Primary Care For Small Business

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Because direct primary care is still a novel healthcare delivery concept, many employers and small businesses have invested resources into determining whether DPC is a good fit for their needs. And as patients rave about extended face to face time with their physicians, improved outcomes, and easy access to healthcare needs, there is more interest from small businesses in offering Direct Primary Care to their employees.

What is Direct Primary Care for Small Business?

The vast majority of Americans have access to health insurance (and, therefore, health care) through their employers. This employer-based insurance system persists because, conceivably, large groups have demonstrated more negotiating power with insurance companies than individuals. 

But as the downsides and perverse incentives of many health insurance setups become more obvious and more prominent, employers have begun considering alternatives.

Direct primary care has emerged as one of the most effective and popular alternative models of delivering primary care. In a direct primary care setting, patients are granted “membership” at a specific clinic or group of clinics. Membership entitles patients to a long list of primary care services at no additional cost. Small employers and organizations that do not want to become mired in insurance can still offer health benefits to their employees by providing memberships at a direct primary care clinic.

This means that employees would get access to:

  • Increased cost savings: Members of direct primary care practices are not subject to additional costs for most primary care. At Progressive Health Primary Care, for example, membership fees cover all appointments, calls, and meetings. These savings would be enjoyed by all employees who become DPC members.
  • Thorough office visits: At a DPC clinic such as Progressive Health Primary Care, patient visits with physicians are given substantial time. This means that all DPC members can expect more compassionate and thorough care.
  • Immediate appointments: Because direct primary care clinics operate successfully with a lower patient-to-physician ratio, it’s easier to make convenient or immediate appointments. This can help patients with mild illness--such as strep throat--seek treatment more quickly, when symptoms are more easily managed.
  • Discounted Prescription Medications: We dispense prescription medications at a discount as a benefit to our members. Discounts are often substantial and less than the co-pay at many pharmacies.

Generally, direct primary care members are still encouraged to carry insurance, so employers who choose to do so can offer supplemental plans to help out in that regard.

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Benefits of Direct Primary Care for Small Business

Research has shown that robust and direct primary care can lead to better outcomes for individual patients. Employers and their employees can enjoy significant benefits as well. There are two compelling ways in which direct primary care in a small business setting can create long-lasting benefits.

Health Benefits

First and foremost, direct primary care leads to important health benefits for patients. In most cases, these improvements to wellness derive from expanded access to primary care. Many studies have found that when making appointments is easy and relationships with physicians are strong, health issues can be addressed earlier and more successfully. In other words, when you’re a DPC member, you tend to no longer delay routine screenings or neglect checkups. 

When employees are healthier, they also tend to be happier and more productive. Research into DPC practices have shown that direct primary care leads to the following health benefits:

  • Patients enrolled in DPC practices have spent 30 days fewer admitted to hospitals
  • Those enrolled in a DPC membership are referred to specialists 62% less often
  • DPC members undergo surgery at a rate of 80% less often
  • Patients enjoy visits that often last well over 60 minutes, providing significant time to discuss health priorities and concerns.

Financial Benefits

Under traditional insurance plans, premiums may rise if employees use their insurance too often. That’s not the case with direct primary care for small business. So even if employees are visiting their physicians more often (which is good, as far as healthcare and wellness are concerned), it will not adversely impact financial balance sheets.

Indeed, most research has concluded that well funded primary care access, in the long run, leads to financial savings for employers. According to some research, companies spend nearly 40-60% of their total healthcare costs on “downstream” care. This could include:

  • Speciality visits
  • Trips to the emergency room
  • Surgery
  • Special diagnostics, such as X-rays or CT scans

Robust primary care tends to reduce downstream visits. Primary care physicians can spot problems before an emergency room visit is necessary or help to reduce risks associated with surgical interventions. This leads to greater cost savings over time as employees need fewer expensive procedures on average.

A study sponsored by The Society of Actuaries compared employees who chose DPC in a large employer to other employees at the same employer who chose traditional primary care. For patients in the DPC group, DPC was associated with a reduction in the overall demand for healthcare services outside of primary care. Specifically:

  • DPC members had 19.90% lower claim costs for employers on an unadjusted basis and 12.64% lower claim costs on a risk-adjusted basis during the two-year period. 

  • DPC members experienced approximately 40% fewer ER visits that those in traditional plans.

  • DPC members experienced a 53.6% reduction in ER claims cost.

  • DPC members experienced 25.54% lower hospital admissions on an unadjusted basis. While this figure may have statistically variance, it validates previous research trends showing a reduction in the use of hospitalization and more complex specialty care by DPC members.

Benefits for Employers With Self-Insured Models

As insurance premiums have continually increased, more employers have started moving to a self-insured model. In this model, employees are responsible for all of their own healthcare and insurance costs, including monthly dues. A direct primary care practice can provide these employers with a cost effective way to offer healthcare benefits to their employees without getting bogged down in skyrocketing insurance costs and paperwork.

Over time, direct primary care for small business can prove to be a beneficial arrangement for both employees and employers. 

How to Get Started

Whether your business is currently offering health insurance or working under a self-insured model, offering direct primary care membership to your employees can produce significant benefits. For a small business or organization, dealing directly with a direct primary care provider will mean that you can find healthcare solutions that truly work for you and your employees.

It’s usually recommended that employers cover the costs of the full membership for their employees, rather than splitting the fees. This helps ensure that employees take full advantage of the direct primary care system, ensuring the long term wellness and financial benefits.

If you have questions about direct primary care or how you can go about offering it to your employees, contact Progressive Health Primary Care today.