a portion of primary care services provided in the DPC practice.
  • Monthly fees at direct practices vary from $25-$85 per month or less. Patients prefer to pay monthly vs. quarterly or annually.
  • DPC patients typically come from the Generation X and Millennial population and earn a combined annual HH income of less than $100k.
  • A DPC health care provider charges a patient a set monthly fee for all primary care services provided in the office, regardless of the number of visits.
  • No insurance plan is involved, although patients may have separate insurance coverage for more costly medical services.
  • Because the insurance “middle man” is removed from the equation, all the overhead associated with claims, coding, claim refiling, write-offs, billing staff, and claims-centric EMR systems disappears.

“One of the main reasons I decided to make this huge career change into a Direct Primary Care practice was to give patients what they deserve from their doctor….time,” writes Dr. Jeffrey Gold, MD of Gold Direct Care based in the Boston, MA. area in an op/ed he wrote recently entitled “What We Strive For With DPC.”

What Is Direct Primary Care (DPC)? The Revised, Modern Definition.

Direct Primary Care (DPC) practices are distinguished from other retainer-based care models, such as concierge care, by lower (monthly) retainer fees (82% cost less than $99/mo), which cover at least a portion of primary care services provided in the DPC practice; No insurance plan is involved, although patients may have separate insurance coverage for more costly medical services; Patients typically prefer to pay monthly vs. quarterly or annually; DPC patients typically come from the Generation X and Millennial population and earn a combined annual HH income of less than $100k (SEE INFOGRAPHIC below for COMPARE/CONTRAST).

RELATED STORY
DPC Journal EDITOR: ‘The defining lines are clearer now — don’t villainize your colleagues … Be Proud to call yourself, ‘Concierge’ or ‘Direct Primary Care’ — but understand what each one entails.” 

DPC is primary and preventative care, urgent care, chronic disease management and wellness support through a monthly care fee patients (or an employer) pay to cover the specific primary care preventative care services. A DPC health care provider charges a patient a set monthly fee for all primary care services provided in the office, regardless of the number of visits. Because the insurance “middle man” is removed from the equation, all the overhead associated with claims, coding, claim refiling, write-offs, billing staff, and claims-centric EMR systems disappears.

patient checklistDPC medical practices bypass insurance and go for a more ‘direct’ financial relationship with patients and also provide comprehensive care and preventive services for an affordable fee. DPC is a ‘mass-market variant of concierge medicine, distinguished by its low prices.’ Simply stated, the biggest difference between ‘direct primary care’ and retainer based practices is that DPC takes a low, flat rate fee whereas concierge medicine models, (although plans may vary by practice) – usually charge an annual retainer fee and promise more ‘access’ to the doctor.

Direct primary care (DPC) is a term often linked to its companion in health care, ‘concierge medicine.’ Although the two terms are similar and belong to the same family, concierge medicine is a term that fully embraces or ‘includes’ many different health care delivery models, direct primary care being one of them.

Source: The DPC Journal, © 2015.

Cypress Concierge Medicine physician, Dr. Brian Nadolne, MD of Marietta, GA noted in his biography to patients … “I became a concierge physician for the same reason I became a doctor – I want to help people. With this model, I can continue to help people even when traditional medicine changes significantly. When a patient has a “one more thing, Doctor…,” the last thing I want to do is to cut the patient off. Patients deserve to be involved in their care and receive the valuable service of planning for optimal health with the guidance of a family physician who is dedicated to the care of the patient.”

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Related: BUSINESS MODELS: A Simple Look at the Best Corporate Structure for Your DPC Practice

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Direct primary care (DPC) is a term often linked to its companion in health care, ‘concierge medicine.’ Although the two terms are similar and belong to the same family, concierge medicine is a term that fully embraces or ‘includes’ many different health care delivery models, direct primary care being one of them.

Similarities

DPC practices, similar in philosophy to their concierge medicine lineage – bypass insurance and go for a more ‘direct’ financial relationship with patients and also provide comprehensive care and preventive services for an affordable fee. However, DPC is only one branch in the family tree of concierge medicine.

DPC, like concierge health care practices, remove many of the financial barriers to ‘accessing’ care whenever care is needed. There are no insurance co-pays, deductibles or co-insurance fees. DPC practices also do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers, which can consume as much as $0.40 of each medical dollar spent (See Sources Below).

Jim Eischen, Esq., said it best this past April 2015 at a physician meeting in Phoenix, Arizona when he said from the podium …’let’s focus on substance, not labels.’”

Differences

According to sources (see below) DPC is a ‘mass-market variant of concierge medicine, distinguished by its low prices.’ Simply stated, the biggest difference between ‘direct primary care’ and retainer based practices is that DPC takes a low, flat rate fee whereas omodels, (although plans may vary by practice) – usually charge an annual retainer fee and promise more ‘access’ to the doctor.

direct primary care journal2“This primary care business model [direct primary care] gives these type of providers the time to deliver more personalized care to their patients and pursue a comprehensive medical home approach,” said Norm Wu, CEO of Qliance Medical Management based in Seattle, Washington. “One in which the provider’s incentives are fully aligned with the patient’s incentives.”

References and Sources

“Doc This Way!: Tech-Savvy Patients and Pros Work Up Healthcare 2.0”. New York Post. 4/7/2009.

Who Killed Marcus Welby? from Seattle’s The Stranger, 1/23/2008

“Direct Medical Practice – The Uninsured Solution to the Primary Medical Care Mess” with Dr. Garrison Bliss (Qliance Medical Group of WA).

“Direct Primary Care: A New Brew In Seattle”. Harvard Medical School – WebWeekly. 2008-03-03.

DPCare.org

Qliance.com

ConciergeMedicineToday.com

2 comments

  1. Jim Eischen is right when he says: ’let’s focus on substance, not labels.’” Maybe trying to draw distinctions makes headlines, or perhaps makes someone feel superior to someone else, but really, let’s focus on high quality, sustainable (meaning works for the docs and the patients) practices that create space for relationship building between people and their physicians. There are lots of ways to make this happen and they all deserve a chance to serve the huge need that exists. No one practice can or should try, to take care of every patient. Let’s celebrate that.

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