Direct Primary Care for Employers

What is Direct Primary Care?

Direct Primary Care (DPC) is a newer model that is becoming increasingly popular among employers because it offers unlimited, cost-effective care by a primary care doctor without any additional expenses like deductibles, co-pays, or coinsurance.

Current Employer based health insurance benefits

According to the Census Bureau, 54.5% of Americans are insured by their employers. Employers usually buy health insurance from big insurance companies for a fixed premium amount, partially paid by employers (usually 70 to 80%) and partially by employees (20 to 30%). According to a survey in Illinois, average annual premiums are $7,547, with employers paying $5,801 and employees paying $1,746. Once employees have insurance, they need to pay a deductible to get any medical care. According to eHealth, the average deductible for marketplace plans for medical and prescription drugs in 2023 is $7,481 for Bronze plans, $4,890 for Silver plans, $1,650 for Gold plans, and $45 for Platinum plans. Due to these high costs, approximately 40% of Americans skip care.

How can Direct Primary Care be used by employers?

Direct Primary Care (DPC) is a newer healthcare model that can be paired with either traditional health insurance plans or a Health Reimbursement Arrangement (HRA) and offers a different solution for healthcare to employees, especially in small employers. For a flat monthly fee, usually between $100 to $160 per month, employees have unlimited access to their primary care doctor without any deductible, coinsurance, or co-pay for visits. DPC practices have heavily negotiated prices for blood work, imaging, and other medical services, often costing only 10% of what they would in the traditional insurance system. This brings overall healthcare costs much lower for employers.

What are the benefits of DPC memberships for employers?

It reduces absenteeism: Physicians who work with insurances only get paid for an in-person or video visit, which is not always required. In a DPC model, physicians get paid a flat monthly fee and have the liberty to communicate with their patients via call, text, or email, saving them a visit. Additionally, most DPC practices are run by independent physicians who can see patients after hours or on weekends.

Zero out-of-pocket cost: There are no additional costs like deductibles, coinsurance, or co-pays for DPC doctor visits. This significantly improves access to healthcare providers for employees.

No or minimal wait times: DPC doctors usually see fewer patients in a day and are able to see their patients at designated times. This means patients do not need to wait hours in waiting areas and do not require a whole day off work for a doctor's appointment.

How can employers find DPC practices near them?

There are several ways to locate a Direct Primary Care doctor near your business. Different websites keep track of these DPC practices and are very helpful. Following are some of the websites with the most accurate and updated DPC practice information:

• DPC Frontier

• DPC Alliance