Beacon Explains: Direct Primary Care


December 29, 2015 2:07PM

The biggest problem with our healthcare system is misaligned incentives. Patients don’t pay directly for care, doctors don’t answer to their patients for costs, etc. This leads to a breakdown in the sacred doctor-patient relationship by inserting a costly middleman in between them.

But a new healthcare delivery model that is gaining steam across the country could change all that. Known as Direct Primary Care, the approach the relationship between patients and their doctors.

With Direct Primary Care, patients pay as little as $40 per month directly to their primary care doctor. In exchange, they get more frequent and longer visits. It’s like a gym membership that people actually use.

This fee often comes at a fraction of the cost of a health insurance plan, and while having insurance is no guarantee toward better health outcomes, the Direct Primary Care model boosts both ongoing and preventative care.

Physicians are also increasingly attracted to this approach. Direct care eliminates the middleman from the process, so that instead of dealing with complicated insurance forms and rules, patients and physicians interact directly with one another to chart their healthcare maps.

Some doctors have experienced saving hundreds of thousands of dollars every year by practicing direct care. That’s money they can reinvest in helping patients and use to keep their monthly membership fees affordable.

So why aren’t doctors moving toward this model in droves? While numerous physicians from Memphis to Knoxville and in between are embracing Direct Primary Care, other doctors fear that government red tape might come down on them if they do the same. Doctors in some states have adopted Direct Primary Care only to be visited by insurance regulators demanding that they register as an insurance company, entangling those same costly mandates and bureaucratic red tape they had sought to avoid.

That’s why state legislators should follow the lead of the 13 states that already allow Direct Primary Care by clarifying that a doctor practicing under the model will not be abruptly treated as an insurance company in the future. Doing so would ensure that those already moving toward this new model will be protected, it will encourage more doctors to do the same, and it will put patients in the driver’s seat.

While much of the debate over the past year has focused on expanding government insurance, Direct Primary Care is a great example of providing quality care to more Tennesseans, rather than mere coverage.