Bethlehem, Pa. - For patients subject to high-deductible health insurance plans, an alternative is emerging: direct primary care.
The direct primary care model is fairly simple. A patient enters into an agreement with a primary care doctor or practice and pays a flat, monthly fee usually based on the patient's age. Essentially, the medical practice accepts patients based on membership status directly with the physician as opposed to membership status with a health insurer. Direct primary care cuts out the "middleman," which in this case, is insurance companies.
Dr. Michael Carnathan, a general practitioner in Bethlehem, Pennsylvania, believes primary care should not "eat into" a patient's deductible. For some, deductibles, the sum of money a patient must pay out-of-pocket before an insurer begins to cover the cost associated with medical care, can total thousands of dollars.
“This is kind of a new twist on old-school medicine,” he said. “So we’re really trying to get back to the way things used to be when the relationship is strictly between the patient and the doctor. There is no middleman. There’s no red tape.”
The American Academy of Family Physicians addressed this growing trend among some of its members.
“Direct primary care offers physicians a way to focus on caring for their patients without being distracted by administrative requirements such as billing and coding,” the academy said in a statement. “Getting rid of the administrative complexity reduces their overhead costs and allows them to spend as much time with each patient as necessary.”
However, membership with a direct primary care physician is not necessarily a way to circumvent the health insurance industry as a whole. Carnathan encourages patients to maintain insurance for health care needs such as specialty care, hospitalization and emergency room visits.