While direct primary care (DPC) is not new, some employee populations have not heard about DPC, or they may not be well-educated on the membership benefits. Most employee populations are familiar with fee-for-service models where they have premiums, deductibles, claims, and co-pays. So how do you introduce direct primary care to an employee population and educate them on the value it delivers them and their families? There are a few things you should highlight for employees to ensure they have a sound understanding before enrollment.
Pricing Structure
One of the most critical questions employees have is how much this plan will cost them. A benefit to direct primary care plans is that they are often more affordable than insurance premiums, averaging $77.38 per month. Be sure to explain the pricing structure for different tiers of enrollment from a single employee to family coverage and what those fees cover. Everyone will be glad to hear that this new benefit is less expensive than paying out-of-pocket for primary care (especially if they have a high-deductible health plan).
Direct Services
Services will be next on their list of questions. Now they are aware of the cost of the membership; they need to understand what it includes. It’s important to stress that direct primary care memberships provide quality services and quick access to primary care physicians (PCP), where employees will regularly go for acute issues. Showcase what services they will be getting for free (labs or physicals), as well as what services will be cheaper compared to their other coverage.
Elaborate on how inclusive services encourage each of them to build a strong, trusting relationship with their physician. From pediatrics to family practitioners, primary care physicians help maintain employee health through preventive care and early intervention. Research has shown that individuals that regularly see their primary care physician manage their chronic disease better, spend less time in the hospital and less time away from work. You can share the mission behind direct primary care by informing them of the value primary care physicians serve in their overall health.
Differentiation of Plan Offerings
Employees have now grasped two significant concepts of direct primary care: 1) how much it’s going to cost, and 2) included services. Now differentiate how this plan differs from their other coverage (major medical insurance, minimum essential coverage or medical cost sharing membership). Employers, or their employees, pay a monthly membership fee for direct primary care to serve as a gap solution, providing primary care within this membership arrangement. This membership grants members access to their physician, eliminating claims for all services performed within the direct primary care environment. Don’t forget to explain that, with direct primary care, fees for appointments and services will be transparent – as their membership fees and included services are disclosed.
At first, direct primary care can sound intimidating or confusing to a group of employees. By covering these three topics, you can ensure they have an overview of the model and plan offering. We suggest expecting more questions as they explore their new benefits. However, it won’t be long until they’re acclimated to direct primary care and able to enjoy the benefits of this innovative healthcare membership.
If you are interested in offering direct primary care to your employer groups, contact Healthcare2U or download more information on our nationwide DPCplus membership.
**Content updated June 3, 2021
