Direct Primary Care

Why Employers Should Consider Direct Primary Care For Employees?

May 22, 2021

Harsha Moole, M.D., MBBS

Direct Primary Care and Concierge medicine have revolutionized health care in recent years, offering members a more personalized and efficient health program. Members can make premium payments annually or monthly, and patients generally receive more than they pay for.

The COVID-19 pandemic has shown that the workforce is still essential and indispensable to the economy. Companies face the dilemma of reducing costs and retaining employees.

How Direct Primary Care Benefits Employers?

For employers, there's probably no investment more worthwhile than in employee healthcare. Compared to insurance, it's the most cost-effective way to keep your employees healthy and fit to do the work.

For this reason, getting Direct Primary Care for employees is probably the best financial decision that business owners can make for their company.

Direct Primary Care for employers has become mainstream in recent years. In many ways, it has become the superior option to pricy insurance companies for businesses looking to safeguard their employees' health and help create a better situation for the company's overall bottom line.

Benefits of Direct Primary Care for Employers

  • Lower overall healthcare cost:

    Employer-initiated Direct Primary Care plans make it a lot cheaper to keep workers fit and healthy to work. Employers can already give their employees a top-notch personalized healthcare plan for a flat rate that usually ranges from $30-$300.

    DPC plans are also often modular to tailor the plan to include only the specific services you want your employees to enjoy. This way, you won't have to pay extra for redundant services.

  • Excellent recruitment and retention incentive:

    Harvard Business Review says that 88% of people would put at least some consideration to lower-paying jobs if they offer good health benefits. So this benefit alone could potentially lower the payroll expense account across the board.

  • Less absenteeism:

    Insurance-based primary care tends to make doctors see thousands of patients each month. With DPC, doctors aren't forced to see as many patients, so it's a lot easier to book appointments.

    Most DPC practices give access to doctors via technological means such as teleconsulting to save even more time. Some DPC physicians even offer emergency house calls

  • Increased productivity:

    A DPC plan is one of the most efficient ways to get quality healthcare. Easy access to physicians and diagnostic tools help give employees better long-term health resulting in fewer hospital visits and more time spent on being productive at the office and home having fun with the family.

    In addition, some practices offer house calls so employees wouldn't even need to spend time and precious money booking appointments and going on commutes to the hospital or clinic.

Does Direct Primary Care count as Insurance?

DPC practices deliberately don't take insurance or Medicare, so they're not bogged down by the administrative demands of insurance companies and other third-party players. This helps make it quicker for employees to schedule appointments and checkups should they need it.

In a lot of ways, DPC practices are avoiding these unnecessary complications of the insurance-based healthcare system. This is good news for employers as this results in employees getting the best possible care without needing employees to file for medical leave to get to an appointment.

What Does Direct Primary Care Cover?

While different DPC practices may offer different healthcare packages, there are some common offerings between many DPC healthcare plans. These include:

  • Treatment of common issues such as the seasonal flu and colds.
  • Routine checkups and preventative screenings such as colonoscopies and pap smears.
  • Minor procedures such as injections, sutures, and sometimes, even minor cosmetic procedures.
  • Referral and coordination with relevant specialists for situations that require it.
  • Special rates for the use of medical facilities and equipment.
  • Comprehensive yearly checkups.

In traditional healthcare models, copay tends to deter employees from seeking medical attention for these issues. With DPC, however, the lack of copay requirements helps encourage employees to go for a checkup as doing so would have absolutely no charge to them.

Direct Primary Care generally covers issues that working people commonly encounter. This ensures that you have a healthy workforce that is ready to take on the challenges of your business at all times.

Is Direct Primary Care Tax Deductible?

Currently, the Treasury Department considers that DPC plans as a variation of a gap insurance therefore, it automatically disqualifies employees who have from using or contributing to a Health Savings Account (HSA).

However, advocates of DPC are trying to educate the IRS and the Treasury that the monthly fees cannot be considered as insurance premiums and therefore cannot be considered as a gap insurance.

As of the present time, the best tax-advantaged way to use DPC is by using an employer-provided health reimbursement arrangement.

In the limited circumstances in which an individual is covered by a DPC arrangement that does not provide coverage under a health plan or insurance or solely provides for disregarded coverage or preventive care. - says Rebecca Moore from Plansponsor

So, employers who choose DPC healthcare for their employees don't have to sacrifice traditional healthcare models' tax incentives and advantages. With proper planning, employers can still enjoy the tax benefits of an HSA.

This flexibility is another benefit that Direct Primary Care for employers has over traditional healthcare modes. With DPC, employers are free to pick and choose the types of services for maximum savings.

Does Medicare cover Direct Primary Care fees?

You can't use Medicare to cover DPC fees. This means that a patient on Medicare must pay out-of-pocket for the monthly membership fees if they wish to enjoy the benefits of a DPC practice.

Despite this, patients with Medicare still often sign up for a DPC plan because of the ease of access to physicians as patients can claim some medicare benefits such as lab fees and medication.

How does Direct Primary Care work with Medicare?

DPC practices can still provide services to patients who have signed up for Medicare. To do this, DPC physicians have to opt out of Medicare.

Patients will still get their medication and laboratory orders from their DPC physician done through Medicare in this arrangement. This essentially gives way for patients to take advantage of the services and benefits offered by DPC practices and the claims they're entitled to in their Medicare coverage.

On the other hand, doctors will not bill Medicare for any of the services they render. Instead, they get their fees paid by the patients themselves through the monthly membership.

This way, employers don't have to worry that their employees won't be covered by Medicare anymore because they're also enrolled in a DPC plan.

Is Direct Primary Care worth it?

The inefficiencies of traditional healthcare models make Direct Primary Care worth shifting to. In addition, considering the poor quality of healthcare patients get and the ever-increasing health insurance premiums, the monthly fees for a DPC plan are an affordable alternative for employers.

Why Should Employers Consider Direct Primary Care for Employees?

In many ways, Direct Primary Care can help put the company's bottom line in a better place by reducing the company's employee healthcare costs while increasing the quality of the service. What's even better is that employers can also leverage employee negotiations to bring the overall payroll expense down.

To top all of the financial savings off, employers would also benefit from having a healthier workforce. Healthy employees use less sick leaves and are generally more focused on being productive at work.

The benefits of direct primary care and other health programs are innumerable. It lowers insurance costs and increases employee morale and productivity.

Employers excel in this global age of health. Investing in direct patient care enables the employer to help their employees at no additional cost but with enormous potential benefits.

Join the movement for improved patient-centred care and see a direct primary care physician in your area today. Find your nearest direct primary care physician at –

Authored by Harsha Moole, M.D., MBBS

Advocate of healthcare models that promote direct relationship between patients and doctors. Founder @ FindMyDirectDoctor, LLC.

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