A new clinic in Indianapolis, Indiana cuts costs and concentrates attention on patients by providing care without involving health insurance.
PureHealth Functional Family Medicine provides services through the direct primary care model, in which providers bypass insurance middlemen to reduce costs and government red tape. PureHealth Functional Family Medicine provides each patient with a package of routine visits in exchange for a regular monthly payment.
Indiana allows practices to use the DPC model, which does not rely on insurance companies to bill patients. There are currently 24 states that do not allow DPC.
Back to Patient Care
Stock, a longtime family medical practitioner in Indiana, says the direct primary care model enables him to provide better care for patients by allowing him to focus on their needs instead of how they pay for examinations and treatment.
“The fundamentals of DPC are that it takes all the financial worries off the doctor’s brain, and he can be concerned only with his patient’s needs,” Stock said. “Insurance companies, governments, and employers all pay doctors better if they see 10 people for six minutes versus seeing one patient for an hour. [DPC is] little more than a prepayment scheme for health care services, and the way you make money in a prepayment scheme is to have people buy lots of services but always at a budgeted rate.”
Improves Doctor-Patient Relationship
Government interference skews the relationship between doctor and patient, and Medicaid exacerbates the problem, Stock says.
“If a patient said they don’t value what the insurance company or the government values, the doctor would be conflicted over what was good for his patient and what was good for himself and his family,” Stock said. “Doctors actually have quotas for business they generate for the hospital, so they have an incentive to order lots of tests. This is never discussed with patients.
“Meanwhile, the states are going bankrupt paying for Medicaid, which the federal government forces on them,” Stock said. “The states that decided to expand Medicaid under Obamacare are getting financially pilloried by it. DPC is a way around the federal government.”
‘Can Work Almost Anywhere’
Matthew Glans, a senior policy analyst for The Heartland Institute, which publishes Health Care News, says DPC returns free market principles to the health care market.
“DPC can work almost anywhere,” Glans said. “Currently, primary care doctors face myriad regulations and a slow and costly reimbursement system that create overhead that can eat up to 60 percent of a typical primary care practice’s revenue. According to the Direct Primary Care Coalition, the number of direct primary care practices nationally has grown from a few in the early 2000s to more than 700 today. A state can open up their health care markets by declaring that DPC is not insurance, one the biggest barriers DPC providers currently face.”
Glans recommends states consider a DPC pilot program in Nebraska as a possible reform model.
“State legislators should also consider following the lead of Nebraska and implement a direct primary care pilot program,” Glans said. “Nebraska’s recently approved pilot program will run through 2022 and offer two DPC plans: a high-deductible option and a low-deductible plan. The program will include wellness incentives as part of the direct primary care health plans.
“Such a pilot program could prove to be an important test case for determining whether additional expansion should be considered,” Glans said.