One Size Fits All Health Insurance Plans Are Failing Your Employer Groups. Here’s Why.
While the cost of goods and housing continues to rise, so does the cost of healthcare. The cost of other necessary items has increased, such as groceries rising 20 percent since 2021 and a significant surge in the cost of utilities and gas in 2022. Healthcare costs have been steadily rising since 2012, with the average monthly cost of traditional insurance being $659 in 2022. This has resulted in financial stress for many Americans. Of those insured, more than two-fifths of working adults consider themselves “inadequately insured”. How can we reconcile spending so much money on health insurance that isn’t fulfilling our needs?
In this blog, we’ll discuss why health insurance plans have a hard time being inclusive, why they’re not the best option for today’s workforce, and how traditional plans and Direct Primary Care (DPC) memberships can partner together to create the perfect solution for everyone.
It’s expensive for a health insurance plan to be inclusive
The soaring costs of healthcare in the United States have become a major concern for individuals and communities across the nation. With health insurance premiums reaching unprecedented levels, finding a sustainable solution has become a priority.
The typical cost per year employers paid for employee insurance in 2022 was $7,911 for single coverage and $22,463 for family coverage. Employees and employers contribute this money, but sometimes the benefit is not utilized, resulting in a waste of finances for both parties.
There are five main factors that affect a plan’s monthly premium: location, age, tobacco use, plan category, and whether the plan covers dependents. These factors make it difficult for employers to keep up with the expensive premiums, as each employee affects the cost differently.
Traditional health insurance plans are not adaptable for a modern-day workforce
Traditional insurance simply isn’t working for today’s modern workforce. Apart from traditional insurance being expensive, it’s also confusing. Fifty-eight percent of Americans say they’ve run into problems when using health insurance within the past year. This includes problems with denied claims, provider networks, and pre-authorization. Through traditional insurance, employers also suffer from surprise bills like “shock claims”, which are claims that are unexpected financial blows to the insured.
Traditional insurance doesn’t prioritize the patient’s experience, affecting people’s motivation to book appointments and seek the medical care they need. Whether it’s because of a lack of flexibility like virtual options, or doctors not having ample time to discuss underlying issues with the patient, traditional insurance doesn’t foster the patient/doctor relationship, and that leads to people being less inclined to access care.
Traditional health insurance is rooted in fee-for-service delivery, not value-based care
Traditional insurance operates by a monthly payment to cover the health plan, with the member paying a fee for each service. The insured are required to meet a deductible before their insurance starts pitching in, and you can also get hit with unexpected bills after treatment or service.
The cost of health insurance and the level of satisfaction people feel toward it are also not equal, and it doesn’t seem like insurance companies have any interest in helping solve this problem. Fee-for-service delivery treats the insured like they’re just another number, but with DPC, the patient/physician relationship is at the forefront, and employers know their employees are receiving quality care.
How traditional insurance plans and DPC memberships partner together
DPC is a healthcare membership that gives its members access to unlimited primary care for a low monthly fee. DPC, at its core, is centered around chronic disease prevention and championing the doctor-patient relationship, supporting members to live a healthy, happy life.
Here’s a quick breakdown of the benefits of DPC:
- Low monthly membership fee and cost transparency
- Unlimited access to primary care for a minimal fee and virtual visits for no fee
- Unlimited access to primary care, urgent care, and chronic disease management for a minimal fee
- Easy-to-understand benefits
- More one-on-one time with your healthcare provider
- Upfront pricing
- In most cases, appointments to see a physician can be made within days
- Continuity of care
- No deductibles
With DPC, you’ll receive continuity of care and a physician who takes the time to listen to you and assess your concerns, whether it’s virtually or in person. This, combined with traditional insurance, allows employees to receive day-to-day care as well as peace of mind for more serious health concerns.
DPC is an answer to many challenges we are facing in healthcare today. To learn more about DPC and how it can partner with traditional insurance, click here.
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