Direct Primary Care - A solution for Small Businesses

CNBC recently aired a special on five ways small businesses can save on healthcare costs.  "Robin Wiener ['owner of health-care IT firm, Get Real Health in Rockville, MD'] has achieved something many small-business owners have struggled to do: She has lowered her firm's health-care premiums."

One of the five recommendations highlighted by CNBC and implemented by Wiener is to "Explore Direct Primary Care."  They highlight that "a growing number of primary-care physicians are partnering with employers to deliver affordable preventative and primary care on a fixed-monthly membership model, in what is known as direct primary care.  Instead of billing patients' insurance, direct primary care providers charge users a monthly fee for unrestricted access to their doctor....Unlike in concierge practices, which also charge monthly fees, providers in direct primary care do not bill insurers or Medicare for medical visits. 'The price point is significantly less than most concierge practices,' said Reiner.  Often, it costs less than $1,000 per year per person." 

"Direct primary care, coupled with a high-deductible health insurance plan, can oftentimes be an outstanding and relatively affordable solution for entrepreneurs and small business," said Reiner. When direct primary care is combined with a high-deductible plan, he said, it can often save 12 percent to 15 percent over what a firm would spend for traditional health insurance."

Time Magazine recently printed a landmark article on the concept.  "The idea is deceptively simple: Pay frontline doctors a fixed monthly fee directly instead of through the byzantine insurance bureaucracy. Make the patient, rather than the paperwork, the focus of the doctor’s day. The result will be happier doctors, healthier patients and a striking reduction in wasted expense."

"Under the law, every American is required to have medical insurance–but direct-primary-care patients can seek less expensive policies, because they require coverage only for hospitalizations, surgeries and other specialized care."

"[Qliance has] signed up previously undreamed-of populations: big private employers like Expedia and Comcast, public and industry employee unions like the one for Seattle firefighters and–most radical of all–at least 15,000 Medicaid patients....Treating a wide variety of patients - young and old, healthy and chronically sick, well-off and poor - Qliance claims to be saving approximately 20% on the average cost of care compared with traditional fee-for-service providers."  


"The American Academy of Family Physicians, which kept concierge medicine at arm's length for years, is moving quickly to embrace the direct-care concept.  And the promise of greater efficiency and better results has attracted the likes of Amazon's Jeff Bezos and his fellow billionare Michael Dell to invest...."

"Expedia was motivated to try direct care for reasons that are familiar to business executives everywhere: health care bills were skyrocketing, but employees were not getting healthier. 'We had a number of catastrophic illnesses in 2011 and a disturbing number of deaths–12,' vice president for human resources Connie Symes tells me. “We found Qliance and their model of spending quality time with patients addressed our need to get employees involved in their own care....At the end of last year, Expedia surveyed the staff, Symes says, and the response was emphatic. More than half the employees had tried Qliance, and of those, more than 95% said they were satisfied. 'They love the doctors,' Symes says. 'They love the personal relationships they’re forming.' And although Expedia still classifies Qliance as an experiment, Symes says direct primary care, with its emphasis on prevention, 'is taking us in the right direction on lowering costs.' "

Dr. Lauren Hedde practices Direct Primary Care at her North Kingstown Direct Doctors practice.  She is currently accepting new patients, including employer-based groups.