1/13/2020 Update. See this post for some cost-adjusted data that suggests that direct primary care has net positive effects. Here’s a chronological list of posts relating to AEG/WP’s “Healthcare Innovations”.
Here’s some data that shows plausible overall cost reduction from direct primary care even after adjusting selection bias. It comes from the Paladina-operated clinic in Union County, North Carolina, the principal subject of two prior posts. The county employees choose either a high-deductible HSA under which primary care is received on a fee for serviceContinue reading “A possible 11% reduction in overall care cost, adjusted for risk, is suggested by Union County's 2018 report.”
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.”
Although the AEG/WP report does not support its key claim with data or citation, the report’s authors responded to my request for information by indicating their sources. One of them was an e-zine article about the CHI clinic. The other two were promotional brochures, denominated case studies used, by the DPC companies Paladina and Nextera,Continue reading “The two largest and most current AEG/WP examples of downstream cost reduction failed to adequately address selection bias.”
As noted in a prior post, the report by the Anderson Economic Group and Wilson Partners supported the assumption that direct primary care reduces downstream care cost by 15% with nothing more than a cryptic reference to “research and case studies prepared by Wilson Partners”, presented with neither data nor citation. Initially, I thought thisContinue reading “Why did Wilson Partners' research into DPC cost-reduction bypass uniquely available and pointedly relevant data?”
A unique and powerful opportunity for quantitatively informed assessment of such claims has come from a DPC clinic serving employees of Union County. There, health plan members are able to choose between receiving primary care in a DPC clinic or through physicians under traditional model of insurance and fee for service. Mark Watson is theContinue reading “Selection bias infected the best documented argument that direct primary care reduced downstream costs.”