Your Questions Answered
What is Direct Primary Care?
Direct Primary Care (DPC) is a model of healthcare delivery that focuses on building a strong relationship between you (the patient) and me (your physician). In DPC, there is a flat membership fee, which covers all or most of the primary care services (preventative care, maintenance visits, sick visits, basic labs, access through in-office visits, phone, text, email, telemedicine/virtual visits).
DPC avoids complex and confusing billing systems and bureaucratic overhead of traditional-based healthcare. This allows more time spent with your physician to focus on preventative care, improving overall health and reaching your goals, for your health. This is especially true for those that cannot afford comprehensive health coverage, or for self-funded employers.
Why don't you take insurance, Medicare/Medicaid?
I have opted to provide primary care services directly to patients through a membership model. By not accepting insurance, I am able to offer a wider range of services at a lower cost, as I do not navigate the complex billing and administrative processes that are often associated with insurance coverage. Therefore, overhead is reduced allowing me to provide more affordable care. Patients can still use their insurance to cover costs of specialists, hospitalizations, emergency services and other medical expenses.
Unfortunately, at this time, I am unable to accept Medicare patients, as I am unable to opt out of Medicare yet. CMS laws/regulations prevent me from being able to charge my monthly fee for services. I will update this in the future when I am able to opt out of Medicare.
Should I still have a health insurance policy?
I do encourage patients to continue with their health insurance plans or obtain a high-deductible PPO, health share plan so that emergencies, hospitalizations and specialist care is covered. HMO plans typically do not work well with the DPC model, as these plans require you to see physicians within their network for referrals and certain medical coverage.
Do you work with employers?
I will, and would be excited to work with employers. Employers of small businesses that cannot afford to pay for a full health plan for their employees would greatly benefit. It has been shown that healthy employees miss less time at work and are happier with their employment. Larger employers that self-fund their insurance plans would benefit as well by changing the structure of their health plan to cover hospitalizations, emergency visits, specialist care, etc and contracting with my office to provide primary care services. DPCs have been demonstrated to decrease overall healthcare costs for employers by approximately 20% by providing more comprehensive preventative care.
Where will I get my labs and imaging done?
Labs will be drawn in my office, most are included in the membership fee. If there is a specific workup/specialty labs, these can be done at a much lower rate than most would pay even utilizing their insurance. Imaging can be done at a facility of your choice if you have insurance, or at a local facility that offers low cash pay rates.