Direct Primary Care: What Is It and Why Do I Need It?

Most people know what a primary care physician is and how to find one. However, understanding what direct primary care is, is a different story. The idea is relatively new, different, and probably confusing to some.

If you have just started to hear the phrase “direct primary care,” you may have some questions. We have your answers. 

What is direct primary care and how does it work? 

Does it work with health insurance? 

Why do I need a membership plan?

Direct primary care is not another way to say primary care physician. The two phrases are distinct medical terms.

Read on to learn more about direct primary care, the membership options, and the benefits of this healthcare model.

Understanding Direct Primary Care

Direct primary care (DPC) is a healthcare model. It differs from your typical fee-for-service and insurance billing type of medical practice. 

What Is Direct Primary Care?

Instead, DPC operates like a subscription service. You join as a member and, as such, you are entitled to certain perks, medical services, and discounted pricing. It is a financial arrangement between the doctor and patient.

Similar to concierge medicine, direct primary care is a type of medical business model that entered the scene in the mid-2000s. It has grown in popularity since then. With the rising costs of medical care and health insurance, some physicians decided to cut out the middle man (the insurance company) and switched to this subscription or membership-based model.

The result is better access to more affordable medical care.

How Membership Works

Consider your Netflix plan. Each month you pay a flat fee and are given access to a specific set of TV shows, documentaries, and movies.

With your direct primary care subscription or membership, you pay your doctor a monthly fee. That fee gives you access to specific medical services, laboratory services, and patient care. The exact coverages vary from doctor to doctor or practice to practice. 

However, the bottom line is that you have upfront, transparent pricing for your health care. 

Your monthly fee may guarantee you a certain number of visits and clinical services, easy access to appointments, and better communication with the practice. Additional services such as injections, minor procedures, or labs may be provided at a discounted price.

Combining DPC Membership with Health Insurance

As mentioned above, DPC practices cut out the insurance middle man and collect payment directly from the patient. This means they spend less time, energy, and resources filing insurance claims and following up on reimbursements.

Because of this, direct primary care doctors do not accept medical insurance. However, that does not mean that if you have health insurance you cannot go to a DPC doctor. In fact, the opposite is true. 

Oftentimes, patients with high deductible insurance plans get direct primary care memberships. This saves the patients money in the long run. They can get routine appointments and treatments at the membership discount rather than paying in full and trying to meet the high deductible.

Whether you have insurance or not, anyone can have a membership.

Benefits of Direct Primary Care

Aside from saving patients money on health care, direct primary care offers the following benefits:

• Better access to a physician
• Easier appointment scheduling due to fewer patients
• Unrushed appointments and ample one-on-one time
• Better patient-doctor relationships and patient-centered medical care
• Continuity of care between your DPC doctor and any specialists you may need
• Open communication
• Transparent pricing and billing
• Lower medical expenses

When patients have a positive relationship with their doctor, they are more likely to schedule appointments for acute, chronic, and routine care. The DPC model gives patients access to improved healthcare. They can make more informed decisions about their health, lifestyle management, and disease prevention.

Direct Primary Care with Blue Skies Family Medicine

Membership Plans

At Blue Skies Family Medicine, we offer various membership plans to meet your needs. We have plans for children, adults, families, and even employee plans for businesses. Among other services, the membership fee includes:

• Routine physicals
• Acute and chronic disease management
• Hearing and vision screenings
• Weight management
• Mental health screenings
• Routine point-of-service labs
• Discounts on additional services

Better Healthcare for Less

With direct primary care in Mooresville, NC, you get 24/7 access to a physician, easier scheduling, unrushed appointments, and a better doctor-patient relationship. Our physician, Dr. Katherine Weeks is a board-certified family physician who is dedicated to more inclusive healthcare.

Schedule an appointment with Blue Skies Family Medicine today!