Christian Care Ministry (“Medi-Share”), whose 400,000 members account for more than a quarter of health cost sharing members nationally, recently acted to allow some of its members to receive credit for their entire direct primary care membership fees up to $1800 per year.
That there is a certain synergy between DPC and health cost sharing plans is testified to in countless instances of mutually interested cross-promotion. But in the end, these are separate economic entities with their own bottom line financial needs.
Precisely because direct primary care entities refuse to work with actual insurers, we do not have much data from insurance companies from which we glean what their actuaries think DPC might be worth.** But a multi-billion dollar, 400k member cost-sharing entity, even if “non-insurance”, needs actuarially skilled professionals to make ends meet. So, when a major cost-sharing ministry rewards direct primary care members with a financial incentive, that may tell us what insurance companies will not.
Tell us what you really think, Medi-Share!
Only one of Christian Care Ministry’s options offers DPC benefits. That plan comes with a $12,000 annual Annual Household Portion (“AHP” is ministry-speak for “deductible”), but it allows its members to apply the full amount of their direct primary care fees toward that AHP. That could be as valuable as lowering an annual deductible from $12,000 to $10,200.
And we can easily estimate the actuarial value of that reduction. Here’s a screen shot from the Colorado ACA plan finder for 2020 for the premiums paid by a 38 year old Coloradan for two Anthem plans that differ only by $2150 in deductible. It costs $2.62 a month to reduce an annual deductible from $8150 to $6000. Necessarily, a reduction of $1800 a year cost less. As well, a reduction of any amount of deductible downward from a higher starting point will have a lesser value than that same amount from a lower starting point, i.e. , Medishare’s $1800 reduction downward from its $12,000 AHB is actuarially worth less than an $1800 reduction down from Anthem’s $8,150.
So there it is. $31 a year.
Wow. In a DPC with a $90 a month fee you’ll be spending twice as much on primary care as the average person using fee for service, but your downstream care savings are estimated by Medishare to be worth a whopping $3 a month on downstream care. It’s like getting one $1500 ED visit for free — every forty years or so.
** On the other hand, we do have the word of the former CEO of the now-defunct Qliance DPC to the effect that, for some presumably nefarious reason, insurance companies were not appropriately responsive to Qliance studies that claimed 20% overall cost savings.
DPC Referee 