Several medical practice models exist in healthcare that provide different experiences for both patients and providers. The changing healthcare landscape in the U.S. has ignited a shift in primary care delivery as providers experience burnout from grueling work schedules and unsustainable patient volumes, with less compensation than ever before. What has emerged? A new way to deliver primary care that not only puts the patient first, but prioritizes the provider as well.
Over the past decade, medical practices have been consumed, quite literally, by large healthcare systems due to changes in reimbursement policies and the economic implications of fee for service care. Health insurance companies drive incentives for providers to see as many patients as possible, making appointment time shorter and provider-patient interactions minimal. Providers are tied to a reimbursement system that compensates less than they deserve and prioritizes volume over value. As a result, prevalence of chronic health conditions has skyrocketed which has even further widened the gap between supply and demand for high-quality care. Patient and provider dissatisfaction levels are at an all time high.
Deviating from the conventional practice norm, concierge medicine and direct primary care practice models have emerged in an attempt to create sustainable private practice models and improve patient outcomes. Both models can seem similar at face-value, but have differences operationally and in their philosophies around care.
Similar but Different
The main difference between concierge medicine and direct primary care is in their provider payment structures and cost implications for patients. Both concierge medicine and direct primary care enroll patients on monthly or yearly payment “subscriptions” that provide direct access to their provider, as well as specialty testing and comprehensive health assessments. However, concierge practices usually also accept insurance, meaning a patient pays an insurance company for concierge services, on top of a subscription fee to the concierge practice. Direct primary care practices, on the other hand, typically do not accept insurance, so the provider is paid directly by the patient (hence its name), and monthly fees tend to be lower. The cost per month in a direct primary care setting covers appointment times, labs and other testing, where in concierge medicine, some of these costs may be billed additionally as “non-covered services.”
Patient panels in both concierge medicine and direct primary care are kept low, with providers typically seeing as few as 5-6 clients per day, as opposed to upwards of 25-30 per day in most conventional settings. In most cases, concierge medicine relies heavily on practicing conventional medical philosophies, while direct primary care often merges other philosophies in health care, like functional and integrative medicine. Without the control of insurance companies, direct primary care practices are able to think outside of the limitations in conventional medicine and focus on whole-person health.
It is clear the healthcare industry is seeing a shift in primary care delivery due to a demand in more personalized care for patients and more freedom for providers. Essential Health’s direct primary care model allows for direct 24/7 access to a provider versed in the best of conventional, functional and integrative medicine, with little or no wait time for appointments.
Learn more about how Essential Health’s direct primary care can help you reach optimal health by scheduling a meet & greet today.