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.”

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”

Three bad ways to bet the health of Georgia citizens on direct primary care.

Every published claim that direct primary care makes a significant dent in necessary health care spending is dubious at best. See, for example, here, here, here, here, here, here, here, here, here, here and here. When the data from the Union County clinic — a Georgia Public Policy Foundation favorite — is age-adjusted, it indicatesContinue reading “Three bad ways to bet the health of Georgia citizens on direct primary care.”

Going insurance-free does not, and cannot, reduce the overhead expenses of primary care practices by 60%, or even 40%.

Substantial correction made on 2/12/2-13. About 13% of revenue (22% of overhead) according to academic research.  I’ve back-tracked Katherine Restrepo’s and Julie Tisdale’s 2016 claim that: By dealing directly with patients and filing no insurance billing whatsoever, DPC practices are able to eliminate 40-60 percent of their overhead expenses. A footnote there takes you to a 2015Continue reading “Going insurance-free does not, and cannot, reduce the overhead expenses of primary care practices by 60%, or even 40%.”

The only academic journal studies on point failed to show the efficacy of direct primary care.

Georgia’s conservative fans of direct primary care swoon over PHS, a 1500 member, insurance-free, hospital-based, direct primary care clinic in Altoona, Pennsylvania. PHS was the subject of not just one, but two quantitatively detailed academic journal articles addressing the efficacy of direct primary care. Since the oft-cited British Medical Journal study on the efficiency of direct primaryContinue reading “The only academic journal studies on point failed to show the efficacy of direct primary care.”