Direct primary care: A new solution for rising health care costs?

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Direct primary care: A new solution for rising health care costs?
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There’s a new movement going on in primary and family care medicine that could deliver better care, cheaper prices and more personalized attention to health care consumers — all while cutting the insurance middle man out of the equation.

RELATED: CVS introduces new RX Savings Finder tool with promise of big savings

Direct primary care puts patients at the center of the business model

Accepting insurance can often be a headache for doctors. That’s led a small but growing segment of the doctor population to switch to cash-only practices that operate on a membership fee basis.

For a monthly fee, you get access to routine checkups, same-day or next-day appointments and even a variety of medications and lab tests at or near wholesale prices.

Think of it as Costco for your medical care!

It’s all part of a movement called direct primary care (DPC), which has been embraced by some pediatricians, family-medicine physicians and internists across the country.

DPC allows them to break the stranglehold that insurance companies have on the industry. After all, it’s insurers who have set up a system by which doctors have to stack their days full of appointments and spend less time with each patient in order to make more money.

In fact, another nice perk of DPC is that you may even get after-hours access to your doctor via video chat or phone call. That’s certainly the case a number of patients experienced, according to a Business Insider article on the trend.

That personalized touch is possible because patient loads at DPC practices tend to be between 500 patients to less than 1,000 patients per practice. Compare that to the estimated more-than-2,000-patient load that’s carried at some traditional family practices!

And let’s not forget those prescriptions at wholesale price, sometimes with a nominal fee added on. One patient in the Business Insider article says she saved more than $100 on prescriptions through her DPC. She reported getting scripts for standard steroids and antibiotics filled for just $6.

But we should note there is one major concern with the DPC business model. While it’s good for basic office visits and discount drugs, if you have a major medical issue like a life-threatening illness, your expenses won’t be covered. That’s because DPC is not an insurance policy.

So the smartest play might be to have some form of insurance in conjunction with a DPC. With the rise of high-deductible policies, it’s possible to get a plan with low monthly premiums as a safety net in case of a major illness. And then you could pay for that one-on-one attention with a direct primary care practitioner if you find one that fits your budget.

How much does direct primary care cost? 

Monthly membership is often around anywhere from $50 to $100 for an individual. Meanwhile, a large family might be able to get a discount and pay $150 or more each month.

But that’s not the only cost here. When you sign yourself of your family up for DPC, there’s typically an enrollment fee that can be anywhere from $50 to $100.

Three practices around metro Atlanta that we price surveyed online charged between $69 and $129/month for singles, couples and families with three people — not including the enrollment fee which varied by provider.

How can I find a direct primary care practice near me?

An estimated 1,000 DPC practices have sprouted up across the country.

To find one near you, visit DPCFrontier.com and click on their interactive map for your state.

Is direct primary care different from concierge care?

Yes, it is. Direct primary care doesn’t accept any insurance, while concierge care typically does.

They’re similar in that you get personalized attention from a doctor. But what you’re paying for with concierge medicine is basically 24/7 access to your doctor.

Pricing on concierge medicine can easily reach into the thousands of dollars, as consumer expert Clark Howard explains in this article.

RELATED: How I save 75% on prescription drugs

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Theo Thimou About the author:
Theo has co-written several books with Clark Howard, including the #1 New York Times bestseller "Living Large in Lean Times."
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