Over the past few years, medical practices have been feeling the squeeze of lower insurance reimbursements and the burdensome of administrative compliance to chase those dollars. Direct care, or retainer-based medicine, is an emerging and alternative way for doctors to serve their patients.
Under direct care, a medical practice provides services in a manner that effectively bypasses insurance companies. The result is lower costs to the patients, lower overhead costs to the practice, and an increase to practice profitability. Additionally, it eliminates the uncertainty of whether insurance companies will pay or not. Cutting out the time spent dealing with insurance compliance allows medical practices to spend more time providing a higher quality of care to their patients.
Doctors using a direct care model do not accept insurance. Direct care medical practices typically charge patients a recurring fixed fee that entitles the patient to a specified group of services. These services generally include better access to the doctor, such as same day or next day appointments, longer appointment time, and home visits. In addition to this fee, the practice may charge a per visit fee similar to a co-pay. Patients can also find some practices that offer both direct care and traditional insurance-based relationships.
In addition to providing new offerings to patients, a direct care practice can negotiate with employers to provide services to all of its employees. As the cost of insurance continues to rise, employers are increasingly looking for innovative ways to reign in policy costs. Direct care can offer them cost saving opportunities while giving employees certainty of cost.
Direct care is not the same as concierge medicine, which emerged in the mid-1990’s. Concierge medicine is similar to traditional insurance-based medicine, with the exception that patients pay a fixed fee for a higher quality service. The cost of office visits and medical services provided remain the same. In the past, concierge medicine allowed doctors to decrease their patient load while making up any lost revenue through concierge fees.
Like concierge medicine, direct care enables practitioners to lighten their patient load and provide a higher quality of care. In comparison, direct care is more affordable for patients then concierge medicine and eliminates the burden of insurance compliance.
Could the direct care model be in your practice’s future? Please contact Aronson’s Professional Services Industry Group to have your practice’s profitability reviewed and learn how an alternate approach may boost your bottom line. Partner Larry Rubin, who focuses on medical professionals, can be reached at firstname.lastname@example.org or 301.222.8212.