By Richard A. Armstrong, MD
State Senator Patrick Colbeck representing Michigan’s 7th District, who has led the efforts to promote Direct Primary Care in Michigan, is once again taking the lead to expand DPC services in his state to the Medicaid population.
Senator Colbeck has been involved with Direct Primary Care in Michigan for over three years. He took the lead along with physicians from the Michigan State Medical Society to educate the legislature and help pass Public Act 522, which was signed into law by Governor Snyder on January 10th, 2015. This act revised the Michigan insurance code so that Direct Primary Care practices would not be defined as “risk bearing entities” in the State of Michigan exempting them from regulation as “insurance”. These practices are now thriving and expanding in Michigan.
The next logical step is to bring the potential cost savings and improved primary care to the state’s Medicaid recipients. Senator Colbeck models his pilot plan on a similar project which was accomplished with 30,000 Medicaid recipients in Washington State. Working with Qliance, the state of Washington was able to save 20% compared to patients on traditional managed care Medicaid plans. Senator Colbeck proposes a pilot project which would enroll 2,400 Michigan Medicaid patients as outlined in this program brief.
According to the Senator’s office, Medicaid is the single largest line item in the Michigan budget. Medicaid in Michigan provides health care coverage for 2.4 million people at a cost of $17 billion annually. If his Direct Primary Care proposal could be fully deployed in support of Medicaid enrollees, the state could free up to $3.4 billion per year from its $54.5 billion state budget and expand access to DPC services for all citizens including rural areas suffering from doctor shortages.
Direct Primary Care practices differ from traditional primary care arrangements in that there is no third party involvement. The patient pays a monthly membership fee for a menu of services and access to their own personal physician. The personal attention and relationships developed with patients in this transparent arrangement have demonstrated, as in the Washington State trial, improved access to care, more effective preventive services and improved patient satisfaction and compliance. The DPC model is discussed in this article.
Direct Primary Care is one of the main components of The Docs 4 Patient Care Foundation’s Prescription For Health Care Reform. The Foundation fully supports Senator Colbeck’s efforts to expand DPC services to the Medicaid population in Michigan. We encourage other states to follow his lead.