Direct primary care is a new model which is changing the way we think about healthcare. Under the “traditional” model, the majority of a visit to the doctor’s office is spent waiting to see the physician, filling out insurance paperwork, and documenting interactions on a computer screen. The actual encounter between doctor and patient might only last a few short minutes, which is unsatisfactory for both parties. If you are interested in learning how DPC is changing all of this, continue reading.

What is Direct Primary Care?

Under the DPC model, patients are billed directly by the doctor rather than by a third party or insurance company. Instead of fee-for-service payments, the patient pays an affordable, flat membership fee on an annual or monthly basis (usually less than $100 per month). This fee, called a retainer fee, covers most or all primary care services, so there is no need for filing individual insurance claims and paperwork.

How Direct Primary Care Helps You

The DPC model brings many benefits for both patients and physicians.

First and foremost, the patient enjoys substantial monetary savings on doctor’s visits because there is no third party to work through. Cutting out the middle man means lower fees for patients and fair compensation for physicians.

One of the biggest benefits to this system is the increased quality of doctor-patient interactions.  Since there is no insurance paperwork to file, the doctor is significantly more available to his patients. Doctors report spending much more time face-to-face with their patients, resulting in better care and satisfied customers.

Because DPC doctors are not pressured to see as many patients as possible in order to make ends meet, they tend to have a smaller patient panel, which allows them to give quality care and really get to know their patients.

Many doctors working in the DPC model have started offering services which extend beyond the office.  Tele-visits, e-visits, and text messaging are often available options, making trusted physicians even more available.

In many cases, contacting a doctor remotely and immediately can prevent an ER visit, or provide critical information during a health crisis.

In addition, about 80% of healthcare needs can be met in a DPC practice, so usually the patient is not forced to go to multiple specialists because of insurance requirements.

Direct Primary Care FAQ’s

How does DPC differ from traditional primary care?

The  main difference is that doctors are not paid for the number of patients they see.  Instead, their income comes directly from visit fees and retainer fees. This leads to a smaller quantity of patients, more time spent with each patient, and even non-face-to-face services.

Can a DPC practice treat patients with insurance coverage?

Yes. Patients who receive insurance coverage (for example, from an employer) can receive primary care from a DPC practice. However, under the DPC model there is greater responsibility on the part of the patient to manage their medical finances. Often patients can be reimbursed by their insurance companies if they file a claim and submit an itemized bill listing the care received at a DPC practice.

What if I am in need of emergency care not provided at a DPC practice?

Participating in the new DPC model does not mean giving up high-quality care at other hospitals or clinics.  The patient might need to pay more out of pocket for specialized care, but most patients choose to purchase a low-cost wraparound insurance plan to cover emergency services and complex procedures such as surgery.

If you are interested in joining a Direct Primary Care practice, please contact Virginia Integrative Practice.  We have three locations in Virginia: Burke, Lexington, and Charlottesville.