The ABCs of DPC – The Building Blocks of Healthcare [ What is Direct Primary Care and Why is it Important? ]

Direct Primary Care is an alternative payment model that provides members with access to their membership for a simple and affordable membership fee. The model encourages members to actively participate in their health by building a trusting relationship with their physician to conduct preventative exams, treat acute conditions, and detect and manage chronic illnesses before they become serious, among other services. DPC provides a solid foundation for members’ health and improves the quality and access to affordable and convenient primary medical care. Let us explore the current state of healthcare and how a health plan can use the ABCs of DPC to redefine healthcare delivery.1

 The Current State of Healthcare

Healthcare expenses are rising. Recently, concerns such as long waiting-periods for acute illnesses, higher copays, and retail healthcare have shifted patients away from their Primary Care Physicians (PCPs), resulting in fragmented care, expensive outcomes, and overall healthcare avoidance.2

  • A majority (70%) of polled Americans believe the state of healthcare has major problems and is in a state of crisis3
  • Nearly 50% of adults do not have a primary healthcare provider,4 and the problem is worse among minorities
  • The average waiting period for an in-office visit with a new primary care physician is 24 days5

This trend of moving away from PCPs drives healthcare costs up and worsens fragmented or unnecessary care. Many Americans6 have skipped recommended medical tests or treatments due to cost, and most say they have a problem paying their basic healthcare bills.7 Because of this avoidance and fragmentation, Americans are developing preventable conditions that are expensive to treat and manage.

  • 92% of Americans have a problem paying basic healthcare bills8
  • 50% of American adults avoid going to a PCP due to costs. 13% of that group said their condition got worse as a result9
  • 50% of Americans have preventable, treatable chronic conditions,10 and these diseases typically cost more than $5,000 per person for care annually.11 For example, the average cost of treating diabetes is $9,601 per person12

For many Americans, our healthcare system is failing them. As health expenses rise, employers shift the financial responsibility of healthcare to their employees, often in the form of High Deductible Health Plans (HDHPs) – raising out-of-pocket costs and deductibles in exchange for fewer benefits, compounding the issue at hand.

  • From 2006 to 2016 out of pocket spending increased by 54%, while deductibles increased by 176%. Employee wage growth was a mere 29%13
  • The average deductible for a HDHP in 2020 is $2,50014

ABCs of DPC: The Building Blocks of Healthcare

Primary Care is the entry point into the healthcare system and is referred to as the foundation of healthcare. Primary Care Physicians (PCPs) treat a range of acute illnesses and are the first to see early signs of chronic diseases, cancer, or many other issues like depression. These physicians guarantee patients receive the right care in the right setting and establish a trusting relationship that inspires patients to participate in their health and wellness and seek care quicker when new issues arise.

Now imagine unlimited access to your primary care physician when and where you need them. By eliminating barriers to primary medical care, DPC allows affordable and convenient access to services on which members depend. The three building blocks of healthcare below establish the baseline for DPC memberships and guarantee the successful delivery of primary medical care.

    • Lower Care Costs – For care performed within the DPC environment, there are no claims generated on the employer’s health plan, and there are no bills for members after receiving care. A review of 116 DPC practices found that the nationwide average for monthly membership fees were $77.38 per month, but can be as low as $45 per month15
    • Better Employee Health – Patients achieve superior health outcomes with DPC’s personalized service delivery. Employees enrolled in direct primary care have 59 percent fewer ER visits, are referred to specialists 62 percent less often, have 65 percent fewer radiology exams and have 80 percent fewer surgeries16
    • Better Patient Experience – Patients receive unrestricted access to physicians through multiple services. Common benefits include comprehensive primary services, such as routine care, regular checkups, preventive care, and care coordination.

ABC's of DPC

Healthcare2U | A Coast-to-Coast Healthcare Membership

Because of their core values, Direct Primary Care (DPC) memberships lay a solid foundation for health plans that want to institute real change and redefine healthcare delivery. Unfortunately, traditional DPC practices are regionally based and may not provide a complete solution for a national or mobile workforce. That is where Healthcare2U comes in.

We are a nationwide, integrated direct primary care organization that has progressed the model’s benefits and removed its limitations. Our solution believes the primary care patient-physician relationship is the foundation for healthy living and is the key to reducing costs and eliminating healthcare barriers. By providing a nationwide solution to primary care, we bring affordability, accessibility, transparency, and mobility to our members. Are you ready to redefine the delivery of healthcare for your clients? Let’s get started.

About Us

Healthcare2U is a hybrid, integrated direct primary care (DPC) organization that ensures employers of all sizes and structures have nationwide access to affordable, consistent, and quality primary care over 40% below the average cost of traditional DPC practices operating in the market today. Through our proprietary Private Physician Network (PPN)™, Healthcare2U promotes healthy living by detecting, treating, and managing acute and chronic conditions before the onset of serious illness. Healthcare2U is headquartered in Austin, Texas, and is available nationwide.

 

Footnotes:
1 AAFP 
2 Kaiser Health News 
3 Gallup Poll 
4 Fierce Healthcare
5 Aristamd 
6 Forbes 
7 Kaiser Family Foundation 
8 Kaiser Family Foundation 
9 Kaiser Family Foundation 
10 The Balance 
11 NCBI 
12 CDC 
13 Kaiser Family Foundation 
14 SHRM 
15 JABFM 
16 BenefitsPro 

How to Cushion the HDHP Blow With Voluntary Benefit Options

Article: How to cushion the HDHP blow with voluntary benefit options. Implementing first-dollar savings through customized benefits can help brokers give employees a soft landing into their new HDHP.
Publication: BenefitsPro.com
AuthorAndy Bonner

We all know successful companies continually recruit the best talent to give themselves a competitive edge. Making employees feel valued, understood, and cared for is integral to retaining top-notch talent, and savvy employers work with knowledgeable brokers to build benefit packages to do just that.

Health plans are evolving, and many employers are shifting the financial burden to their employees, often in the form of high deductible health plans (HDHPs). The best brokers teach employer clients how to take a HDHP and incorporate voluntary benefits options that deliver real value to their employees.

Read the full article at BenefitsPro.com.

 

 

About Healthcare2U: Healthcare2U is a membership-based, hybrid direct primary care (DPC) organization that ensures employers of all sizes and structures have nationwide access to affordable, consistent, and quality primary care 40% below the average cost of traditional DPC practices operating in the market today. Through our proprietary Private Physician Network (PPN)™, Healthcare2U promotes healthy living by detecting, treating, and managing acute and chronic conditions before the onset of serious illness. Healthcare2U is headquartered in Austin, Texas, and is available nationwide. For more information, visit www.healthc2u.com.

Happy Women’s Equality Day

In honor of Women’s Equality Day, we celebrate all the brilliant and unbreakable women making positive contributions to the world.

Women’s Equality Day is celebrated in the United States on August 26th. It commemorates the 1920 adoption of the Nineteenth Amendment to the U.S. Constitution, which prohibits state and federal governments from denying the right to vote to anyone on the basis of sex. However, the fight for women’s suffrage was only the first step toward full and equal participation of women in our nation.

We’ve made other strides by attacking discrimination through our laws and by paving new avenues to equal economic opportunity for women. Today, in virtually every corner of our society, women are making important contributions to the quality of American life. And yet, much still remains to be done for women’s equality. According to the Census Bureau, women still earned 81 cents for every dollar earned by males as of 2018. Like many other disadvantaged groups, women have been expected to do more with less for decades.

So today, in honor of Women’s Equality Day, we’d simply like to say to all the strong, brave, selfless, brilliant, unstoppable, beautiful, compassionate women holding families, corporations, non-profits, schools, and governments together: We see you. Happy Women’s Equality Day!

Tips to Reopen Businesses Safely During the COVID-19 Pandemic

 

Weeks after lifting stay-at-home orders, some states are seeing record numbers of hospitalizations from #Covid19 as thousands more Americans get infected each day. Here are some essential factors to consider as businesses seek to reopen.

According to a new study by the Kaiser Family Foundation, almost 25 percent of adult workers are vulnerable to severe illness from COVID-19. Most people, including at-risk workers, can’t afford to miss work for long periods of time. Some people at risk have continued to go to work outside their homes due to the nature of their jobs, many as essential workers. Others may have been able to work remotely, but this option isn’t available to all workers. Many have lost their jobs or may be at risk of losing them. How can we reopen businesses safely?

As more workplaces reopen there will be increasing pressures for all workers, including those at higher risk, to return to jobs or seek new jobs outside of their homes. This will raise issues both for employees concerned about their safety and for employers concerned about how to keep these workers safe. As you consider reopening your business, here are some best practices recommended by the CDC to reopen businesses safely:

  • Practice social distancing by staying at least 6 feet away from others when working in a shared space
  • Wash hands frequently or use an alcohol-based hand sanitizer that is at least 60% alcohol when soap and water are not available
  • Wear cloth face coverings
  • Avoid touching eyes, nose, and mouth
  • Stay home when sick
  • Clean and disinfect frequently touched objects and surfaces

Stay safe and healthy!

Direct, Virtual, Telehealth: A 360 View of Three Primary Healthcare Alternatives for 2020

Article: Direct, Virtual, Telehealth: A 360 View of Three Primary Healthcare Alternatives for 2020

Publication: America’s Benefit Specialist Magazine

Author: Andy Bonner

With accessibility and convenience waning in traditional healthcare, three primary care alternatives have entered the picture: direct primary care, telehealth, and virtual care. These three solutions were born out of a need to make the doctor-patient relationship more effective and efficient. In the process, they’ve created impressive returns for employers as well.

At face value, direct primary care, telehealth, and virtual care may seem interchangeable or redundant – but they aren’t. They’re more like three walls of a triangle: each one strengthening the other. They’re powering the future of healthcare while driving down costs in surprising ways.

Read the full article at BenefitsSpecialistMagazine.com

Interested in learning more? Let’s get in touch

3 challenges facing benefits brokers in 2020

A new age is dawning for health benefits

Publication: BenefitsPro
AuthorAndy Bonner

There’s a great deal of business buzz around getting more “focused” in 2020. The reality is that, for benefits brokers, it’s not just a snappy catchphrase. Focusing your services and providing clarity within the increasingly murky waters of health benefits will be critical for your business’ survival. Only those who are willing to get creative, be change-makers, and meet employee’s needs will come out ahead. Read the full article at BenefitsPro.com

Interested in learning more? Let’s get in touch >

DPC Brings Non-Benefited Employees into the Fold


Article: DPC Brings Non-Benefited Employees into the Fold
Publication: BenefitsPro
Author: Andy Bonner

Dear brokers: You’re ignoring a huge segment of non-benefited employees during open enrollment and, in the process, you’re leaving thousands of revenue dollars for yourself on the table. Direct primary care has become a key enrollment strategy to fill the non-benefited gap. If you’re new to the conversation, the good news is that direct primary care is an easy sell. Employees need it to fill their gaps in coverage, and employers are surprised at how affordable it is.

Read the full article at BenefitsPro.com

Interested in learning more? Let’s get in touch

Health Insurance Literacy: Employees Need More Resources

Without a doubt, healthcare is a complex entity that includes multiple constituents beyond the patient and care provider. From various carriers to government regulations, the intricacies of healthcare can turn around even the most informed consumers. So, what happens when consumers become overwhelmed by options and guidelines? Among other factors, the complications lead to a lack of health insurance literacy.

Health insurance literacy is the degree to which an individual has the knowledge, ability and confidence to find and evaluate information about health plans, select the best plan for their own financial and health circumstances and use the plan accordingly. Related to the public health term “health literacy,” it focuses on individuals’ ability to make well-informed health decisions based on their plans.

Employees Speak Up

A recent study by Maestro Health surveyed 1,000 employees with employer-sponsored health plans about their sentiment towards the current state of healthcare as well as how it impacts their care-seeking decisions. The survey concluded that 35 percent of the employees either somewhat understand, don’t understand or know nothing about their healthcare coverage. Even if they do fully understand, 62 percent of respondents feel their employer does not serve as a resource for their healthcare-related questions.

Employer-sponsored insurance covers over half of non-elderly Americans – approximately 152 million adults. Therefore, this lack of understanding is detrimental to not only employee health and finance, but to an employer’s bottom-line and the nation’s growing healthcare deficit. Group plan premiums begin to skyrocket with the increase of unnecessary claims and absenteeism can set back a productive business. Diabetes, alone, costs U.S. employers $20.4 billion in unplanned absenteeism and the nation $246 billion in extra healthcare costs.

Providing Care and a Resource

Employee communication is a valuable factor. When done properly, it can leave employees feeling well-informed and confident in their care-seeking decisions. Therefore, healthcare professionals and companies must share the duty of providing transparent and insightful information. At Healthcare2U, we strive to do just that.

All Healthcare2U members seek better health and wellness with a phone call. Our bilingual Medical Assistants triage their symptoms and schedule either an in-person doctor visit or virtual telehealth. Should care be provided outside of Healthcare2U’s partner-clinics, our staff walks the member through their plan to explain alternative options and how to use them.

To learn more about how Healthcare2U serves as a resource to shield claims from employer-sponsored health plans as well as navigate patients through their coverage, contact us!

Are High-Deductible Plans Placing Employee Health at Risk?

Chronic disease management is not only expensive and complex but it’s key in improving patient outcomes and minimizing overall healthcare expenditures. Currently, the price tag of chronic illnesses accounts for 72 percent of the $2.2 trillion spent on healthcare in the U.S. each year. Diabetes is one such chronic condition that is so common, 30 million Americans are affected by the disease which can lead to blindness, kidney disease, amputations and heart disease. With the prevalence of chronic diseases, what happens to ill employees when their employer raises health insurance deductibles?

In the article, Getting the Diabetes Care You Need on a High-Deductible Plan, a study follows 34,000 diabetic employees through their transition from a $500 maximum low-deductible health plan to a high-deductible insurance plan that boasted out-of-pocket costs of $1,000 or more. Compared to individuals who remained on low-deductible plans, employees who switched to high-deductibles waited longer to seek various treatments because of expenses. For example, patients waited an average of 1.5 months longer to seek care for chest pain – the first major symptom of atherosclerosis, a high-risk condition for diabetic patients. Employees also delayed treatment by two months for the first major diagnostic test, and three months (or longer) for the test result’s recommended medical procedure.

The study didn’t include research of the health outcomes of these individuals or how the delay in care affected their pre-existing diabetes. However, it is important for employers and healthcare professionals to note the value in time-sensitive decisions for care. If left untreated, diabetes can create numerous health complications to include heart attack, stroke or amputation of extremities. With atherosclerosis, in particular, a delay in treatment can result in heart attack, stroke or another medical emergency.

End Delayed Care with an Affordable Solution

Many factors can contribute to delayed care – however, it’s a fact that the cost of healthcare is a huge concern for patients. Employees with less-than-adequate health coverage/insurance may decide to “wait-out” their symptoms, increasing their risk for serious health complications in the future. If your clients utilize a high-deductible option, their insurance plan is at-risk for serious health expenditures down the line.

To offset an employee’s health expenses from a high-deductible health plan, employers may to offer gap plans that include affordable and convenient access to care. Gap insurance is a supplemental health plan that cushions expenses for employers and employees who utilize high-deductible health care plans. By offering a gap plan, employers improve the entry point to healthcare and encourage their employees to seek treatment at the onset of an illness, reducing urgent care and emergency room visits.

One gap solution is to provide employees a membership to Healthcare2U’s No-Claims Healthcare™. Through unlimited access to our patient-navigation platform, Healthcare2U shifts care away from traditional insurance and towards membership services, avoiding claims. By directing members towards affordable and convenient care, Healthcare2U can educate employees about their health and their next steps towards wellness. Healthcare2U works with employers of all sizes and there is no exclusion of pre-existing conditions. Benefits include – but are not limited to – same or next-day acute care with a board-certified physician for $10 a visit, 24/7/365 bilingual telehealth for no additional cost and chronic disease management for 13 of the most prevalent chronic disease states for the same $10 visit fee. Because of Healthcare2U’s cost-containment nature, employers have seen an ROI of 15 percent within their first year of implementation.

With DPC, members create a trusting relationship with their primary care physician, unaffected by budgeting concerns. This educates them to lead a healthier lifestyle, minimizing future insurance premiums for their employers. Are you interested in learning what Healthcare2U can do for your employer groups? If so, let’s talk.