The COVID-19 Pandemic Proves Need for More Direct Primary Care Clinics

May 6, 2020

The COVID-19 Pandemic Proves Need for More Direct Primary Care Clinics

About the Author

As Chief Exectuive Officer, Chris Miller oversees the strategy and growth of Paladina Health as we realize our vision of bringing quality direct primary care to patients across the country.

Meet Chris Miller

By Chris Miller, CEO, Paladina Health

The current COVID-19 crisis and subsequent government-mandated shutdowns are taking a toll on many industries, forcing businesses of all sizes and stature to shutter their operations. Some industry experts, in fact, are suggesting that the extended course of the latest coronavirus threatens the viability of many physicians' offices as a result of reduced patient volumes and lack of reimbursement for telehealth services. While the crisis could affect traditional physicians' offices, this grim projection does not take into account the growing popularity of direct primary care clinics.

By definition, direct primary care features a direct billing and payment arrangement between organizations, such as employers or unions, and healthcare providers without sending claims to insurance providers. Although the concept of direct primary care has been around for well over a decade, its popularity has accelerated in recent years largely due to concerns over skyrocketing healthcare costs. With the escalation of the COVID-19 pandemic, however, direct primary care has proven more valuable and relevant than ever. And, unlike traditional primary care, it is well positioned to survive and even thrive throughout the current healthcare crisis.

Why? Because direct primary care does not rely on a fee-for-service model in which healthcare providers are paid a set amount of money by insurance companies for services rendered. Direct primary care providers offer the appropriate services 24/7 without reimbursement concerns.

Take telemedicine, for example. It has rightly become the preferred venue for patient care during the current pandemic. Many direct primary care providers are equipped and properly trained to handle nearly all patient visits via virtual care (phone or video). Since their reimbursement is based on a fixed per-member fee, and not a fee for services rendered, they have no disincentive to avoid treating patients virtually and doing so does not threaten their ability to keep their doors open.

Effective telehealth care is crucial in the coming months and, in the case of organization-sponsored primary care, it will be critical in helping employers stave off high medical costs during this pandemic. Through telehealth, primary care clinics can remain the front door for patients, ensuring they only visit emergency departments when necessary – something that matters now more than ever when every vacant hospital bed counts.

Beyond telehealth capabilities, direct primary care clinics offer added benefits that are especially critical during crises like the COVID-19 pandemic. Key is their preventative care approach. Direct primary care providers spend more time with patients and work with them to manage key risk factors, such as heart disease, diabetes and high blood pressure – some of the very conditions that increase the mortality rate of COVID-19-infected patients. Long after the current crisis is over, such health management is essential to lowering healthcare costs, since it is significantly less expensive to treat a minor problem before it reaches a life-threatening level.

Our country cannot afford to be without its primary care providers, especially during a crisis. While hospitals are focused on treating the most severe of cases, it is primary care physicians who are left to evaluate and treat the symptoms and answer questions that might otherwise result in a hospital visit. The primary care physicians at Paladina Health, for example, have been busier than ever since the onset of COVID-19. Primarily through telehealth visits, our physicians have helped to alleviate fears by helping patients differentiate common upper respiratory distress from COVID-19 symptoms. Paladina doctors are working with patients to ensure they are managing any health risks and providing wraparound services to improve patient outcomes physically and mentally.

Without question, there is a critical need to keep primary care physicians in business, especially in these current challenging times. We need to keep these "front doors" open to improve overall health and help prevent overload on our hospital systems. Fortunately, there is a proven model in the form of direct primary care that is available to show us exactly how to do just that.

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