Direct pay primary care is not a familiar term. A new term that many people are becoming familiar with in the medical industry is “direct pay provider”. Put simply, direct pay primary care providers are family practice primary and urgent care doctors that are not involved with health insurance and only accept cash payments for their services.
Direct pay primary care began to appear around 2007 and has been steadily gaining in popularity. What these doctors have discovered is that by cutting out the insurance agencies they can deliver quality care to their patients without interruption and at affordable prices. Many doctors believe that nearly 40 percent of the costs associated with their practice go to processing and fighting insurance claims. By eliminating this issue, they can drop prices and increase revenue.
The Benefits Of Direct Pay Practices
• Nearly 65 percent of all medical problems can be treated or are already treated by a family physician. If you look at this figure, it means that a majority of health problems can be solved at this type of practice and at an affordable rate.
• Patients spend more time interacting with the doctor. When there is not a push to get people in and out of the office to generate enough revenue to cover insurance expenses, patient care and visit quality improve.
• More preventative care is given. When the doctor has the ability to devote more time to a patient, more preventative care measures are given to the patient. Additionally, many of these care tips do not include medications, which keep the cost lower for the patient.
• The medical staff is happier. Doctors and other health professionals that work within a direct pay practice report that they are happier with their work and that they feel they can provide better service to their patients. Many report that insurance companies often prevent the best treatment available to the patient, and this is stressful to them personally. An office where everyone is happier is beneficial to the patients.
What About The Affordable Care Act?
With the onset of the Affordable Care Act (ACA) which requires everyone to carry health insurance or be penalized, it is easy to assume that this type of practice will quickly fade. However, the truth is that the ACA has made this type of practice more in demand.
In response to the ACA, insurance companies quickly changed their health care plans to be more expensive to use. It is their belief that this is the only way that they can afford to provide health coverage to everyone.
This change in health care has made it less affordable for everyone. With ridiculously large co-pays and a majority of basic services not covered by these health care plans, people need to be able to turn to a different method of receiving basic health care.
As has already been established, over 60 percent of all health care can be provided by a family doctor. If consumers lean towards direct pay primary care, they can eliminate their need for overpriced insurance policies and stick to cheaper ones that cover catastrophic events. The reduction in premium prices helps pay for the direct care costs, and consumers are receiving quality care at an affordable price.
Finding a Direct Pay Practice
There has been an increase in practices across the country that are converting to direct pay. Some doctors are banding together and forming associations only consisting of direct pay providers, while others just advertise as one in their local area.
It was not that long ago that medical care came from a family doctor that received payment at time of service. Insurance for medical care did not exist, and if it did, it was for hospitalization only. Consumers did not suffer in this type of care environment and medical professionals were not harmed financially. This change back to the “old” ways of receiving care is perhaps one of the best steps the medial industry can take.