Direct Primary Care (DPC) is on the rise in the United States. When combined with a high deductible health plan or health savings account, it fulfills the requirements of the Affordable Care Act (ACA or “Obamacare”). This is important for employers to know because it is a genuinely affordable option. Unlike most options under the ACA, it does not drive up insurance costs or other costs of care. In fact, it tends to drive them down. This is especially relevant for smaller employers in need of Small Group Employee Benefits.
However, there is fairly widespread confusion about what this means. This confusion if fueled in part by the fact that a Direct Primary Clinic may not use the correct terminology. Sometimes, they refer to themselves as Direct Primary Care and sometimes they refer to their practice as a concierge medical practice. In fact, concierge medical practices also sometimes confuse the two terms.
The two types of care are related, but not identical. In a nutshell, DPC can be viewed as “concierge care for the common man.”
Concierge care was created to serve well-to-do individuals who were tired of the second rate care provided by the standard American approach to medical care currently. With it, patients pay a monthly fee in order to get better than average access to a doctor. The fee can be quite high and it comes with a great many other perks, such as house calls and email access to a physician.
Similarly, service through a Direct Primary Clinic will charge a monthly fee and will give patients greater access to a primary care physician. However, the fee is typically lower than that charged by concierge services and does not include some of the more high end perks. In terms of qualifying as proper coverage under the ACA, it will not ever charge insurance or Medicare for any primary visits. Concierge care sometimes charges a monthly fee to patients while also billing insurance. This means it does not qualify as a substitute for basic insurance coverage under Obamacare.
Anyone trying to arrange Small Group Employee Benefits should check to see if there area for a Direct Primary Clinic . When combined with either a high deductible health plan or a health savings account, it complies with ACA requirements while genuinely bringing down costs and raising the quality of care provided for the patients. It is a win-win option.