Create More Value in DPC by Offering Comprehensive Care

"More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations" this was the name of a study published in the May/June 2015 Annals of Family Medicine.  

Who has the kind of time to offer comprehensive patient care these days?  (Rhetorical Question)

The study concluded that "increasing family physician comprehensiveness of care, especially
as measured by claims measures, is associated with decreasing Medicare costs and hospitalizations. Payment and practice policies that enhance primary care comprehensiveness may help bend the cost curve.”  

The problem faced by many DPC pioneers these days is that we have had difficulty doing this kind of data mining.  Filing claims is not an activity most DPC practices even consider.  Placing ghost claims in an EMR for tracking purposes is one option, but even this measure could theoretically decrease efficiency.  When we actually find a way to aggregate quality data across DPC practices and present it in a meaningful way the debate about whether to convert a practice will be over.  

Arkansas Makes 14 States with DPC laws - Albeit Bad Law

We recently learned that Arkansas passed a "concierge" law in February of this year.  It was an effort to protect DPC-ish physicians from "business of insurance" concerns.  Unfortunately the authors of the legislation failed miserably in their drafting efforts.  

In brief, the definition of concierge services is too vague to be useful, and other than a mandatory non-insurance disclosure the law is missing many important pieces of information that would be needed to survive judicial scrutiny.

What About OB?

Multiple DPC Summit attendees have asked about whether continuing OB is possible within the DPC arena.  

Including OB can be tricky.  I do not know a lot about Cottontree Family Practice (in Utah), but according to their website their medical services include "complete obstetrical care including delivery."

When it comes to negotiating cash prices for obstetrical care, keep in mind that most hospitals are capable of doing this, but it would probably require persistence on your part.  Every once in a while you run across refreshing examples like Good Sheppard Health System where you know up front that the cost of a delivery will be $2,750.