Direct primary care is an expanding model promising to achieve the holy grail of health care reform: healthier patients at lower cost. Pioneered by Dr. Garrison Bliss in the late ‘90s, the model replaces fee-for-service incentives with a flat monthly rate for unlimited patient access – in person and by phone or email – to their primary care doctor. A recent TIME Magazine article tells the story of Bliss’ vision, explaining the model and the ways it’s being implemented today.
The short version is this: when people receive good primary care their maladies can be addressed before they end up in expensive hospital beds or emergency room visits. Under the current health care system, insurance reimbursements set payment rates that value procedures like surgeries or scans more than checkups or management of existing conditions. A primary care doctor is reimbursed for one exam, whether they see a patient for one hour or 10 minutes. No one gets paid to answer patient questions, so patients are less likely to be informed and take accountability for their own health.
Direct primary care allows doctors to focus on caring for patients and take the time for a proper exam, with follow-up questions and counseling. The cost of a monthly fee is easily recovered by fewer hospital and emergency room visits, and patients can save by choosing less expensive insurance policies because they’re already covered for primary care. More than 15,000 Medicaid patients are signed up, as are several big private employers like Expedia and Comcast.
Communication is one of the key components emphasized by the direct primary care model. As Dr. Bliss’ Seattle-based company Qliance Health advertises: “Our highly-trained physicians focus completely on helping you reach optimal health—and your doctor will take the time to listen to you, answer your questions, and provide medical care customized to your particular needs.”
This is where mobile health enters the picture – by providing secure options for remote communication with your medical team, certain mHealth apps can facilitate direct primary care. Apps like our Mobius Mobile allow patients to instantly message their doctor, schedule a virtual appointment, and share vital signs from anywhere – all with secure and (beyond) HIPPA-compliant technology. Instead of a costly emergency room visit, direct primary care allows a patient to consult their doctor for no additional charge. Instead of making a trip to the clinic, the proper mHealth app can first allow that patient to check in with their medical team remotely.
This type of functionality extends unlimited physician access beyond the doctor’s office, further improving efficiency and the patient experience. While Dr. Bliss’ model is being picked up around the country, mHealth is changing the meaning of “direct” primary care.