Your questions, answered.

What is Direct Primary Care (DPC)?

Direct Primary Care, or DPC, is a model of healthcare that puts patients first by getting rid of the red tape by which most other traditional practices are restricted.

How is this different than utilizing my primary care doctor?

Reducing the number of patients we accept results in significantly more time spent with  patients (the average primary care doctor sees upwards of 2500 patients, averaging only 8 minutes of face time per visit).  Hence, we can understand patients better and manage more complex problems.

There is no bad time.  24×7 phone/email/text access, and appointments within 24 hours. Easy access is a powerful tool to surface health problems early and head-off ER visits, many of which occur only because the primary care provider is not available.

Because we are paid for care, not for procedures, we can use phone consults, email, video, and other technology much more extensively. This gives us more of a connection with patients and faster response when we’re needed. Today, many providers resist phone and email consults with patients partly because insurance reimbursement for these encounters is much less than for an office visit.  We do not spend time jumping through hoops with insurance companies.   We focus on treating patients. With less time spent on administrative duties, we can provide care that’s more personal and convenient than in other practices.

Does Redefine HealthCare accept health insurance?

No. Happily, no. Perhaps the most critical distinction in our model of care centers on a direct, personal relationship between you and your provider. That directness carries over to our business model as well. While the tender mercies of an insurance company might apply to the fixing of a damaged fender on your automobile, we see no reason for any insurer to have a voice about either the quality or the cost of your family’s care.

We forgo insurance payments in order to save our patients from the arbitrary, intrusive decisions that inevitably follow with third-party payors. Furthermore, this direct fee-for-services arrangement frees us from the typical contractual agreements that prevent physicians from offering wholesale prices on laboratory tests, imaging, and medications.

Do I still need insurance?

We encourage patients to maintain a high deductible wrap around plan in case of emergencies such as hospitalizations or surgeries, or other life-threatening situations. However, for routine cases like physicals, labs, medicines or most other minor emergency situations, the Direct Care subscription fee covers nearly everything and can be handled in-house the majority of the time.

Why does Redefine Healthcare choose to forgo insurance?

Before 1940, health insurance the way we know it today did not exist – people paid for their health care like they did anything else. Health insurance was formed as an incentive to get soldiers back into the workforce after WWII ended.  Its sole purpose was to provide coverage for costly events like major accidents, surgery and long term chronic issues.  Health insurance was never intended to pay for basic medical care.  In the present day, health insurance is used for everything medical, which is part of the reason why it is so costly.

We understand health insurance is a critical element in the health care of Americans  for catastrophic, unpredictable events and it is something we all must have now, and our service is not a replacement for health insurance.  It does, however, create significant and costly problems when it is used as a payment system for primary care services.

When health insurance claims are filed routinely, health insurance premiums rise as we have steadily and sharply seen for the last 15 years. The only logical way to decrease or control insurance premiums is to reduce the frequency of claim filing. In order to do this, some portion of health care needs to be affordable enough to render health insurance unnecessary.  Thankfully, “not all healthcare is expensive”.  When you remove the driver of expense (health insurance) the real cost of a test or medication is revealed and is very often easily afforded.

Unfortunately, having health insurance does not mean having access to quality, affordable healthcare.  In fact, health insurance is often the very thing that makes getting what you really need take the longest (and most costly).

Redefine HealthCare prides itself on bringing back the “old fashion” way of doing things…we build trusting, long lasting relationships with patients while providing personalized, timely, quality care.

What is the difference between Direct Primary Care and Concierge Medicine?

The main reason for all the confusion surrounding DPC and concierge medicine is that the concept of operating a medical practice that does not bill services through an insurance company is still new.  With these two models emerging in the healthcare marketplace, there is a lot of misinformation floating around.

Here are some of the basic differences:

  • Concierge practices often charge higher fees – in the ballpark of $183 per month.
  • The traditional form of concierge medicine involves the patient paying a monthly or annual fee in exchange for direct access to a physician. While the practice profits from these membership fees, they also bill insurance companies for visits. However, under the DPC model, many providers do not accept insurance whatsoever, and solely rely on the monthly/annual fee they receive from their patients.

Under both models of care, physicians benefit from being able to keep their patient numbers small and can spend more quality time treating patients – generally 35 – 45 minutes, compared with eight minutes in the current model.

Another key distinction between the two is that direct primary care is explicitly mentioned in the Affordable Care Act as an acceptable option for receiving medical care without insurance, while concierge medicine is not.

What if I need to be admitted to the hospital or see a specialist?

In providing superb care with unprecedented sorts of access, we seek to prevent or reduce hospitalizations and specialty referrals. In instances where those types of care are required, we will certainly continue to work with your hospitalist during your hospital stay as well as work closely with any specialist. In some cases, depending on the level of care and the sorts of expertise required, we may rely on those specialized caregivers to manage your treatment.