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Information on Direct Primary Care and Reflections on Medical Practice

Insurance premiums got you down?  Let’s do some Direct Primary Care math.

10/26/2017

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When I considered getting out of corporate medicine, seeing one patient every 15 minutes day in and day out, I was excited by the possibilities I saw in Direct Primary Care. But I’m not the type to recommend a big change that I haven’t tried myself, so I changed my employer based insurance for myself and my family from a low deductible plan to a high deductible plan combined with a Direct Primary Care Membership. I was amazed that by switching, not only did we have a better health care experience, we saved $183 a pay period, or $366 a month by making the simple move from a low deductible to a high deductible plan.

This year, I decided to price out on the health exchange how the math might work out for a family in 2018 converting from a low deductible plan to a high deductible with Direct Primary Care.

Certainly, some people choose Direct Primary Care because they want a stable provider who is going to be their doctor no matter what. Others choose it because of the customer service: they value getting an appointment when they need one and talking directly to their doctor when they are concerned about something. For many, however, the deciding factor is financial. 

Let’s Do some Driect Primary Care Math

I performed a search on the Colorado exchange, Connect for Health Colorado (http://connectforhealthco.com/). Using a family of four as my example, I searched for plans in Denver for “low need” patients, without a subsidy.  Here’s what I found:
  • The cost of a low-deductible insurance plan $1,798.54 per month 
    (Details: $0 individual and $0 group deductibles and a $6,900 out of pocket maximum for each individual covered was Anthem Gold Pathway X HMO, family of four).
  • The cost of the high deductible insurance plan $825.18 per month 
    (Details: $7,150 individual and $14,300 group deductibles and $7,150 out of pocket maximum per individual, Bright Health EPO/Bronze, family of four).
  • Cost of Direct Osteopathic Primary Care monthly membership for a family of four $210 
    (Details: no fine print needed, month to month payment, no commitment)

So the total savings by switching to Direct Osteopathic Primary Care with High Deductible Plan is $763.36 per month!  That is a 42% savings!
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If that family put all of that saved premium into a savings account, they’d have an extra $9,160.32 per year to cover emergencies and costs subject to their deductibles.

Regular office visits, wellness visit, most urgent care issues and day to day care would be covered through Direct Osteopathic Primary Care. Health insurance is then left to act like car insurance, to cover you when you an emergency hits. For daily savings, at Direct Osteopathic we use our discounted lab services and our in house pharmacy which can beat the big box pharmacies on generic medications. For example, our basic wellness lab panel is $29 and we get Flonase for $8.

For families looking for even more savings, Direct Primary Care can be combined with a cost-sharing insurance plan as an alternative to traditional health insurance. One of them, Liberty Health, actually reimburses for a portion of the monthly membership fees (https://www.libertyhealthshare.org/).


Now that Open Enrollment has come around again, think about how you might save if you think outside the box about healthcare this year. Even if you are lucky enough to have insurance through your employer look closely, you too might save by switching to a high-deductible plan plus Direct Primary Care.

At Direct Osteopathic Primary Care we want to keep your out-of-pocket costs low. We are built on core values of cost effectiveness and cost transparency. It's the way Direct Primary Care was started. Personally, I can never turn back.

​
Dr Brie
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