Modern Definition of Direct Primary Care

What Is Direct Primary Care (DPC)? The Revised, Modern Definition.

Direct Primary Care (DPC) practices are distinguished from other retainer-based care models, such as concierge care, by lower (monthly) retainer fees (82% cost less than $99/mo), which cover at least a portion of primary care services provided in the DPC practice; No insurance plan is involved, although patients may have separate insurance coverage for more costly medical services; Patients typically prefer to pay monthly vs. quarterly or annually; DPC patients typically come from the Generation X and Millennial population and earn a combined annual HH income of less than $100k (SEE INFOGRAPHIC below for COMPARE/CONTRAST).

DPC Journal EDITOR: ‘The defining lines are clearer now — don’t villainize your colleagues … Be Proud to call yourself, ‘Concierge’ or ‘Direct Primary Care’ — but understand what each one entails.” 

DPC is primary and preventative care, urgent care, chronic disease management and wellness support through a monthly care fee patients (or an employer) pay to cover the specific primary care preventative care services. A DPC health care provider charges a patient a set monthly fee for all primary care services provided in the office, regardless of the number of visits. Because the insurance “middle man” is removed from the equation, all the overhead associated with claims, coding, claim refiling, write-offs, billing staff, and claims-centric EMR systems disappears.

DPC medical practices bypass insurance and go for a more ‘direct’ financial relationship with patients and also provide comprehensive care and preventive services for an affordable fee. DPC is a ‘mass-market variant of concierge medicine, distinguished by its low prices.’ Simply stated, the biggest difference between ‘direct primary care’ and retainer based practices is that DPC takes a low, flat rate fee whereas concierge medicine models, (although plans may vary by practice) – usually charge an annual retainer fee and promise more ‘access’ to the doctor.

Direct primary care (DPC) is a term often linked to its companion in health care, ‘concierge medicine.’ Although the two terms are similar and belong to the same family, concierge medicine is a term that fully embraces or ‘includes’ many different health care delivery models, direct primary care being one of them.

Source: The DPC Journal, © 2015.

About the author: Dr. Dino Ramzi