DPC Decoded: Why It’s Making Waves
By Elise Zielicke, Employee Benefits Consultant
You may have heard the term DPC by now and wonder, what’s with all the noise?
Direct Primary Care (DPC) is a model of providing primary care health care services to patients through a monthly membership fee that covers most of what the average patient needs. Think of it like a gym membership – you pay a flat rate fee no matter how little or much you go. DPC is the same.
It is important to remember that DPC is NOT insurance – you still need traditional insurance coverage for specialty, urgent, and emergent care. DPC is best paired with a High Deductible Health Plan in a self-funded model. Some Employers, however, have invested in offering DPC memberships to employees in HDHPs in a fully insured environment as a benefit-add rather than a cost saving mechanism.
The data does not lie - DPC is proving itself in real health results. According to the most recent Hint Health Survey of 2023:
- DPC members with hypertension are 12% more likely to have their blook pressure controlled than Americans on a commercial PPO Plan
- DPC members with diabetes are 32% more likely to have their blood pressure control than Americans on a PPO plan
- DPC members with diabetes are 39% more likely to have their Hemoglobin A1c levels controlled than Americans on a PPO plan
For employers, DPC can have a significant cost impact as well. The Hint Health Survey of 2023 also showcases that employees enrolled in DPC had:
- 40% fewer ER visits
- 53% lower ER spend
- 20% fewer hospitalizations
And some say this is just the beginning of understanding how DPC can impact overall health and disrupt the healthcare marketplace.
Dr. Nicole Hemkes, Owner and Physician at Advocate MD, a Madison-based Direct Primary Care clinic shares a bit more about why physicians decide to work in the DPC model and their experiences working with employer groups: “Physicians are looking for more autonomy and the ability to spend more time with patients. DPC allows them to spend more time in direct patient care rather than filling out paperwork and working on the computer. They have the time now to take more comprehensive care of patients, perform in office procedures, and there are less referrals to specialists.
“DPCs partnering with employer groups is the future and will continue to build. Employers are seeking affordable, accessible, higher quality primary care for employees. Self-funded employers are looking to control downstream costs and divert most medical care away from expensive hospital systems. Being able to help navigate patients to high quality, free-standing, independent radiology facilities, surgery centers, lower cost medication options is key. These employer agreements have helped our practice to grow significantly in the last 3-4 years.
“Patients will have an experience like they have never had in a doctor's office: no wait in the waiting room, a doctor who knows them and their family well, a doctor who spends an hour talking with them during the visit, and the ability to communicate directly with a physician after hours for urgent care.”
Direct Primary Care is not just a trend, it is a tool that employers will continue to use to recruit and retain talent all while challenging how our healthcare system works today. It is something not only to keep an eye on but to explore if it fits your organization’s culture. If you’d like more information, we at Hausmann Group would be happy to discuss if this option might be a fit for you and your organization!
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