DPC vs Concierge

Uncategorized / /

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.

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Payment Plan vs Membership

Individuals / /

We are often asked what it is we do at Nova Direct Primary Care (DPC), and after explaining are often asked the same question again… That’s on us. Fortunately, we recently had a prospective patient summarize it better. 

“So, you’re like an annual payment plan?” Yes! That’s a great way to think of us. We have long thought of the DPC as a model that reflects Netflix or a gym membership, monthly payments made for monthly service. But, really to think of it as an annual fee broken into monthly installments, really makes as much if not more sense. It’s a system where you can access your physician when you need to already knowing what you’re going to spend, rather than getting hit with surprise bills. In another sense it could be thought of like a retainer, except there’s still no copay or additional fee for our services when we do see you. Being a patient member gets you access to most medications at wholesale cost when you need them, greatly discounted prices on most labs and imaging. Procedures we can perform in office are included at no extra fee as well. You also have the benefit of being able to cancel with 30 days notice without having to worry about pro-rating or refunds.

One of the big differences with our model is that you know the cost of your care in advance. Typically payment plans are thought of as starting after a cost has occurred and it is too expensive to pay off at once. Additionally, payment plans are generally for a single service, such as for a single office visit or procedure. In our model you can have multiple visits, procedures, wholesale medications, etc. throughout the year. We keep our rates fixed and affordable. This helps our patients plan their medical care expenses.  

Never has anything needed to be done like this before. With COVID, layoffs, unemployment and financial instability, the last thing people need is another bill, unexpected or surprise cost. Our costs are predictable and management decisions are made ahead of the cost. Telemedicine is booming, but Direct Primary Care has always done this and will continue to do this more effectively with increased access, affordability and service. 

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Grand Rapids physicians offer non-traditional tele-medicine services

Employers / /

As recently as 2017 the average Telemedicine visit cost anywhere from $60-$145 per single visit, as opposed to the average in person office visit of $120-$200. Telemedicine typically will only treat a small fraction of health concerns due to limitations set by the service such as lack of patient continuity, state laws, standards of medical practice etc… In traditional telemedicine a patient is talking to a physician they have never met before and there is no doctor-patient relationship. This can lead to anxiety and lack of coordinated care.

At Nova Direct Primary Care you know you will get either Dr. Nick or Dr. Matt when you have a health concern. Nova DPC offers telemedicine at no additional cost for our members. This not only increases access for our patients, but also continuity of care.

For a flat rate per month (see here for more details) we can offer broad scope family medicine services, such as wellness visits, non emergent acute sick care, chronic care management, and procedures at no additional cost to the member (see here for list of services). There are no co-pays or charges per visit. There is virtually no limit on number of visits whether they be in person, video call, or over the phone.

Telemedicine not only allows us to be more efficient in our health care delivery, but also more effective and accessible for our patients at a LOWER COST. It truly is a win-win situation!

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Large Health Benefit for Employers in Grand Rapids and West Michigan

Employers / /

The Covid-19 pandemic is going to have long lasting effects in the social realm (i.e social distancing), but also the economic realm. A recent article on The Hill mentioned that insurers will likely be increasing premiums more next year, due to instability of the market, but also delayed procedures, wellness visits etc…all happening next year instead of this year. This will absolutely affect employers and their employees with increased out of pocket expenses, layoffs, decreasing benefits etc…

https://thehill.com/policy/healthcare/health-insurance/492619-health-insurers-warn-of-higher-premiums-without

Nova Direct Primary Care is a way for employers to decrease their overall health spending, claims, and premiums every year. For a fixed cost their employee can have access to Primary Care Physicians virtually 24/7. Direct Primary Care is known to decrease costs, decrease employee absenteeism, all while providing evidence based primary care services. Some of the best data associated with this is from the John Locke Foundation in North Carolina.

https://www.johnlocke.org/policy-position/direct-primary-care/

Based in Grand Rapids, MI, Nova Direct Primary Care is in a position to assist employers around West Michigan. For larger employers with employees around the state, and even to other states, we can work with independent Direct Primary Care practices to create a high quality, cost saving solution as well.

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Direct care practices perfectly positioned to help patients (and businesses) during coronavirus outbreak

Shared Articles / /

Access to your doctor when you need them has always been invaluable, but has never been more true than now. The current health care system infrastructure was not prepared for this setting. Some systems have quickly launched expanded telemedicine capabilities to varying degrees of success. However, DPC practices like Nova Direct Primary Care have been prepared for this since their beginning. Access is a corner stone of DPC and the vast majoiry of practices have implemented remote access via phone call, text message, video chat, email, and even some via twitter as a mainstay of their practice since opening. This article highlights some of these features and how DPC can be better ulitized during the COVID-19 pandemic crisis and beyond.

Beyond the direct communication to your doctor, we have the capability to send medications directly to your home (no pharmacy trips). We oftentimes can order bloodwork and imaging studies without having to see you in person. All of this for a set price per month. If you haven’t heard of Nova Direct Primary Care, check us out!

Direct care practices perfectly positioned to help patients during coronavirus outbreak

The novel coronavirus (COVD-19) outbreak has created unprecedented challenges for physicians and patients across the health care system. Office-based doctors are scrambling to provide access to their patients through telemedicine and virtual visits while navigating a new terrain of billing codes and payment rules for these services.

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