Direct Primary Care in 2015

A Survey with Selected Comparisons to 2005 Survey Data

Abstract

Introduction. Direct primary care (DPC), a fee for membership
type of practice, is an evolving innovative primary care
delivery model. Little is known about current membership
fees, insurance billing status, physician training, and patient
panel size in DPC practices. This study aimed to obtain current
data for these variables, as well as additional demographic
and financial indicators, and relate the findings to the Healthy
People 2020 goals. It was predicted that DPC practices would
(1) submit fewer claims to insurance, (2) have decreased membership
fees, (3) be primarily family medicine trained, and
(4) have increased the projected patient panel size since 2005.

Methods. An electronic survey was sent to DPC practices
(n = 65) requesting location, membership fees, projected
patient panel size, insurance billing status, training,
and other demographic and financial indicators. Data
were aggregated, reported anonymously, and compared to
two prior characterizations of DPC practices done in 2005.

Results. Thirty-eight of 65 (59%) practices responded to the
2015 survey. The majority of respondents (84%) reported using
an EMR, offering physician email access (82%), 24-hour access
(76%), same day appointments (92%), and wholesale labs (74%).
Few respondents offered inpatient care (16%), obstetrics (3%),
or financial/insurance consultant services. Eighty-eight percent
(88%) of practices reported annual individual adult membership
rates between $500 and $1,499, decreased from 2005 where
81% reported greater than a $1,500 annual fee. The proportion of
practices who submit bills to insurance decreased from 75% in
2005 to 11% in 2015. Fifty-six percent (56%) of practices reported
projected patient panel size to be greater than 600, increased
from 40% in 2005. Family medicine physicians represented 87%
of respondents, markedly different from 2005 when 62 - 77% of
DPC respondents were general internal medicine physicians.

Conclusions. Most DPC practices no longer submit to insurance
and are family medicine trained. Compared
with the previous sampling, DPC practices report decreased
membership fees and increased projected panel
size. These trends may signify the DPC movement’s
growth in application and scope. KS J Med 2017;10(1):3-6.