Tag Archives: direct primary care

Actuarially adjusted study makes clear that Nextera’s DPC clinic was a flop.

Relying on deeply flawed studies and strained interpretations, as set out here and elsewhere, Nextera and Paladina (now part of Everside) still brag that their respective “school district” and “county government” direct primary care option programs for employer heatlh care plans produce huge overall health care cost savings. 2024 saw publication of two university doctoralContinue reading “Actuarially adjusted study makes clear that Nextera’s DPC clinic was a flop.”

That the Union County DPC experiment was a flop is clear from a careful reading of its two actuarial studies, including the one claimed to vindicate DPC.

This post in a three minute nutshell Union County created a direct primary care option for its health insured employees. There were two particularly salient features: the monthly DPC fees were extravagant; and the county sweetened the DPC option with cost-sharing reductions (CSR) for downstream care. Despite CSR, the DPC clinic was able to reduceContinue reading “That the Union County DPC experiment was a flop is clear from a careful reading of its two actuarial studies, including the one claimed to vindicate DPC.”

Quick guide/recap for Brekke’s “Paying for Primary HealthCare” and my responses

In an e-book and blog about paying for primary care, Gayle Brekke presents an argument laced with actuarial theory and jargon, calculations, notes, and citations. An appearance of scholarly pursuit and mathematical precision is thereby created; in both blog and e-book Brekke makes clear that she is an experienced actuary who is also deep intoContinue reading “Quick guide/recap for Brekke’s “Paying for Primary HealthCare” and my responses”

The mathmatical core of Brekke’s “Paying for Primary Healthcare is not reasonably supported by the sources to which Brekke points.

Because paying for primary care with insurance incurs administrative costs not encountered in direct pay models, a case can be made that direct primary care should cost a patient less than insured primary care. But most DPC advocates are themselves PCPs and they just might have less to gain from offering discount pricing and moreContinue reading “The mathmatical core of Brekke’s “Paying for Primary Healthcare is not reasonably supported by the sources to which Brekke points.”

In rural areas, decreased primary care panel size is a problem, not a solution.

Montana’s last governor twice vetoed DPC legislation. He was not wrong. Over the last month or so, DPC advocates from think-tanks of the right have trotted out the proposition that direct primary care could be “the key to addressing disparities in health care access in underserved areas of Montana facing severe shortages of primary care”.Continue reading “In rural areas, decreased primary care panel size is a problem, not a solution.”

Try due diligence before betting the health of your employees on Lee-Gross-style Direct Primary Care

In his latest Direct Primary Care slide-show brag, attributing significant overall medical cost reduction for employees electing DPC over and FFS primary care alternative offered by the same employer, Dr Lee Gross insists that the favorable results do not reflect “cherry picking”. And yet, Dr Gross fails to compare the health status of the DPC-coveredContinue reading “Try due diligence before betting the health of your employees on Lee-Gross-style Direct Primary Care”

Including Primary Care in Health Insurance Policy Coverage Is Reasonable

The missing part 5 of Brekke’s “Paying for Primary Care”, a comment. Under the traditional insurance model, patients receiving covered primary will indirectly pay significant administrative costs, but they may also gain compensating financial advantages that Gayle Brekke’s multipart “Paying for Primary Care” series fails to recognize, ignores, or minimizes. At the top of theContinue reading “Including Primary Care in Health Insurance Policy Coverage Is Reasonable”

Brekke’s “Paying for Primary Care”, Comment on Part 4

In the first three installments of her Paying for Primary Care series, actuary Gayle Brekke’s invoked actuarial principles and behavioral economics to scold coverage of primary care on the ground that the costs of primary care are “predictable, routine, likely events over which the customer has a great deal of control”. In her fourth installment,Continue reading “Brekke’s “Paying for Primary Care”, Comment on Part 4″

Brekke’s “Paying for Primary Care”, Comment on Part 3

In Part 3 of Paying for Primary Care, Gayle Brekke discourses on the behavioral economics of shared health cost arrangements to conclude that insuring primary care adds costs not seen in direct pay. These cost, she contends, simply add on to the 50% administrative cost burden of insurance she had already she had already declaredContinue reading “Brekke’s “Paying for Primary Care”, Comment on Part 3″