SSM Health recently announced its partnership with Paladina Health to open direct primary care (DPC) clinics in the St. Louis region in 4Q 2019.
Direct primary care is a direct-to-consumer relationship. Members pay a flat monthly fee, similar to a gym membership, for unlimited access to their personal physician. No insurance is taken, no coding of claims, no discounts off of billed charges. Members never pay a copay for their visit and most of the services rendered are covered under the monthly fee.
So why does this matter? In a DPC arrangement, we’re transitioning from volume to value. Many DPC practices will limit their patient panels to around 500 versus 2000-3000 in the fee-for-service arena. DPC physicians now have adequate time to holistically care for their patients and not cart them out to specialists. It’s not uncommon for visit times to routinely range from 45-60 minutes and patients can call, text, or visit with their personal doctor in person as often as needed.
Dr. Alex Lickerman of ImagineMD provides us with an anecdote about a patient that had a long history of illness and hospitalization that continued to be misdiagnosed. “The reason I was finally able to correctly diagnose B.’s abdominal pain as abdominal migraines and treat them successfully is because as a direct primary care physician, I now work in a system that affords me not just adequate time to spend with patients, not just adequate time to research and think, but also, most importantly, adequate time to breathe. I now have the emotional energy required to stick with someone as sick as B. and not become discouraged myself.”
We’ve long been proponents of value-based primary care models. St. Louis will soon have options for both employers and individuals seeking unparalleled access to personalized care.