Direct primary care is a concept that is swiftly gaining ground in the mainstream healthcare industry. Patients who are mainly homebound, often grapple with complicated medical issues which are costly as well.
They also have issues visiting the offices of doctors, clinics, and hospitals. Some also tend to be more comfortable and happier when they are at home.
This may lead to a direct primary care wave that engulfs the healthcare sector in the near future.
Reports by McKinsey indicate estimates of close to $265 billion in care services (covering up to 25% of healthcare costs) for Medicare Advantage and Medicare-fee-for-service beneficiaries switching to home-based patient care models by 2025.
There will be a team-centric primary care framework that will also encompass non-conventional service providers as per experts.
Direct primary care is a model of alternative and affordable care which does away with the third-party billing and fee-for-service payment system.
Patients can get quality care at home while paying providers a flat monthly or annual charge for routine services including lab testing, quarterly examinations, telemedicine or telehealth, and home-based visits as well.
At the same time, while this system enhances patient access, it will also have ramifications for the health insurance system as well.
Many believe that there could be a more rational and universal framework for getting direct primary care into the health insurance package of benefits for consumers.
Here are some other points worth noting in this regard:
There will be a digital framework necessary for the success of the system and for driving the service provider network with proper tools and other infrastructure.
Community-based entities will have to be integrated into the care network and providers should be able to leverage technologies for data capturing, onboarding, exchange, and digitization as well.
They should support several use cases including quality reporting and SDOH as well. Suitable cloud-based digital platforms can boost the multiple relationships and procedures required to coordinate patient care.
Through analytics and information-sharing, along with the inclusion of both non-medical and medical services, providers may tap a sizable care network and community for patients.
Direct primary care is an alternative system of healthcare that eliminates the fee-for-service payment system and third-party billing. It involves direct patient care with lower costs, easier accessibility, and better engagement and outcomes.
Technology is the driving force behind primary care, enabling the digital infrastructure for at-home primary care services, onboarding, data sharing, analytics, SDOH, exchange, and more.
At the same time, it will help providers take care of the multiple care procedures and coordination mechanisms more effectively.
Direct primary care has several benefits including better patient outcomes, lower physician fatigue, more time spent with patients, lower medical costs overall, greater transparency in billing, zero reimbursement or administrative hassles for providers, more convenience, and a lot more.
Direct primary care impacts healthcare costs greatly. They come down sizably since telemedicine and other remote solutions do away with the need for hospital visits.
At the same time, administrative and infrastructural load reduces greatly, which ultimately lowers costs. Third-party billing and fee-for-service systems are not required, with more transparency and annual/monthly fees for flat charges.
