DPC is uniquely able to telemed: a meme that suffered an early death.

An update to this post. Larry A Green Center / Primary Care Collaborative’s Covid-19 primary care survey, May 8-11, 2020: In less than two months, clinicians have transformed primary care, the largest health care platform in the nation, with 85% now making significant use of virtual health through video-based and telephone-based care. Larry A GreenContinue reading “DPC is uniquely able to telemed: a meme that suffered an early death.”

The Nextera/DigitalGlobe study design made any conclusion on the downstream effect of subscription primary care impossible.

The study indiscriminately mixed subscription patients with pay-per-visit patients. Selection bias was self-evident; the study period was brief; and the study cohort tiny. Still, the study suggests that choosing Nextera and its doctors was associated with lower costs; but the study’s core defect prevent the drawing of conclusions about subscription primary care. UPDATED JUNE 2020.Continue reading “The Nextera/DigitalGlobe study design made any conclusion on the downstream effect of subscription primary care impossible.”

Iora’s Las Vegas experience is an inapt model for DPC, and shows no real cost reduction.

While DPC Coalition features an Iora Clinic in Las Vegas as a data model of the joys of direct primary care, it is simply not representative of a general population. That clinic focused on a very high need population, every member chronically ill. We are looking at people with $11,000 claim levels at 2014 prices;Continue reading “Iora’s Las Vegas experience is an inapt model for DPC, and shows no real cost reduction.”

Why is subscription DPC the precise hill on which self-styled “patient-centered” providers have chosen to make a stand?

A subscription model is not the most patient-centered way. Consider this primary health care arrangement: Provider operates a cash practice no insurance taken no third party billed Provider may secure payment with a retainer balance is carried refreshed when balance falls below a set threshold Provider may bill patient for services rendered on any basisContinue reading “Why is subscription DPC the precise hill on which self-styled “patient-centered” providers have chosen to make a stand?”

Union County Direct Primary Care in a nutshell.

Union County is estimated by Milliman to have lost money. The odds that Union County saved more than 5.2% are less than one in twenty. The odds that Union County saved 28% or anything near that are miniscule. Do you remember when DPC was claimed to be saving Union County $1.25 Million per year? SoContinue reading “Union County Direct Primary Care in a nutshell.”

DPC Alliance manifesto steps on its own foot attempting to prove that DPC saves money.

On May 13th, the Direct Primary Alliance published a manifesto: Building the Path to Direct Primary Care. It was signed by every officer and board member of the largest membership organization of direct primary care physicians. In so many words, it said: FFS primary care practice is being destroyed, financially, by the Covid-19 pandemic. DPCContinue reading “DPC Alliance manifesto steps on its own foot attempting to prove that DPC saves money.”

dpcreferee’s 2017 op-ed on Union County’s failure to save with DPC proved to be almost spot on.

In February 2017, I sent the op-ed piece below to the Charlotte Observer. It was not selected for publication. But it has been proven accurate in a detailed, independent study by team of health care actuaries from a firm of highly regarded actuaries known widely for its health care work. The study was prepared forContinue reading “dpcreferee’s 2017 op-ed on Union County’s failure to save with DPC proved to be almost spot on.”

That “DPC is working while FFS is failing financially because of COVID” meme takes a big hit; proof furnished by DPC Alliance.

Reality: while it is may not be a pretty picture, no one has a clear view what the pandemic’s ultimate effects on primary care practices, FFS or DPC, will be. On May 13th, the Direct Primary Alliance published a manifesto: Building the Path to Direct Primary Care. It was signed by every officer and boardContinue reading “That “DPC is working while FFS is failing financially because of COVID” meme takes a big hit; proof furnished by DPC Alliance.”

DPC advocates: an undoubtedly small number of individuals can be as high as 23,000,000.

Summer 2019 DPC advocates argue against a $1.8 budget score for their pet DPC/HPHP/HSA fix. They argue the impact is zero, and they cite a study by The Moran Company that says: The number of individuals presently barred from HSA participation solely by reason of DPC enrollment is undoubtedly small. March 2020 DPC Coalition glumlyContinue reading “DPC advocates: an undoubtedly small number of individuals can be as high as 23,000,000.”

DPC: “Unlike FFS, we’re keeping our doors open, except when they’re not.”

Ahem, indeed! The thrust of the vox.com article cited by Dr. Edwards is that primary care physicians are losing in-person visits and telemedicine visits return fewer dollars. It’s key sentence: “Doctors and other health care providers have seen a precipitous drop in the routine visits they depend on for revenue, and experts fear many officesContinue reading “DPC: “Unlike FFS, we’re keeping our doors open, except when they’re not.””