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.”
Tag Archives: direct primary care
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.”
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 a team of health care actuaries from the Milliman firm, known widely for its health care work. The study was prepared for the SocietyContinue reading “dpcreferee’s 2017 op-ed on Union County’s failure to save with DPC proved to be almost spot on.”
DPC and the pandemic: more capable than FFS? Or less?
DPC advocates are talking a lot these days about how a pandemic shows the superiority of direct primary care. There are aspects they don’t talk about. The Milliman study’s survey — the same survey DPC advocates turn to when emphasizing, for example, how much telemedicine DPC clinics do — indicated that over a third ofContinue reading “DPC and the pandemic: more capable than FFS? Or less?”
Dr Priceline’s downstream cost reduction plan cannot simply be scaled up.
Dr. Lee Gross of Epiphany, a direct primary care leader, brags about the great discounts he gets for his patients on downstream procedures like advanced radiology. And, specifically, he proudly lets us know that a big part of this involves accessing advanced equipment during slack hours. This is, of course, the same strategy by whichContinue reading “Dr Priceline’s downstream cost reduction plan cannot simply be scaled up.”
Making cost reduction claims more honest and helpful to decision-makers — random thoughts.
Claims of cost reductions need to look comprehensively at all costs. Consider this chart from an Iora presentation of some years ago. The net drop in spending would look a lot bigger if prescription drugs (the green bar) were not part of the picture. But, a lot of how primary care, direct or otherwise, worksContinue reading “Making cost reduction claims more honest and helpful to decision-makers — random thoughts.”
DPC and Medicaid expansion politics.
DPC docs uniformly recommend that their non-indigent patients have wrap-around insurance coverage. But for indigents, particularly for what are known as “Medicaid expansion adults” too many DPC docs are willing to push their state for an indigents’ program heavy on direct primary care coupled to, at best, skimpy coverage of downstream costs. They’re eager forContinue reading “DPC and Medicaid expansion politics.”
A moment of clarity about selection bias – at a DPC summit.
At 2019 Summit, Mike Tuggy, MD, FAAFP, presented this: What Have Primary Care Practices Provided to Employers Who Invested in Primary Care? The Results Speak for Themselves–Reports from Across the U.S.2019 DPCSummit62019 Direct Primary Care (DPC) Summit His presentation began with high praise for Qliance and others. He suggested that these models might be usedContinue reading “A moment of clarity about selection bias – at a DPC summit.”
Dr Rice’s “DPC saves money” fantasy.
When the third word of an article with a quantitative angle is hyperlinked to an article by the same author, an MD who also holds an MBA, and the linked article reveals that the author can not actually calculate “markup” correctly, look hard at both pieces. Behold Why direct primary care is the future byContinue reading “Dr Rice’s “DPC saves money” fantasy.”
DPC + Cat is not a good substitute for full ACA Medicaid expansion
When Brain Forrest MD, the founder of the Access Healthcare direct primary care clinic, does legislative advocacy at, for example, the United States Senate, he shows the data of the foregoing chart. It’s from a 2013 course project by three NC State post-baccalaureate management students. He advocates pro-DPC legislation, apparently telling policy makers that theContinue reading “DPC + Cat is not a good substitute for full ACA Medicaid expansion”