Direct Primary Care - Background

Background

Direct primary care is intended to remove many of the financial barriers of healthcare. Often, there are no insurance co-pays, deductibles or co-insurance fees thus avoiding the overhead and complexity of maintaining relationships with insurers.

Under this model, patients may pay a combination of visit fees and/or fixed monthly fees which grant them access to a set of medical services, including same and next-day appointments, both in the form of house-calls and office visits.

Typically a direct primary care arrangement is paired with either:

  • A high-deductible health plan, as DPC alone will not cover catastrophic health care such as most surgeries
  • A health savings account, or health reimbursement account as the associated tax-benefits can generally be applied to DPC and other medical expenses.

One of the lesser known provisions of the Patient Protection and Affordable Care Act can be found on page 77. This provision allows for direct primary care to compete with traditional health insurance options in the mandated Health insurance exchange when combined with a low cost high deductible plan.

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