Direct Primary Care(DPC) involves cutting out the middle man–insurance companies. As health insurance becomes increasingly confusing, expensive, and frustrating, Direct Primary Care removes it from the equation.
At Direct Medical Care, you have the option of obtaining a membership, which includes the cost of provider visits along with other perks. However, a membership is not required, and you can pay for waht you need as you go.
With this type of healthcare in place you should expect:
To spend more time with your healthcare provider as they are spending less time filling and billing for insurance
Affordable wholesale medications, labs, imaging, and procedures
Accessibility and convenience such as same day appointments, virtual visits, and so much more
Flexibility! You still have the option to submit to insurance. We will provide you the necessary information at the end of your visit to do so.
My traditional high deductible healthcare insurance plan I carried in 2016 was increasing from $820.00per month to $2100.00 per month with an even higher deductible.
I was looking at an annual premium cost of $25,200.00
When we made the transition to the cost sharing program with Liberty HealthShare in 2017 it made sense as long as we were healthy. The cost savings were profound. We opted for their top coverage: Liberty Complete
With the Liberty HealthShare option we chose we have an annual registration fee of $75.00 and pay $449.00/month for our family of four.
I was now looking at an annual “premium” of $5,463.00
Now we had a few medical bills in 2017:
an MRI for my husband’s shoulder $240.00
a screening mammogram for me $200.00
remember I am a family practitioner so some minor coughs/colds etc. would be handled by me that we will account for $500.00
Our general out-of-pocket expenses for the year were around $940.00. Let’s round that number up for a few other incidentals and we are at $1000.00 for the year.
So our first year savings came out to almost $19,000.00
So year two brings on a different twist as we have a medical need arise. Craig’s MRI and poor response to conservative therapy leads to major surgery. We researched our options and chose the Surgery Center of Oklahoma.
Our annual “premium” is still $5,463.00
Craig’s Surgery and Rehabilitation Costs:
Surgical Consultation: $200.00
Surgery Center of Oklahoma: $5,749.00*
Continuous Passive Motion(CPM) Chair: $775.00
Physical Therapy: $540.00
*includes surgeon fee, facility fee, and anesthesia fee
Liberty HealthShare Shared Amounts(reimbursements):
Surgical Consultation: $200
Surgery Center of Oklahoma: $4,249.00
CPM Chair: $0
Physical Therapy: $0
Our final unshared(out-of-pocket) amount we were responsible for was only $2,815.00
So in two years after leaving traditional health insurance we will have saved about $35,000 with a major event occurring
If I still haven’t convinced you…
Now let’s go back to the traditional insurance world…the national average projected cost for arthroscopic shoulder surgery with one of the major insurance carriers in the United States is:
Facility and Anesthesia Fee: $16,150.00*
Surgeon fee: $8,985.00
*based on outpatient surgery, national average for inpatient surgery increases that fee by $11,000
My husband Craig had been complaining about his right shoulder hurting the summer of 2017. To be the spouse of a doctor can be challenging because getting my attention medically can be tough at home.
We had tried conservative care with ice and ibuprofen for months. We tried cold laser therapy. We even tried steroid injections with minimal relief. He had significantly modified his activities due to the pain.
The final straw: he could no longer play catch with his daughters.
In January 2018 Craig was set-up for a surgical consult late Thursday afternoon with anticipated surgery the following Friday morning in Oklahoma City. We braved the typical January weather from KC to OKC.
After reviewing Craig’s case, the anesthesiologists/owners of the Surgery Center of Oklahoma hand-picked Dr. Couppens as the surgeon. This former US Olympic team doctor met with Craig and modified the surgical plans with him given the magnitude of adhesive capsulitis(aka frozen shoulder) that had developed.
The next morning we arrived bright and early for surgery. While Craig was being attended to I got to enjoy the company of Dr. Keith Smith and Dr. Steven Lantier the masterminds behind the Surgery Center of Oklahoma and the pioneers in the movement for price transparency.
The surgery was deemed a success and we drove home later that day. The road to recovery included lots of rehabilitation over the next several months and we are now happy to report Craig is once again playing catch with his daughters.
I resisted giving up my traditional health insurance because of the beauty of the triple tax savings with the Health Savings Account(HSA) that I married to my high deductible plan. I saw such value in that piece that I lost out on the bigger picture–saving money without sacrificing care.
I paid for my daughter’s surgery out of pocket in 2016 when the cost for the negotiated insurance pricing was higher than actually just paying cash.
As family practitioners we are expected to know a wide range of topics and health conditions. And while we pride ourselves on knowing as much as we can about all things medical, it is impossible for us to know all the intricacies of specialty medicine. We realize that a physician or colleague that focuses on one area of medicine has insight in that area that we might not have.
A Team of Specialists
Never fear at Direct Medical Care we have a team of hundreds of specialists available to us for consultation.
Over the past year we have been utilizing an online service called Rubicon MD. It is an online eConsult platform that gives us access to hundreds of specialists and subspecialists in medicine. What often takes three to six months to get consultation we can get in less than 24 hours. Not to mention the cost to see that specialist after that long wait is estimated to exceed $200.
Quality Care that is Timely
Last night I was reminded what an incredible offering it really is for our patients:
I had an interesting case that had me puzzled and decided to ask the specialist via Rubicon MD for some input and guidance. I put together the clinical history and data at 6PM and had a response by 9PM. The patient’s case was reviewed and reassurance that we were managing things correctly with added precautions on what to do moving forward.
Better care for patients that is affordable and timely is another added bonus at Direct Medical Care.