Pure or Hybrid Practice

Which Direct Care model would work best for you?

Physicians considering making the transition to direct primary care (DPC) will notice that current DPC practices operate in either a “pure” model or a “hybrid model.”  Pure DPC practitioners only see patients via the membership model, and do not permit any cohort of patients to continue to finance their healthcare through the third party fee for service system.  Hybrid practices will dedicate a portion of the practice to DPC member patients – not participating in any third party fee for service billing with this group, and the other portion of their practice will be spent serving patients in the traditional third party fee for service system.  We hope that practices will decide to operate in the pure model for both economic and legal reasons.

How do you decide which model is right for you?

The Pure Practice

-    You are starting a direct practice straight out of residency
-    You are leaving a health system / hospital where you were an employee
-    You plan to run a direct practice for many years
-    You want to be able to compete for patients at the lowest price points (lower overhead, lower malpractice costs, etc.)
-    You are willing to “Opt out” of Medicare every two years
-    You prefer to minimize your legal risks related to the False Claims Act and Stark Laws (link to my other article)
-    You want to be able to provide the same level of high quality care to all your patients 

The Hybrid Practice

-    You have an established independent practice and are less than ten years from retirement
-    You prefer a gradual transition
-    You have decided you are unwilling or unable to “opt out” of Medicare 
-    You are willing to play the risky “fee for non-covered services” game (link to my other article)
-    You are comfortable giving better quality care (more time) to some patients than others
-    You want to remain a part of a larger group where not all physicians are willing to make the switch to direct care