TL;DR: Not much
Earlier this year, the Biden-Harris Administration announced a new initiative as part of ongoing efforts to strengthen the primary care system, reduce costs, and improve equitable access to healthcare across the country. This initiative, the ACO Primary Care Flex Model1 (ACO PC Flex Model), aims to boost investments in primary Care, and is designed to help primary care providers offer better, more personalized care to underserved Medicare populations.
When we hear better access to quality, affordable care, we get excited, so we dug in a bit to see if this would have any effect on Direct Primary Care (spoiler alert: there’s not much connection. But, the initiative does affect primary healthcare, so it’s nice to have some general knowledge).
By providing financial support to primary care providers up front, the ACO PC Flex Model provides resources and flexibility to primary care providers, enabling them to deliver high-quality, team-based, and personalized care.
The ACO PC Flex Model aims to benefit patients with Medicare, especially those who reside in underserved communities, as they should receive improved access to care, including home visits, virtual care, and better management of chronic diseases. It also encourages preventive care to keep people healthier. As a result, the initiative also could enhance the quality of care, promote competition among healthcare providers, and address health disparities
While the ACO PC Flex Model emphasizes the importance of primary care and personalized care, that's about where the parallels with Direct Primary Care (DPC) start to curve. This new model is funded through Medicare, providing payment directly from the government, while DPCs are funded by patients through memberships, bypassing traditional insurance or government funding and regulations. Second, the patient population is extremely limited with this model, focusing on underserved populations within the Medicare program. DPCs serve a broad patient base, including those with private insurance, uninsured patients, and sometimes those with Medicare, but with no limits. And finally, care coordination through the ACO PC Flex Model occurs within a network of providers, holding ACOs accountable for patient outcomes and cost savings. DPCs, as we know, provide comprehensive care directly to patients.
Ultimately, for those still wondering what the ACO Primary Care Flex Model Means for DPC, the answer is there’s likely not much impact at all. It’s a government-backed initiative targeting Medicare beneficiaries and operating within the Medicare system. Direct Primary Care, on the other hand, continues to be run by independent physicians, patient-funded, and climbing its way to mainstream healthcare.
1. https://www.hhs.gov/about/news/2024/03/19/biden-harris-administration-announces-new-initiative-to-increase-investments-in-person-centered-primary-care.html