Direct Primary Care Acts as Subscription Supplement to Enrich Patient and Doctor Experience

Subscriptions offer affordable ways to access valuable experiences on an ongoing basis that benefit customer and provider, so why not add healthcare to that mix?

It already is, although web searches for “subscription healthcare” are confusing. The term for subscription health plans is “direct primary care” (DCP), into which insurance does not figure.

In this practice model, which resembles concierge healthcare in certain respects, members pay a monthly fee to a see clinicians and physicians. Those fees vary widely. Concierge medicine category mainstay One Medical charges $199 per year, while DCP firm Hint Health reports its clients have a median membership fee of $80 per month for individuals and $165 a month for a family of four.

Some providers in this sector are specialized, like Simple Health, which provides reproductive health on a subscription basis, offering a slate of services for a flat $15 annual fee.

Members still need health insurance — often a high deductible health plan (HDHP) — should the doctor find something needing surgical or other major intervention. This may explain why the concept hasn’t exactly caught fire.

However, proponents say DCP’s biggest impact on healthcare is weaning physicians off health insurance reimbursements, creating a better level of doctor-patient engagement.

In a blog entitled “Is Subscription-Based Digital Health on the Horizon?,” the American Hospital Association (AHA) said, “Companies that drive the post-pandemic economy will be looking beyond transactional, episodic relationships with consumers and may instead focus on subscription-based programs,” freeing doctors from rigid insurance rules and incentives.

While some look askance at an option that seems like paying just to cut the waiting room line and spend 10 extra minutes with a doctor than at a traditional practice, others see a better experience for patients and practitioners wanting a new way of accessing and delivering care.

As Erin Sullivan, PhD, research and curriculum director at the Center for Primary Care at Harvard Medical School told WebMD, “When you look at direct primary care and other models that are cropping up, it points to our broken system that doctors don’t want to practice in and are looking for alternate solutions — and so are patients.”

See also: Payments Is the Prescription for Healthier Patient, Provider Cash Flow

New Blood for an Established Concept

While direct primary care subscriptions plans have been around for about 10 years, new venture capital is flowing to startups trying to revitalize a concept that’s finding its niche, increasingly among employers offering DPC in place of company-provided health plans.

Hint Connect announced Tuesday (April 12) new hires meant to enhance and expand its offering, appointing David Cameron as chief medical officer to provide clinical oversight as the network expands nationally, and Beth Holmes as head of network development.

In a press release, Hint Health CEO and Co-Founder Zak Holdsworth said: “Hint Health launched this first-of-its-kind network product to foster deeper relationships between key stakeholders in the DPC ecosystem and solve critical industry challenges in order to make primary care more affordable and accessible to all.”

Less than a week earlier, U.K.-based DPC startup Lime Global announced Thursday (April 7) the launch of Lime OnCall, described in a press release as “a modular healthcare subscription service for employers, designed to be used by the entire workforce.”

DPC solutions are gaining interest partly due to traditional healthcare inefficiencies made worse by the pandemic, from scheduling to wait times, and as employers seek more affordable ways to offer healthcare coverage when costly private medical insurance isn’t an option — or for those just seeking better bedside manner.

Read also: Cost Transparency Is Patient Payments Starting Point

Up and Downs of Subscription Health

In a blog post, prescription discount platform GoodRx cited the pros and cons of DPC, saying, “The monthly fee covers all — or most — typical primary care services. This includes preventative care and laboratory tests like blood tests or urinalysis, care coordination (medication check-ups), comprehensive care (visits for strep throat or the flu), and consultations,” adding that specialists, urgent care, hospital and prescriptions are not covered.

Even so, supporters are keen on cost savings associated with DPC that occur when something that could have become an expensive health problem is diagnosed and treated early.

Category leader Premise Health announced March 30 that its Connected Care+ solution “has achieved 25% average risk-adjusted cost savings for Premise clients” since launch in 2019.

“Average per member per month costs for members attributed to the Premise wellness centers with Connected Care+ were $102 lower than those for members attributed to community providers” in 2021, a Premise Health press release stated. “Lower costs resulted mainly from increased engagement with primary care teams, which closed care gaps and led to significant reductions in emergency room visits and inpatient admissions.”

See also: Healthcare Organizations Turn to Gig Apps for Hiring, Payroll Help Amid Nursing Shortage

DPC is known to reduce wait times for patients and allow physicians to spend more time with them, while traditional models are volume-based, limiting doctor-patient face time.

For practitioners, a subscription model removes laborious insurance-related form work while guaranteeing a monthly recurring revenue flow. Healthcare workers suffering burnout are increasingly drawn to DPC for its emphasis on personal care over insurance protocols.

Payment service provider (PSP) Payment Cloud blogged that for DPC, “Instead of seeing thousands of patients during very short consultations, doctors can spend more time and offer quality service. Doctors working with subscription models see about 1/5 the number of patients a traditional doctor would see annually.”

DPC isn’t for everyone — like those satisfied with healthcare as they’ve always known it — and as Amazon and Walmart jump in with new health offerings, DPC fills a market niche.