By: Nic Hayes
Primary care in the US is broken. Primary care clinicians should be the front door to the healthcare system, with the ability to take care of most of your healthcare issues and long-term, preventative care. However, in today’s health system visits are short, typically lasting seven to ten minutes. It is often also difficult to get in to see primary care clinicians, especially outside of operating hours. For patients, primary care is even more frustrating because instead of being able to build a relationship with their primary care clinician, they are often referred out to specialty care for concerns that cannot be addressed in such a short visit.
A lot of the problems of traditional primary care stem from the insurance-based fee-for-service payment system. Under this system, a doctor gets paid every time a patient comes in, so for doctors, shorter visits allow them to see more patients meaning more pay. Instead of emphasizing improving health outcomes for patients, this system emphasizes maximizing the number of visits for each doctor.
With the shortcomings of traditional primary care, solutions that Hint Health provides offers an innovative and effective alternative approach to primary care.
Direct Primary Care
Hint Health has been around for 10 years, and its mission since inception has been to make direct care the new standard of care. Many of their customers are Direct Primary Care (DPC) practices that work on a membership model and care relationship with their patients, removing any middlemen from the equation and enhancing the patient's primary care experience.
With the DPC model, clinicians accept a flat monthly fee, around $70 - $90 on average. For that fee, all care in the primary care setting is included. This model allows patients to see their primary care clinician as many times as needed – every week, multiple times a week, or for urgent care needs. DPC clinicians are available to patients whenever patients need them through the utilization of omni-channel virtual care, including text, email, phone, and video chat, at no extra cost to the patient.
With this model, DPC practices typically see a quarter of the number of patients that traditional primary care does, anywhere from 400-800 patients in their whole panel, whereas fee-for-service primary care practices see anywhere from 2,000-3,000. This difference not only allows DPC clinicians to provide better and more timely service but also gives clinicians the time to build a relationship and a healthcare plan with their patients.
The access that Direct Primary Care provides patients truly makes it a front door to the healthcare system. It gives patients the ability to have a doctor who knows them, who they can trust, and who they can get in touch with at any time – a night and day difference from fee-for-service primary care networks. The result of this increased access to Direct Primary Care is a better healthcare experience for patients.
Direct Primary Care as an Employer Benefit
Direct Primary Care has really gained steam over the past few years. As Beth Holmes, Head of Hint Connect said, "Employer use of direct primary care has skyrocketed over the past 5 years. We just published our Employer Trends in Direct Primary Care report, and what we've seen is an 800% increase in the number of businesses using DPC as a benefit for their employees since 2017."
DPC has a profound impact on both the overall cost of care and member health outcomes. For starters, this system saves on overall healthcare expenditures by reducing allocation of high-cost settings for patients. Often people go to high-cost settings – emergency room, specialist, urgent care – because there is no lower-cost setting available. However, when direct primary care is implemented, the access it provides leads to costs coming down in those categories. A 2020 study that was published by Milliman found that a business that implemented direct primary care experienced a 13% overall claims cost reduction compared to the group with a traditional plan.
In addition to reduced costs, the direct primary care model provides patients with improved health conditions. A large study done by Primary Health Partners found that their patients were 50% more likely to have their chronic diseases under control with DPC than the national average as measured by the National Committee for Quality Assurance. Direct primary care presents significantly better outcomes because clinicians have the time, relationship, and trust with the patient to create accountability so that they can work on a care plan together.
"What employers are finding is that DPC is a benefit that really differentiates them from the competition in their area. When you have a doctor who knows you, who knows your family, who you can trust and who you can get in touch with at any time, it is a night and day difference [from] a fee-for-service primary care network."
Beth Holmes, Head of Hint Connect
Employers considering DPC for their employees should consider a solution such as the Hint Connect platform. Hint Connect is a national DPC network that works in conjunction with local independent DPCs as well as regional DPC networks to bring them together to serve large and geographically dispersed employers. Hint standardizes the benefit, puts it all on one contract, and puts it all in their technology so that employers can simply plug and play.
Employers can implement direct primary care in a variety of different ways. Fully insured plans can add direct primary care on top to help improve member experience and stay healthier. Self-insured employers can work with advisors and brokers who put together tailored plans that pair direct primary care with reference-based pricing or a narrow network plus a pharmacy benefit manager or navigation company and have direct primary care be the front door to these alternative benefit plans. Employers have also worked locally with their insurance company to carve out primary care from a PPO offering and put direct primary care instead. As direct primary care has grown, more and more TPAs and insurance companies see this as a way for them to provide the needed primary care and work with the Hint network as the solution.
In conclusion, direct primary care can be a great solution for your employees providing them with unlimited access to care and decreased high-cost care trips. Ultimately, direct primary care acts as the front door to the healthcare system leading to improved health outcomes for employees and decreased costs for the plan.
Be sure to listen to the episode of The Granite List Live featuring Beth Holmes.
We are proud to feature Hint on the Granite List.
