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DPC: ADDRESSING COST, COVERAGE AND CONVENIENCE

Updated: May 2, 2024

How Does The Direct Primary Care Model Work, And Is It A Fit For Your Health And Wellness Needs? Let’s Answer Some Common Questions About DPC.





Many people associate concierge care, hourlong doctor’s appointments and home visits with dollar signs and costly bills. All these benefits must really add up, right? Direct Primary Care (DPC) must be out of the budget. How is all this possible with a flat-rate monthly fee?

 

Trained by a traditional system of packed healthcare provider schedules, double charging (appointment and procedural fees), and no limit to the number of patients a practice sees, we have learned to accept long wait times and extra costs.

 

It doesn’t have to be this way.

             

When patients understand the DPC philosophy, a lightbulb flicks on. It is truly a valuable health and wellness benefit.

             

DPC is patient-centered care. DPC care offers a personal relationship with a trusted provider who gets to know you as a whole person. It is convenient and straightforward, meaning you won’t get pushed into a queue of front desk, third party, platform. And it is affordable, with cost-effective options for screenings, prescriptions, lab tests, and treatments for illness and injury.

             

Because our society is used to typical healthcare, patients are often surprised to learn they can have 24/7 accessibility to a doctor—video, phone, text, email and in clinic during office hours—and pay less for care than they do with insurance.

             

Let’s answer your questions about Direct Primary Care, the health and wellness services offered and what to expect as a member.

 



Q: What are some key differences between traditional healthcare and Direct Primary Care?

A: With traditional healthcare, patients often experience complex insurance expenses, including co-pays, facility fees and extra charges, and many times patients are not aware of additional costs until they receive an explanation of benefits from their insurance company. It’s no fault of the doctors, who are managing a higher volume of patients than ever because of a nationwide physician shortage. Many doctors bear pressure to manage 2,000 to 3,000 patients, so an average appointment time is 10 to 15 minutes. The system has removed any form of maximum patient numbers: some practices have as many as 4,000 patients.

 

Other systemic challenges center on fee structure: double charging if any health topic is discussed other than preventative care at a physical, for example. Other convenience barriers in the institutional system include allowing “one issue” per visit. If another health matter needs to be addressed, this requires an additional appointment—an inevitable wait.

 

The bottom line: Shortage Of Doctors + A System Based On Throughput = Frustrated Doctors And Unsatisfied Patients.

             

Direct Primary Care is patient-centered at its core. The model is structured to prioritize the power of the patient-physician relationship to improve health outcomes and lower overall healthcare costs. Importantly, the DPC model is consistent with the American Academy of Family Physicians’ (AAFP) advocacy efforts focused on primary care and affordable access.


        Following are some differentiating benefits of Direct Primary Care:


  • You communicate directly with your clinician by text, email or phone, and a HIPAA-approved gateway ensures privacy while providing access to medical information.

  • Hourlong appointments provide an opportunity for asking questions and focusing on wellness strategies.

  • Same-day and next-day appointments are available to provide flexibility and timely care.

  • Injury and minor ailment treatment on-site helps prevent ER visits for simple injuries or ailments.

  • In-house discount pharmacy offers affordable options for prescriptions and labs that often cost less than typical co-pays.

  • Lab services are discounted as well. A complete set of labs costs $17.30, less expensive than most insurance co-pays.

  • Home visits are free for newborns and available (for an extra fee) for all members.

  • A wide range of services prevents multiple doctors visits at different offices.

 


Q: How quickly can I see a Direct Primary Care doctor?

A: Convenience and access are hallmarks of Direct Primary Care. At Maple Health DPC, you can see a clinician in our office the same or next day—and you can communicate at any time, 24/7, with a provider by email, text, phone or our secure HIPAA-approved gateway.

 

The reason we can provide readily available appointments is because our practice enrolls a limited number of patients, so everyone gets the care they deserve rather than booking up schedules with thousands of patients, which is the case with institutional healthcare and why you experience months-long wait times.  Most DPC practices limit the number of patients to 600 per clinician rather than the 2,000 or even 4,000 patient load traditional general practice physicians are expected to treat.

 

Rather than waiting for an appointment to ask questions, you can simply contact a clinician via text, email or phone We encourage our patients, “Just ask.”

 

Q: Can our whole family access healthcare services from Direct Primary Care?

A: Yes, Maple Health DPC healthcare services for all ages and stages, from newborn to geriatric care. As a comprehensive healthcare provider, services also include pregnancy testing and prenatal care, along with school/sport/camp physicals. We cover the full spectrum of health and wellness needs for families, and we grow along with you, getting to know you personally.

 




Q: What health and wellness services are available through Direct Primary Care?

A: One of the many advantages of the DPC model is accessing a wide range of care from one trusted provider—so there is no run-around and constant referrals elsewhere for services like lab tests, dermatological procedures and even nutritional planning.

 

At Maple Health, our services include treating illness and injuries, from bladder infections and animal bites to lacerations and ear infections. This includes minor eye injuries, rashes, sprains and fractures, and splints and sutures.

 

Combined with a full menu of family health services, we also offer sexual health care such as STI testing and treatment, and PrEP therapy.

 

Q: Can Direct Primary Care fill prescriptions and conduct lab tests?

A: Yes, Maple Health DPC has an on-site pharmacy, and many prescriptions are priced lower than most co-pays. Patients also appreciate the convenience of leaving their appointments with necessary medications in hand—no extra trip to the drug store pharmacy. Our nurse and phlebotomist conduct lab testing in the clinic, and some results are available immediately.

 




Q: I’m an employer. How can Direct Primary Care augment our health insurance offering?

A: DPC programs can stand alone as a comprehensive primary care solution or complement wrap-around insurance with services you would not get otherwise. According to a 2022 poll of American workers by the U.S. Chamber of commerce, 96% of employees view health insurance as extremely or very important. Our employer members say a DPC benefit offers a competitive advantage for recruiting and retaining talent.

 

DPC for employers helps reduce healthcare costs while ensuring total care for their workforces. It gives you the option to choose less expensive high-deductible plans with lower premiums while ensuring employees get care they can afford with the DPC benefit.

 

The access to care 24/7 is also valuable to employers because their team members can see a healthcare provider on evenings or weekends, and our physician assistant provides services at your site one day per month for companies with 60 or more workers. These efforts help reduce PTO and lost productivity.

 

If your organization does not offer health insurance to its workers, DPC is a cost-effective way to provide basic health care to your employees at only $70 per month. 

 

Q: I have health insurance through my employer, so is Direct Primary Care like ‘doubling up?’

A: Insurance covers specialists, hospital stays and imaging. Direct Primary Care provides doctor visits, physicals, in-office procedures, lab testing and a pharmacy. They work hand-in-hand, allowing you to accept a higher-deductible, more affordable commercial health insurance plan while maintaining access to cost-effective care when and where you need it.

 

Q: What fees are associated with Direct Primary Care membership?

A: Memberships are available for children, adults, seniors, and employers and include a monthly fee that starts at $70 per month.. There are no hidden costs or expenses like facilities charges or copays. The flat membership fee is 100% transparent and gives patients access to all services, treatments, available lab testing and the pharmacy, plus personalized attention and 24/7 access.

 

Elevate Your Standards for Primary Care

At Maple Health DPC, you get one-on-one attention from a provider who is tuned in to your whole health. Our Direct Primary Care clinic is a full-service, membership-based primary care practice that offers flexible access, longer appointment times, less waiting and a relationship with a practitioner you know and trust. Access affordable, quality healthcare 24/7. Contact us any time.

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