Medical Cost Sharing Is a Game-changer for Direct Primary Care

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Starting this week, DPC practices running on the Hint platform can offer their patients a low-cost way to get peace of mind for major medical expenses. Hint has partnered with medical cost sharing community Sedera Health to create DPC’s first-ever “membership add-on” aimed at helping doctors overcome the common objection, “what do I do for larger unexpected medical expenses?” Now, when a DPC patient wants affordable peace of mind for major medical needs, their doctor can invite them to join Sedera with a single click through Hint. And the best part... Sedera can save patients 30-60% on their monthly healthcare costs compared to insurance.*

Interested DPC practices can sign up to start offering Sedera at hint.com/sedera. There's no additional cost for DPC practices to offer Sedera to their patients.

* Sedera Health survey: 2016-2017

 

How Medical Cost Sharing works

The first thing to know about medical cost sharing is that it’s NOT a form of insurance. Sedera members are self-pay patients. They make fixed monthly contributions and the costs of members’ medical needs are shared across the community. It’s the sharing economy’s take on how to prevent financial disaster in the face of large, unforeseen medical expenses.

Sedera has successfully grown to serve patients in over 45 states. For some physicians, this healthcare -sharing model may sound familiar. Healthcare sharing ministriesreligious groups that typically require their members to submit certifications of their faith—have been using this model for over 30 years. But sometimes patients are turned off by the religious requirements. Sedera is not a healthcare sharing ministry and does not ask members to disclose their personal religious beliefs.

 

Different than insurance

“Bronze” health insurance plans typically have a high annual deductible, after which they only cover a percentage of the patient’s costs. When patients can’t afford to pay that high deductible on top of their monthly premium, they become functionally uninsured. Additionally, limited coverage leaves many patients surprised by exorbitantly high out-of-pocket costs since they’re still required to foot the bill for both copays and coinsurance amounts. Considering this lack of price transparency, it’s no wonder why the number of uninsured Americans is skyrocketing.

Sedera works differently. Instead of an annual deductible, Sedera members pay an Initial Unshareable Amount (IUA) for each medical need. After that IUA is paid, the Sedera community kicks in to share the rest according to the principles outlined in their Membership Guidelines. For instance, if a patient with a $500 IUA breaks their leg, they will be responsible for $500 of the broken leg-related costs, and the community will share all other costs related to that same injury. For patients, this means clear costs and no confusing nuances like “Have I hit my deductible?” and “Is this x-ray facility in-network or not?” Even better, members are responsible for paying a maximum of 3 IUAs in a 12-month period. After three medical needs in a year, they are no longer responsible for paying the IUA.

For most patients, Sedera ends up being much less expensive than insurance. On average, monthly premiums for insurance bronze plans reached $440 in 2018 with annual deductibles soaring past $5,000. In stark contrast, a 45-year-old Sedera member will contribute $215 per month for a plan with an IUA of $500, typically saving thousands of dollars every year compared to even the most basic insurance alternatives.

“After years of dealing with insurance companies, we finally have someone on our side who is looking out for our best interests.”

David & Sharon Robinson
Sedera Health Members

 

Complementing the doctor-patient relationship

Direct Primary Care physicians care about their patients’ financial well-being in addition to their physical health. The new Sedera membership add-on respects that a patient’s relationship with their DPC doctor is at the heart of their entire healthcare experience. That's why patients sign up for Sedera through their DPC doctor. (Hint makes this incredibly easy.) We believe that giving DPC doctors more ways to show value to their patients will help their practices and the DPC movement continue to grow.

 

Eliminating the "double-pay" problem

A common patient objection to joining a DPC practice is that they don't want to pay twice for the same service. The expensive insurance they pay for already covers primary care, and they need to keep that insurance in case they need major medical care. That's hard to argue with and sometimes a tough objection for patients to get past despite all the value that DPC doctors provide.

Now however, by having Sedera as an option for patients to consider, DPC docs have another way to overcome the "double-pay" objection. Unlike insurance, Sedera provides complementary (not duplicative) value to DPC patients.

 

We're just getting started

Sedera is only the beginning. Our team at Hint is working to make more membership add-ons available so that you can give your patients more ways to create whole-health solutions that work best for their individual needs.

If this sounds good to you, check out hint.com/sedera, and sign up to start offering Sedera as an option to your patients. Once you sign up, we'll provide you with all the free training and patient marketing materials that you'll need to get started. Hint customers can add Sedera to their account at no additional cost.

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