The Move to Direct Primary Care Medicine – Niche or Mainstream?

I’m seeing a lot of companies that are going after the direct primary care market. There are a lot of tech solutions that can benefit the direct primary care market. It’s amazing how the relationship between a patient and doctor changes when they have a direct care relationship. A whole new wave of technology possibilities come into play that are really exciting. I see a number of companies trying to capitalize on this.

There’s also a lot of interest in direct primary care from doctors. Many have sold out to hospitals and are now looking at a way to get back out on their own. Even more are tired of the ridiculously complex and often messed up insurance reimbursement system and they’re looking for a way to get out from under it. As one doctor friend of mine recently said, “Insurance Company A is the worst reimbursement out there. They don’t pay enough to cover the cost for me to be there.” While we could argue the details of this statement, this is the sentiment that so many doctors feel about insurance.

While I see these trends that seem in favor of the direct primary care model, I still can’t figure out how they’ll actually scale. Certainly I can see plenty of situations (mostly in affluent areas) where the direct primary care model can really work for a doctor and the patient. However, I don’t see how that model can scale across all of healthcare. Is there something I’m missing? Are high deductible plans going to become so big that direct primary care is cheaper?

Let’s hear your thoughts and ideas on direct primary care. Will it become the de facto standard for healthcare or is it just a niche movement? What role does technology play in that movement?

About the author

John Lynn

John Lynn

John Lynn is the Founder of the HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

3 Comments

  • Certainly DPC has a promising future and growth rate among certain demographics – mostly the more affluent. One thing I see touted by more than a few DPC outfits is that “One monthly fee covers ALL your medical needs.” What they fail to note is that “ALL” only includes “ALL your primary care needs.” So specialty services are, of course, extra.

    And the extra costs for ancillary services like diagnostic imaging and lab work (beyond simple plain films and ultrasounds the provider may have on site – and simple blood tests onsite) are EXTRA also.

    And I wonder how one’s medical insurance comes into play here. I understand that it won’t cover the monthly DPC fee but how are specialists and “benefit accumulators” handled? What if the person is in a gated network where they need a PCP referral? Will the payer accept the referral from the DPC? And I have other questions…

  • I actually have (although it’s done at the end of the year) an insurance that included DPC as part of the insurance. We’ll see where that goes since the co-op decided to shut its doors at the end of the year.

  • In our recent survey with AAPP we saw many practices using DPC or membership program of some kind as only one portion of their practice. I think we may see more practices expanding to include different models under one roof. And if one is most successful then perhaps moving more fully in that direction. There are clearly many ways to do private pay medicine in an independent practice.

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