Direct Primary Care (DPC) is a model for providing primary care where patients pay physicians directly on a monthly or annual basis. The retainer that patients pay covers most primary medical care services including clinical care, consultative services, care coordination and comprehensive care management. Direct Primary Care is not health insurance, nor it is a replacement for health insurance. Patients should retain their own insurance for hospitalizations, specialist visits, and emergency room care.
The Direct Primary Care model is analogous to essential routine maintenance for your body. Most people would not file a claim with their auto insurance for an oil change or a tire rotation. In the same way DPC is designed to cover the routine health issues that will make up 80%-90% of a typical individuals health care visits.
Empowering the relationship between a patient and their physician is the key to achieving superior health outcomes, lower costs and an enhanced patient experience. DPC fosters this relationship by focusing on five key tenets:
1. Service: The hallmark of DPC is adequate time spent between patient and physician, creating an enduring doctor-patient relationship. Supported by unfettered access to care, DPC enables unhurried interactions and frequent discussions to assess lifestyle choices and treatment decisions aimed at long-term health and wellbeing. DPC practices have extended hours, ready access to urgent care, and patient panel sizes small enough to support this commitment to service.
2. Patient Choice: Patients in DPC choose their own personal physician and are active partners in their healthcare. Empowered by accurate information at the point of care, patients are fully involved in making their own medical and financial choices. DPC patients have the right to transparent pricing, access, and availability of all services provided.
3. Elimination of Fee-For-Service: DPC eliminates undesired fee-for-service (FFS) incentives in primary care. These incentives distort healthcare decision-making by rewarding volume over value. This undermines the trust that supports the patient-provider relationship and rewards expensive and inappropriate testing, referral, and treatment. DPC replaces FFS with a simple flat monthly fee that covers comprehensive primary care services. Fees must be adequate to allow for appropriately sized patient panels to support this level of care so that DPC providers can resist the numerous other financial incentives that distort care decisions and endanger the doctor-patient relationship.
4. Advocacy: DPC providers are committed advocates for patients within the healthcare system. They have time to make informed, appropriate referrals and support patient needs when they are outside of primary care. DPC providers accept the responsibility to be available to patients serving as patient guides. No matter where patients are in the system, physicians provide them with information about the quality, cost, and patient experience of care.
5. Stewardship: DPC providers believe that healthcare must provide more value to the patient and the system. Healthcare can, and must, be higher-performing, more patient-responsive, less invasive, and less expensive than it is today. The ultimate goal is health and wellbeing, not simply the treatment of disease.