Benefits Think

Stop overpaying for healthcare that doesn't work

Doctor holding the hand of patient
Adobe Stock

I became a doctor because I wanted to make sure no other family experienced the devastating loss that mine did. I lost my sister and mother way too young because insurance-driven healthcare prioritizes crisis care over prevention and fails millions of Americans every year. I was complicit in that failure, until I reached my breaking point. 

It was a typical Saturday shift, and I walked in to find a waiting room full of frustrated patients. They had been there for hours, and I knew I would never catch up. I was already drowning in billing codes and documentation. I did not have time to sit, listen or build trust with my patients. I realized that if I stayed, I was condoning a system I no longer believed in. I couldn't do it anymore. So, I gave my 90-day notice. 

From there, I started building the kind of medical practice I would want for my own family. It has brought me tremendous joy and fulfillment and has renewed my love for medicine. My patients are amazed when I text them back directly. They are grateful for same or next-day appointments. More than anything, they are so thankful to finally have healthcare that feels personal, accessible and built around them — not insurance codes.

Read more:  This AI-powered platform wants to overhaul your performance review process

My direct primary care (DPC) practice works with individuals, families and employers with the mission of restoring access, trust and excellence in healthcare centered in prevention, powered by relationships and grounded in science. I want benefit brokers and advisers to know that DPC is a strategic advantage for their employer clients. 

Healthcare costs are rising every year. Premiums are going up double digits. Patients are saddled with higher and higher annual deductibles — and access is getting worse.  Every year, brokers are tasked with finding creative solutions and an insurance plan that keeps costs down while still providing excellent care. This usually means switching carriers, which is what I hear from patients who gripe that "they no longer take my insurance so I have to find a new doctor!"

Midsize companies are especially stuck. They have to provide healthcare coverage but aren't large enough to have negotiating power, so they are left feeling the full financial weight of rising premiums. Additionally, their employees are avoiding care. They can't afford the deductible and eventually end up in urgent care or the emergency room. 

Read more:  New survey reveals the best employee benefits to beat stress

This is where DPC comes in.

DPC offers comprehensive, relationship-based primary care for a flat monthly fee that's typically $70 to $90 per employee. That comes with a host of advantages that not only save substantial costs for health plan sponsors and members alike but also improve the employee experience and clinical outcomes. They include: 

  • The aforementioned same or next-day appointments
  • Direct communication via text, video or phone
  • Zero copays or surprise bills
  • Labs and medications at wholesale cost — often 80% less than insurance rates
  • Fewer urgent care and emergency room visits
  • More time with patients, which means earlier intervention and better outcomes

This works because it removes the insurance middleman from primary care. 
For brokers and advisers, DPC creates an immediate value-add. Thanks to Section 71308 of the One Big Beautiful Bill, DPC memberships are now compatible with health savings accounts and can be paired with a high-deductible health plan (HDHP), level-funded plan or individual coverage health reimbursement arrangements (ICHRAs). 

It is no surprise that when employees are healthy, they miss less work and are more productive. Convenient and reliable access to patient-centered and preventative primary care is the way we keep people healthy. Chronic conditions are managed, and in some cases reversed, rather than ignored. 

I've had patients say they appreciate that their health is valued by a doctor who is approachable and loving toward them — that it's refreshing not to be treated like a number as part of a model that recognizes their humanity. 

Read more:  Protecting retirement for the sandwich generation

Imagine what that kind of care does for retention and morale in the employee populations you serve. Having a doctor who texts back, sees them the same or next day and doesn't require them to take half a day off work. This is what healthcare should look like!

Rather than moving to another insurance carrier to reduce costs by a few percentage points, work with your employer clients to design a new plan that is centered around DPC. It will also allow you to differentiate yourself and truly help your clients save money and provide greater access and higher-quality healthcare.

Now more than ever is the time to wrap DPC with an HDHP, level-funded plan or ICHRA. Your clients will save money, their employees will get exceptional care, and you'll be the one who made it happen. 

Healthcare doesn't have to be complicated. It doesn't have to be wasteful and it doesn't have to make people feel like they're fighting to be seen. Let's restore access, trust and excellence in healthcare.

For reprint and licensing requests for this article, click here.
Healthcare Employee benefits
MORE FROM EMPLOYEE BENEFIT NEWS