Submitted by: Mason Reiner, Founder & CEO, R-Health
No matter how you’ve been referring to it – the Affordable Care Act (ACA), healthcare reform, or Obamacare – the new changes to the healthcare system are getting you and your employees talking. Whether in the boardroom or over the dinner table, everyone in the country is wondering: “What exactly do these changes mean for me?”
If you are a small or mid-size business, there is important information you should be aware of. Direct Primary Care (DPC) is one of the best kept secrets in the ACA. It enables you to offer ACA-compliant health benefits your employees will love at a fraction of your current costs. How much money are we talking about? Well, average annual savings can be $1,500 to $2,000 per employee.
So how does this work? DPC delivers comprehensive, accessible primary care for an affordable, fixed membership fee of less than $80 per month. DPC physicians serve as a home base for primary, preventive, urgent, and chronic care as well as coordination among specialists. The model emphasizes a strong doctor-patient relationship through convenient, accessible, and affordable care, and recognizes this relationship is paramount to keeping people healthy and reducing costs.
With DPC as the foundation of your health benefit, you have the flexibility to choose amongst affordable wraparound insurance products that make the most sense for your company. The DPC physician can take care of 80 to 90% of a patient’s healthcare needs and the insurance product on the back-end protects against unexpected medical events.
Let’s use an example to illustrate the potential savings.
The premium for a traditional Silver-level PPO health insurance plan is approximately $3,490 per year for a healthy 30-year old in Philadelphia. Replace this with a combination of DPC and a wraparound insurance plan and the annual premium is approximately $1,770, a savings of $1,720 for just that one employee.
And it’s not just the sizeable reductions in annual premiums. By offering superior, convenient, proactive primary care, you will dramatically reduce expensive and unnecessary ER visits, specialist visits, and hospitalizations. As an example, a DPC provider based in Washington State found a 53% decrease in ER visits, a 58% decrease in specialist visits, and a 16% decrease in hospitalizations among their patients. This translates into substantial savings for your employees by reducing out-of-pocket payments for co-pays, deductibles, and co-insurance.
DPC is a movement that is quickly gaining popularity across the U.S. Employers and individuals in over 25 states, including Pennsylvania, are utilizing the model. The DPC model is being embraced by employers such as Expedia, Zappos, and DaVita and it may be the best kept secret in the ACA for your business as well.
