Direct Care Supports Scaled Down Operations

As you’ve read here, the spectrum of business models accessible to urgent care operators is constantly expanding. “Direct care,” in which patients pay a monthly fee for a range of basic services, is one that may appeal to operators and clinicians desiring a less-structured approach to running their business—such as getting insurance companies “out of the room,” as explained by Linnea Meyer, MD in an article published in The Wall Street Journal recently. Patients pay a monthly fee—in Meyer’s case, ranging from $25 to $125 a month, depending on the patient’s age—for basic primary care needs. Because she doesn’t accept insurance or bill patients in the traditional sense, there’s no office staff to pay. Her practice is small, so she’s able to get by in a smaller, less expensive space. Best of all, from her perspective, is that leaving the hassles of dealing with third-party payers behind allows her to focus on providing care to patients. Such structures are not for the faint of heart or those with shallow pockets at the start, however; right now, Meyer has only 50 patients in her practice, though she expects it to quadruple in size. The Journal estimates that <2% of physicians work in a direct care capacity in the United States at this time, though that could change, depending on how the national healthcare landscape continues to evolve. Tom Price, the new Health and Human Services secretary, introduced legislation while he was in Congress that called for replacing the Affordable Care Act (ACA, or “Obamacare) with tax credit-funded health savings accounts; that could make direct care arrangements more appealing to patients who do not have insurance, or those with high-deductible plans.