July 2022 Maximixe your HSA e-Newsletter  Vol. 18, Issue 14

Direct Primary Care Is a Better Option for Small Businesses

 

What Are DPCs for Small Groups?

 Today, insurers dictate what medical providers your employees can see, when they can see them, and more. It’s not unusual for an employee to have to drive far outside their local community to find a primary care physician covered under their insurance plan. 

It doesn’t have to be this way, though. Direct primary care plans are growing in popularity and offer employees the ability to choose a doctor in their local community, whom they know and trust.

 DPCs for small businesses are precisely what they sound like – plans that allow employees to receive primary care from specific, local primary care physicians.

 How Do DPCs for Small Businesses Work?

 Understanding how small group DPC memberships work is the key to ensuring that your employees have access to the benefits, flexibility, and control they deserve when it comes to their healthcare.

 Essentially, DPCs for small groups do away with insurance entirely. This non-insurance healthcare model allows the patient to pay a flat monthly fee to a primary care physician in exchange for access to specific primary care services – typically with no caps and no limits on the amount of care that employees can receive!

What sorts of procedures and services might DPCs for small groups offer? They cover a wide range of commonly needed options, including:

  • In-office testing (note that there may be additional fees required here but they will be explained at the time of testing)
  • Annual exams, including:

 

 

 

o   Sports and school physicals

o   Well-woman exams

o   Annual physical exams for adults, teens, and children

o   Services designed to manage chronic diseases, including:

  • Diabetes
  • Hypertension (high blood pressure)
  • Asthma
  • COPD
  • Chronic pain
  • High cholesterol

o     Treatment for acute conditions, such as cold and flu

o    Help with weight management

o   Preventative care, such as vaccinations

 

 How Do DPCs for Small Groups Benefit Employees?

 With a better understanding of how small group DPC memberships work, let’s explore how they benefit employees, and through them, the small businesses that employ them.

 First, it allows employees to reduce their out-of-pocket insurance costs. Many employees can shift to large deductible insurance plans (so-called catastrophic coverage). This allows them to keep more of their pay each month but also reduces the share that employers must pay for health coverage.

 Another benefit is that patients with complex medical histories can spend more time with their physicians and build stronger relationships. It’s the difference between having a doctor who doesn’t really know you or your healthcare challenges, and someone who’s been working with you for months or even years and is intimately familiar with what works for you and what doesn’t. In this sense, it’s a throwback to how doctors and patients once interacted decades ago.

 A DPC membership is also incredibly empowering, as it allows patients to take charge of their own healthcare and reduce the amount of interference from the government, as well as from insurance companies. After all, why should an insurer who has never met a patient, let alone treated their health condition, be allowed to make decisions about what care they can receive and what treatments they cannot?

 Finally, DPCs can also alleviate the burden on self-employed professionals, as well as those who are between jobs and have no insurance coverage, or whose insurance has been canceled.

 In short, DPCs for small groups offer more personal care in a patient-centric environment. They improve autonomy, increase convenience, and strengthen the doctor/patient relationship considerably. They also reduce the costs of healthcare for both employees and business owners, something that anyone can appreciate in this economy.

 Is There a Catch?

While there’s no catch with DPCs, it is important to understand their limitations. It’s really right there in the name – direct primary care. Unlike health insurance, DPCs offer no assistance if you’re hospitalized, need to schedule surgery, or need to see a specialist who isn’t part of the DPC practice. 

This makes it important for employees to still have access to traditional health insurance, or a catastrophic policy or low-cost health sharing plan. One of the most popular health share options is DPC Direct, which is a healthsharing program specifically designed to work in conjunction with a DPC membership. 

DPC Direct doesn’t share for treatments already provided by the DPC, but is there to protect against those medical expenses that are not already covered. It’s a lean design that reduces costs and eliminates redundant coverage, while ensuring your employees have vital protection in these scenarios. 

In fact, a business can offer a DPC membership plus the DPC Direct healthshare plan, and still cut their costs by 30% or more compared to a small group health insurance plan.

How Much Do DPCs Typically Cost?

While there is no standard price that applies across the board, membership typically costs between $75 and $100 per month. That low price gives employees access to all the primary care services they need or want.  The DPC Direct healthshare plan, which would protect against larger unexpected bills,  starts at $170 per month for an individual, and $460 per month for a family of four.

 If you’d like more information about a direct primary care plan or ways you could offer health benefits to your employees, schedule a call with your Personal Benefits Manager.

Click here to schedule an appointment, or call 800-913-0172 to get started.    

To your health and wealth,

Wiley Long Signature

Wiley P. Long, III
President - HSA for America

Wiley Long Portrait

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Wiley Long HSA for America President

Wiley Long is President of HSA for America. He believes that consumers should have choice and price transparency, so they can make the best healthcare decisions for their needs. Read more about Wiley on his Bio page.
 
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