Direct primary care was designed to help American citizens save money on healthcare costs, and so far it has done just that. A broad definition of direct primary care includes several key attributes, such as doctors seeing fewer patients and patients having direct access to a doctor in person, by phone or email. In order to access these benefits, patients are charged an annual or monthly fee. Proven benefits that patients have reported consist of a better relationship with their doctor, access to more preventative medicine, as well as more and helpful advice on wellness and nutrition. The advantages that doctors have experienced from direct primary care include stability of income, improved hours of work, and an opportunity to simply be a physician.
While the price of entering a direct primary care contract can vary from as little a $1000 per year for each patient under direct primary care, there seems to be no upper end to what a doctor can charge to provide his services to individuals or to families.
In most cases, doctors will complete a process whereby their patient base is asked to join a direct primary care arrangement. In some practices, patients’ options are to either continue on with their current doctor under the new program, which allows them access day and night, or to find a new doctor. Patients may also benefit from getting better access to their doctor, being appointments the same or next day. Longer appointments allowing more advice to be offered in preventative measure supporting well-being, such as a nutritional diet being encouraged. Additionally, your doctor may decide to retain those patients who do not wish to convert to the new format.
Under direct primary care, patients are asked pay a combination of visit fees or fixed monthly fees (or a combination of both), which grant them access to a certain prearranged set of medical services.
These services typically include same and next-day appointments; these could be in the form of house calls or office visits. Access to a high deductible health plan (HDHP), a health savings account (HSA), and direct primary care also takes away the normal hassle of dealing with insurance companies, since direct primary care practices do not normally accept insurance payment.
Because physicians under a direct primary care plan are better compensated than they normally would be under an insurance billing scheme, they can afford to spend more time with their patient, which is something that may help to better assess the root problems and thus give better advice than they can under a traditional system.
The moral argument for direct primary care is that all patients are potentially equal and should not be discriminated against based on how much coverage their health insurance. This way, the problem of a doctor being obliged to spend time with one patient who has a non-life threatening problem, than with another who is more seriously ill, is avoided.
One of the main drawbacks of direct primary care is that it only goes so far in the treatment of patients and needs to be backed up and supported by other insurance plans. Additionally, it does not cover the many conditions that are too complex to be treated at the physician’s office.
Quick question: There seems to be some ambiguity regarding whether or not HSA’s and HRA’s are permitted under IRS regulations in conjunction with DPC. From the evidence I’ve seen, such an arrangement constitutes a violating form of “health coverage”. Even if DPC payments are not made out of an HSA or HRA, it seems that one cannot enjoy the tax benefits if one has a DPC contract.
Can you comment on this dilemma? Many DPC clinics suggest that HSA’s and HRA’s can be used as tax shelters and even as a payment source for DPC contracts. It’s a little confusing.
Is this a situation where the IRS finds itself simply unable to enforce tax regulations? After all, if I have a private contract…does the IRS ever need to know about it (assuming I’m a private citizen and not a business with obligations to publish all expenses)?