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    Improve your practice: Facilitate patient access

    As patients abandon their medical homes for retail clinics and telehealth visits, let's remove the obstacles that hinder patients’ access to our services.


    Direct Primary Care

    The Affordable Care Act (ACA) has led some physicians to create a new model of healthcare delivery, one that can bypass insurance coverage and enable physicians to focus on medical care. This model is called Direct Primary Care (DPC). It entails having patients subscribe to your practice for a monthly or yearly fee. No insurance companies are billed and no co-pays are collected. Patients are advised to have catastrophic health plans in case they need hospitalization, medical tests, or surgery.

    In the DPC model, physician panels are capped at 600 to 1000 patients, allowing physicians to do well economically while affording patients ready access to their PCP. In most DPC models, office testing is billed to the patient at cost. Doing the math indicates that if you have patients pay $60 per month per patient ($720) per year, a 1000 patient panel generates $720,000 per physician per year. Even if your overhead remains unchanged, then physicians often make more than they would under traditional models of care. Usually the overhead decreases as well because you are no longer billing patients, and you hire fewer staff because you see fewer patients per day than you would under the traditional care model.

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    Physicians as well as patients praise this model because wait times are minimal, and visits are longer and unrushed. Obviously, you could not transition to a DPC model if you have a significant Medicaid population in your practice.

    Food for thought

    There are a multitude of ways physicians can facilitate patient access to care. Choices range from improving practice workflow so more patients can be seen per day, to making changes to your scheduling system. Physicians who wish to change their practice model entirely might consider adopting a DPC model of care. Although the choices are many, only you can decide if your current system is working well. If not, consider the many options discussed in this article.

    Send your comments to [email protected]

    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...


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