Misconceptions of Employer Sponsored Direct Primary Care (DPC)
Direct Primary Care (DPC) has emerged as a viable, high-quality primary care model that liberates itself from the constraints of traditional fee-for-service (FFS) products. Employers are increasingly finding that DPC offers a personalized doctor-patient relationship, comprehensive preventive care, and overall cost savings.
In spite of the clear advantages of DPC, there are several misconceptions that employers might harbor. We're here to shed light on the top 5 misconceptions concerning DPC for employers, focusing on Plum Health’s DPC model.
Misconception #1: DPC Adds Extra Costs to Existing Health Insurance
The fact is, for employers operating self-funded programs, the DPC investment redirects claims costs. As employees change their healthcare usage behavior, both primary and specialty care claims decrease. Easy access and relationship-driven care minimize long-term healthcare expenses and cut down on unnecessary urgent care and emergency room visits.
Thus, DPC forms a better long-term investment focused on preventive care, as opposed to only treating patients post-diagnosis.
Misconception #2: DPC Mandates a Switch in Primary Care Providers (PCP)
Employees aren't required to change their PCP under the employer-sponsored DPC model. DPC can be offered as an optional benefit, providing a convenient, preventive care solution that removes the common deterrents to seeking care.
DPC clinics provide members with:
Personalized, preventive care
Management of chronic conditions
No co-pays or insurance billing
Treatment of ailments and illnesses
Same-day appointments and no wait times
Unlimited appointment lengths
24/7 access to care
Exams, labs, and testing
Specialist referrals, as necessary
And much more...
If you have a great relationship with your PCP, keep it! Sadly, up to 80% do not.
Misconception #3: DPC Necessitates Insurance Plan Integration or Can Only Be Offered at Renewal
Employer-based DPC models usually function independently of insurance and the FFS model. Membership can be offered anytime, and employees can join at their convenience.
Overall, DPC replaces insurance-based, FFS products with a patient-centric, relationship-driven model of care where the interests align with the patient and employer.
Please note, there are various DPC models, each with different insurance relationships. We invite you to speak with a member of our team for more information.
Misconception #4: Geographically Dispersed Companies Can't Implement DPC
Healthcare delivery varies by market. Factors such as insurance carriers, network, hospital system(s), plan structure, location, and demographics play crucial roles.
Many employers opt to offer a DPC practice in locations with a high concentration of employees. Virtual access to the "company doctor" is a convenient solution for remote employees. On average, 60-80% of employees will enroll in the first 1-3 years. Additionally, DPC doctors can contract with other DPC doctors out of their region to handle any employees that are near the contracted doctor’s location.
Misconception #5: All DPC Models Are Identical
It's crucial to understand that DPC models are as diverse as they are innovative. Key components like vendors, location, delivery, scope of care, and pricing vary among DPC practices.
In conclusion, as your company contemplates implementing a DPC model, remember:
Finding the right Doctor is essential
Healthcare delivery is unique by market
The scope of services can vary
Insurance may still be necessary, depending on the model you choose
Membership fee structures differ
Primary care is a small investment that yields substantial returns in overall care costs. Access to high-quality medical care is critical for your employees and your organization's health.
Plum Health can help you establish a customized DPC solution, track its impact on employee health and company finances, monitor metrics such as claim reductions, enhanced employee engagement, and improved chronic disease prevention and management.
Get started by contacting us today.
