We like to call our version of Direct Primary Care (DPC) “vintage”—and here’s why. Like other DPCs, patients pay directly for services without a third party. Unlike current DPCs, patients do not pay a monthly membership fee. They simply pay for the services provided at the time of service. This “fee for service” model is increasingly unpopular in healthcare reform in favor of “value-based” payment. However, we believe a fee for service model is the most economical for primary care.
While we do not submit claims to Medicare or commercial insurance, we still welcome patients who have these plans. Medicare (Part B) cannot be used to cover office visits. Likewise, a Medicare patient cannot submit a claim to Medicare for an office visit. This is because the doctors have “opted out” of Medicare. However, Medicare still covers services ordered by the doctors. Commercial insurers, on the other hand, may provide some reimbursement for office visits, depending on the type of plan. In the age of high-deductible plans, this model is much more affordable for insured patients than most people think! Our office manager can provide more details.
The reason for this model is thoroughly explained in Dr. Yeager’s
Transforming Healthcare Together.
