Patients Save as Docs Combine Direct Primary Care with Cost Sharing

Published May 12, 2016

Some direct primary care (DPC) providers are recommending patients combine their DPC membership with membership in a health care sharing ministry (HCSM) to increase savings and coverage for their health care needs.

DPC memberships are private doctor-patient agreements offering a range of preventive care services in exchange for a monthly fee of approximately $50 to $100 per person. HCSM monthly fees, or “shares,” cost about $200 per person and up to $500 per family, enabling members to submit most of their health care costs for reimbursement by other members.

Saving $5,200 per Year

Dr. Brian Forrest, CEO and Network Manager of Access Healthcare Direct in Apex, North Carolina, says 10 percent of the 3,500 patients at his three-physician DPC practice are members of the HCSMs Medi-Share and Samaritan Ministries, and Forrest says up to 2 percent are enrolled in Liberty Direct (LD), a plan offered by the HCSM Liberty Healthshare.

Forrest says dual membership in his DPC and LD would satisfy the Affordable Care Act’s (ACA) individual health insurance mandate and cover monthly DPC membership fees.

“Let’s say we have a 55-year-old-patient that pays Liberty Direct $199 per month,” Forrest said. “This will qualify him in terms of not paying the ACA penalty, which could be double the amount of the yearly cost for the LD plan. Also, LD pays 100 percent of his membership fee for our practice out of the $199 per month. This means he would have little if any costs at all to come to our practice.”

Forrest says this patient’s dual membership in a DPC and LD would cost thousands of dollars less per year than the combined cost of a Bronze ACA plan premium and deductible.

“Since we charge between $45 and $59 per month normally, that means he is saving about 60 percent on his monthly premium costs compared to the Bronze ACA plan—the cheapest available to him—and up to 100 percent of our costs,” Forrest said. “This could save this patient a total of $5,200 per year in out-of-pocket costs. That does not even take into account that his deductible amount, which was $6,300, is now limited to $500 per year [in] out-of-pocket [expenses] prior to the ‘expense sharing’ funding his care.”

Increasing Value, Options

Dr. Michael Stevenson, owner and founder of Direct Access Family Care—located in Poplar Bluff, Missouri—says he started encouraging DPC patients to combine their DPC membership with an LD membership in December 2015 to increase value and options for patients.

“We started this process to add value to the membership and to provide another alternative in our community,” Stevenson said. “Many people are just frustrated with the high cost of insurance, only to find out they still have no coverage except for a major medical event where they would be required to meet a high deductible.”

Stevenson said the 200 individuals in his 1,200-patient practice who are enrolled in LD “can save between $492 and $720 per year by using Liberty Direct.”

“My main mission is to get information out to the community that Liberty Direct is available and a common-sense, responsible financial solution for providing good health care,” Stevenson said.

Jenni White ([email protected]writes from Oklahoma City, Oklahoma.