In the United States, direct primary care (DPC) is primary care offered directly to the consumer, without insurance intervention. It is an umbrella term, incorporating various health care delivery systems that involve direct financial relationships between patients and health care providers.
One niche variant of direct primary care is concierge medicine.
Direct primary care is intended to remove many of the financial barriers of healthcare. Often, there are no insurance co-pays, deductibles or co-insurance fees thus avoiding the overhead and complexity of maintaining relationships with insurers.
Under this model, patients may pay a combination of visit fees and/or fixed monthly fees which grant them access to a set of medical services, including same and next-day appointments, both in the form of house-calls and office visits.
Typically a direct primary care arrangement is paired with either:
- A high-deductible health plan, as DPC alone will not cover catastrophic health care such as most surgeries
- A health savings account, or health reimbursement account as the associated tax-benefits can generally be applied to DPC and other medical expenses.
Direct primary care practices do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers, which can take as much as $0.40 of each medical dollar spent.
Because direct primary care payments are typically paid over time, rather than in return for specific services, the economic incentives are such that the long-term health of the patient is the most lucrative situation for the doctor. As such, preventative care gains greater emphasis under DPC.
Because the primary care physician is better compensated than they would be under insurance billing, they can afford to spend more time with the patient, rather than simply referring them to a highly-paid specialist after a short consultation.