Direct primary care as a subscription supplement

Subscriptions offer affordable ways to continuously access valuable experiences that benefit both customer and provider, so why not add healthcare to that mix?

It already does, although web searches for “subscription health care” are confusing. The term for subscription health plans is “direct primary care” (DCP), in which insurance does not appear.

In this practice model, which in some ways resembles concierge services, members pay monthly fees to clinicians and physicians. These fees vary widely. Category stalwart One Medical charges $199 a year, while rival Hint Health offers consumer subscriptions for $50 a month, a business option for $300 a month, and custom company-wide pricing. .

Some providers in this area are specialized, such as Simple Health, which provides reproductive health services on a subscription basis, offering a range of services for an annual fee of $15.

Members still need health insurance—often a high-deductible health plan (HDHP)—if the doctor finds anything requiring surgery or other major intervention. This may explain why the concept didn’t really catch fire.

However, proponents say the biggest impact of DCP on health care is to wean doctors off health insurance reimbursements, creating a better level of doctor-patient engagement.

In a blog titled “Is Subscription-Based Digital Health on the Horizon?”, the American Hospital Association (AHA) said, “Companies driving the post-pandemic economy will look beyond transactional, episodic relationships with consumers and could instead focus on subscription-based programs,” freeing physicians from rigid insurance rules and incentives.

While some look askance at an option that seems to pay just to skip the line in the waiting room and spend 10 minutes longer with a doctor than in a traditional practice, others see a better experience for patients and practitioners who want a new way to access and deliver care. .

As Erin Sullivan, PhD, director of research and curriculum at Harvard Medical School’s Center for Primary Care told WebMD, “When you look at direct primary care and other models that come up, it indicates our faulty system that doctors do not. want to practice and are looking for alternative solutions – and so are the patients.

See also: Payments are the prescription for better patient and provider cash flow health

New blood for an established concept

While primary care direct subscription plans have been around for about 10 years, new venture capital is flowing to startups trying to revitalize a concept that is finding its niche, increasingly among employers offering CPDs instead. company-provided health plans.

Hint Connect announced new hires on Tuesday (April 12) to enhance and expand its offering, appointing David Cameron as Chief Medical Officer to provide clinical oversight as the network expands nationwide, and Beth Holmes leading the development of the network.

In a press release, Hint Health CEO and Co-Founder Zak Holdsworth said, “Hint Health launched this first-of-its-kind networking product to foster deeper relationships among key ecosystem stakeholders. DPC and solving critical industry challenges to make primary care more affordable and accessible to all.

Less than a week earlier, UK-based DPC startup Lime Global on Thursday (April 7th) announced the launch of Lime OnCall, described in a press release as “a modular healthcare subscription service for employers, designed for use by the entire workforce”.

DPC solutions are gaining traction in part due to traditional healthcare inefficiencies compounded by the pandemic, from planning to wait times, and as employers look for more affordable ways to provide medical coverage when a Expensive private medical insurance is not an option – or for those simply looking for better bedside manner.

Read also: Cost transparency is the starting point for patient payments

Top and bottom of subscription health

In a blog post, prescription discount platform GoodRx cited the pros and cons of DPC, saying, “The monthly fee covers all – or most – typical primary care services. This includes preventative care and lab tests like blood tests or urine tests, care coordination (medication checks), comprehensive care (visits for strep throat or flu), and consultations,” adding that specialists, emergency care, hospital and prescriptions are not covered.

Even so, proponents are eager for the cost savings associated with CPD that occur when a problem that could have become a costly health condition is diagnosed and treated early.

Category leader Premise Health announced on March 30 that its Connected Care+ solution “has achieved 25% average risk-adjusted savings for Premise customers” since its launch in 2019.

“Average costs per member per month for members assigned to Premise Wellness Centers with Connected Care+ were $102 lower than members assigned to community providers” in 2021, according to a press release from Premise Health. “The lower costs are primarily the result of increased engagement with primary care teams, which has closed gaps in care and resulted in a significant reduction in emergency department visits and hospitalizations.”

See also: Healthcare Organizations Turn to Gig Apps for Hiring and Payroll Help Amid Nurse Shortage

DPC is known to reduce patient wait times and allow physicians to spend more time with them, whereas traditional models are volume-based, which limits the amount of time spent between doctor and patient.

For practitioners, a subscription model eliminates tedious insurance-related forms while ensuring a monthly recurring revenue stream. Healthcare workers suffering from burnout are increasingly drawn to CPD for its emphasis on self-care rather than insurance protocols.

Payment service provider (PSP) Payment Cloud said on the DPC blog: “Instead of seeing thousands of patients in very short consultations, doctors can spend more time and deliver quality service. Doctors who work with subscription models see about 1/5 the number of patients a traditional doctor would see each year. »

DPC isn’t for everyone – like those who are happy with healthcare as they’ve always known it – and as Amazon and Walmart launch with new healthcare offerings, DPC fills a niche of market.

Read also: Subscription Commerce Conversion Index

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