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Affordable Primary Care Without Insurance or Hassles?

undefinedFlorida Legislature Seeks to Approve Direct Primary Care Agreements

As personal injury lawyers in Tallahassee, we pay close attention to what is happening down the street at the Capitol. When the Republican-controlled Florida legislature is in session, we expect to see bills aimed at restricting or abrogating an individual’s right to recover damages if injured by medical malpractice. Our own Dana Brooks, a shareholder here at Fasig & Brooks, has testified several times in front of legislative committees, attempting to educate lawmakers on the hardships our clients face as a result of the laws they pass that favor big business and special interests at great costs to the rest of us Florida citizens.

It piqued our interest that the Senate Health Policy Committee on Monday approved a measure (SB 132), which is aimed at clearing the way for direct primary care agreements in Florida. The Senate and House (HB 37) bills would further define primary care agreements, and would make clear that these agreements are not subject to insurance laws.

In Florida, a small but growing number of doctors are walking away from the traditional insurance model, and are instead running their practices on a membership model. Doctors who have changed to this new (but old-fashioned) method of providing care tout the benefits to their patients. Because dealing with insurance companies is time and labor intensive, direct primary care providers say they are able to reduce their own overhead costs, which allows them to offer their services at a very reduced rate, and allows them to have spend more time with their clients.

At Fasig & Brooks, we know all too well that, for the consumer, insurance companies are frustratingly difficult to deal with. As long as direct primary care providers are required to carry adequate medical malpractice insurance, and the contracts between doctor and patient don’t force people to go to arbitration for all disputes, we are cautiously optimistic that this might be helpful for some patients.

What is direct primary care?

Direct primary care is an innovative alternative payment model in primary care model embraced by patients, physicians, employers, payers and policymakers across the United States.The defining element of DPC is an enduring and trusting relationship between a patient and his or her primary care provider. In DPC unwanted fee-for-service incentives are replaced with a simple flat monthly fee. This empowers the doctor-patient relationship and is the key to achieving superior health outcomes, lower costs and an enhanced patient experience,” according to Direct Primary Care Coalition, an advocacy group for direct care providers.

Patients who use direct primary care pay a monthly membership fee to their doctor — typically $50 to $80 (The American Academy of Family Physicians (AAFP) estimates that typical fees run from $50 to $150 per month.) Some practices require a small (usually $10) copay per visit, but routine tests and procedures are usually included. Because they don’t have to deal with insurance-contracted rates, doctors can offer other services at wholesale prices.

What are the Pros and Cons of Direct Primary Care?

Pros: More, quality, time with your doctor, less insurance hassles.

Cons: Because this type of patient care is aimed at primary physician care only, you will also need to have catastrophic (at least) medical insurance for severe health problems and hospitalizations. Additionally, if you don’t see a doctor very often, your costs may end up being greater than with traditional fee-for-service health insurance.