How Direct Primary Care and Self-Funding Fit Together

Yesterday we looked at why self-funded employers have a more direct interest in the actual cost of care.

Now let’s connect that with Direct Primary Care.

DPC fits naturally with a self-funded plan because it strengthens the part of the system that should help people make good decisions early.

The DPC practice becomes the practical, relationship-based front door.

Employees and family members can ask questions sooner. They can come in without worrying that every primary care visit will create another out-of-pocket bill. They can get help deciding what the next step should be.

That matters because the most expensive place to make health care decisions is often at the point of crisis.

If people don’t know where to go, they tend to go where the lights are on and the doors are open. That may be urgent care. It may be the emergency room. It may be a hospital-affiliated setting where every next step is expensive.

Sometimes that level of care is exactly what’s needed.

Often it isn’t.

A strong primary care relationship helps sort that out.

Consider an employee with high blood pressure. In a high-deductible plan, follow-up visits or lab work may feel like another bill to avoid. In a DPC model, it’s easier to check in, monitor progress, adjust medication, review labs and answer questions before they become bigger problems.

No one can guarantee outcomes. Your mileage may vary.

But better access creates better opportunities.

Employers benefit in another way too: DPC gives employees a benefit they can actually use. Primary care with $0 out of pocket feels very different from having an insurance card paired with a deductible so high that people hesitate to get care.

And importantly, the employer’s job still isn’t to practice medicine. The employer designs the plan. The practitioner cares for the patient.

DPC can improve access without putting the employer in the exam room.Tomorrow, we’ll wrap up the series by looking at the limits of the model, and why those limits don’t diminish the value of getting the everyday things right.

HELPcare Clinic is the only Direct Primary Care clinic in Southeastern Minnesota, with locations in Austin, Rochesterand Albert Lea. Check out our membership options for individuals and for employers.

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Lee Aase

Lee Aase is the founder of HELPcare LLC, which provides comprehensive membership, marketing and management services for provider-owned HELPcare Clinics, as well as metabolic health education and coaching for people interested in restoring health and reversing disease through lifestyle changes. Lee and his wife Lisa live in Austin, MN and have six married children and 20 grandchildren.