DPC vs Concierge
In many respects Direct Primary Care (DPC) is a form of concierge practice. However, there are important factors that differentiate DPC practices from other concierge practices.
Concierge practices generally charge a fee on top of charging insurance, including still collecting co-pays as required by their contracts with insurance companies. DPCs on the other hand do not participate with insurance. The only cost associated with a DPC is the membership fee – so no copays! Though it should be mentioned some DPCs will charge additional fees for after hours visits, so be sure to know a practices policies before joining. Costs such as dispensed medications, labs, imaging are generally in addition to the membership fee, though again that varies by practice.
With regards to medications, labs, imaging, at a concierge practice these will typically be ordered to an outside facility (pharmacy, lab, etc.) and payment deferred to a patient’s health insurance. Depending on the practice and state law, DPCs will dispense medication from their office, have cash based pricing for labs that are generally much cheaper than going through insurance, and the same for imaging. Procedures may or may not be included with the DPC membership. At Nova DPC, we dispense medications at 10% above wholesale pricing, have cash based labs through independent labs (most common labs are $5-7 each), and access to cash based pricing for most imaging modalities. The downside to the cash base pricing is that if someone has insurance it will not count towards their deductible, though some insurance will reimburse policy holders the price of their testing due to the lower cost. If a patient prefers to use their insurance at pharmacies, labs, etc. they may opt to do so instead of using the available cash based pricing.
Both DPC and concierge practices share increased patient access to their physician. Some examples include texting, email, physician cell phone numbers. Both may or may not guarantee 24-hour access to physicians. Both typically will have regular business hours to see patients during and may or may not have in person after hours or weekend options, though typically will at least offer after hours virtual or phone visits. Depending on the practice the after hours services may utilize nurse triage services or mid-level practitioners. At Nova DPC, it is just Dr. Nick and Dr. Matt who take these calls.