Beth Holmes, Head of Network Development at Hint Health sits down with Justin Steinman, Host of Definitively Speaking to break down the shortcomings of the health insurance reimbursement model in healthcare and the benefits of shifting towards the Direct Primary Care (DPC) model.
The problem with fee-for-service is that healthcare providers have to see a large number of patients and as a result have limited time to engage with their patients. This focus on volume sabotages the establishment of a strong doctor and patient relationship.
Justin Steinman remarks on how doctors operating in fee-for-service may proceed with treatments and labs that may not be necessary because they are incentivized to do so whereas, with value-based care, doctors are paid a set fee instead of by procedure. This model of care reminded Justin of concierge care so he then asks Beth, “do you make a distinction between DPC and concierge care?”
Concierge care and Direct Primary Care have very important differences in terms of payment model and cost, as Beth goes on to explain:
"Concierge care is typically a fee on top of fee-for-service payments so that your doctors are able to deliver a more high-end experience or take on fewer patients, but they're still billing your insurance. Direct Primary Care averages a monthly price of $70-$75, which is a lot more affordable than something that might be a couple hundred or a couple thousand [per month] in the concierge model."
Direct Primary Care usually offers a monthly price on a per member, per month basis, however, there are often discounts and bundles for families. While there is tremendous value in DPC, people are not accustomed to spending more on primary care. This “defunding” of primary care essentially means that more dollars get funneled into specialty care and hospitalization since people are not seeing and/or getting value from their primary care doctors to avoid complications down the line. In comparison to other OECD countries, the U.S. spends far less on primary care but more on health care overall while getting deficient health care outcomes.
DPC started out as a retail movement but now employers are beginning to offer this benefit. In fact, 51% of members on the HintOS platform are employer-sponsored.
“We also have a network of Direct Primary Care practices [Hint Connect], that large employers can work with so that they can have that health insurance network experience, rather than having to work directly with many different Direct Primary Care practices in their communities,” Beth explains.
Hint Connect was launched to help employers navigate incorporating DPC as part of their benefits package. Because DPC is a standalone benefit that works outside of traditional insurance, many employers are not sure how to make it fit within their offerings. Therefore, many employers that do offer DPC tend to be smaller since they are often more nimble and can make changes more easily than larger employers.
Listen to the entire podcast episode to get more insight on how Hint Health is transforming healthcare by accelerating the adoption of DPC by leveraging its technology, HintOS, and its DPC network, Hint Connect.