DPC News

(Download) Society of Actuaries, 2020 DPC Study | Direct Primary Care: Evaluating a New Model of Delivery and Financing

Study Conducted By the Society of Actuaries | Released May 19, 2020

Direct Primary Care: Evaluating a New Model of Delivery and Financing
  • Date Published: May 2020

The Society of Actuaries (SOA) commissioned Milliman to develop this report to provide health care stakeholders (patients, payers, policymakers and actuaries) with a comprehensive description of Direct Primary Care (DPC) as well as an objective actuarial evaluation of certain claims made about the DPC model of care.

Our friends at The DPC Coalition pulled out some relevant data points that jumped out:

Virtual Care and Telehealth are at the core of DPC service offerings:

  • 99% of all DPC practices surveyed were doing virtual consults via text/phone as a part of the membership fee (two years prior to COVID-19).
  • 88% said they provided “telemedicine” benefits (meaning expanded video or additional digital communications assets).

Enrollment in DPC is associated with a reduction in overall member demand for health care services outside primary care:

  • DPC members had 19.90% lower claim costs for employers on an unadjusted basis and 12.64% lower claim costs on a risk-adjusted basis during the two-year period.
  • DPC members experienced approximately 40% fewer ER visits that those in traditional plans.
  • DPC members experienced a 53.6% reduction in ER claims cost.
  • DPC members experienced 25.54% lower hospital admissions.  (This number may be statistically small but verifies the downward trend)

DPC is Affordable Primary Care

  • The average adult monthly DPC Fee is $73.92. (DPC fees are paid on a monthly subscription basis).
  • The median age for DPC patient was 31.8 years old, v. 36.1 for traditional insured (PPO).  The survey finds the member mix did not vary materially between the DPC option and traditional option.

IN OTHER NEWS | DPC | Employers | Patient Care
New, Part 2 (DPC Journal Podcast) | How DPC Can Approach the Uninsured and Under-Insured Younger Demographics


Direct Primary Care: Evaluating a New Model of Delivery and Financing

Questions Or Comments?

If you have comments or questions, please send an email to research@soa.org.

Executive Summary

Primary care is a vital and even foundational component of any health care system. Primary care physicians (PCPs) are the front line of health care and …


SOURCE: https://www.soa.org/resources/research-reports/2020/direct-primary-care-eval-model/


Session 116: Health Research Update

This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes. Research … Research, Patient Centered Medical Homes, Direct Primary Care, Health Care Cost & Utilization Trends, Characteristics …

View Description

  • Authors: Fritz Busch, Dustin Grzeskowiak, Achilles M Natsis , Casey Hammer
  • Date: Feb 2020
  • Competency: External Forces & Industry Knowledge
  • Topics: Health & Disability; Health & Disability>Health insurance


Categories: DPC News

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