Benefits and Compensation

What Is Direct Primary Care (DPC)?

Direct primary care (DPC), as the name implies, is a type of program that provides and covers care from a primary care physician (PCP). Typically, this means only PCP visits are covered but not other services or providers.primary

DPC is not health insurance, but it does provide primary health coverage within specific parameters for a set monthly fee. Some employers offer it as a supplement to health insurance coverage, while others offer it in lieu of health insurance. (Likewise, consumers can buy it directly for similar situations.)

There are several benefits for employers opting to provide DPC coverage:

  • Typically, this coverage is much cheaper than providing standard health insurance if you’re not going to provide both.
  • It can help employees get preventive care when they otherwise may not have been able to because of unaffordable coverage options or high out-of-pocket costs.
  • Preventive care can reduce long-term health problems and costs for employees, thus reducing absenteeism related to those problems.
  • It can be used as a recruiting tool, especially in industries where healthcare benefits are uncommon.
  • The costs for DPC plans don’t typically rise as quickly year to year as with standard health insurance.

There are also benefits for employees who have DPC coverage. For example:

  • This type of plan usually means the individual gets more quality time with his or her PCP. The person can spend more time discussing issues and formulating care plans. PCPs who participate in these programs are freed from the burdens of insurance filings, so they have more time for patients and a lower breakeven point in terms of number of patients seen each day.
  • The out-of-pocket costs of such a plan are usually low for employees.
  • Individuals usually can see their doctor more often and have longer visits than with standard insurance. This means they can visit doctors for true preventive care rather than only for when there’s a problem.
  • Getting an appointment is usually quick, with the average wait time between making the appointment and seeing the doctor being shorter than with regular healthcare options.
  • Other services (those not covered by the DPC program) are typically provided at a reduced cost.
  • Even when combining with regular insurance premiums, the total cost of care often decreases because there’s so much more emphasis on preventive care and less emphasis on pay-per-occurrence testing and the like. It often means individuals are less likely to need to see specialists or utilize costly options like going to the ER for basic care.
  • DPC plans can often be combined with high-deductible insurance plans, which can reduce costs for employees because the insurance premiums are lower, but they still get more preventive care without having to meet the deductible first. (This benefit is especially true if the employer covers the tab for the DPC fee.)

With these benefits, it’s easy to see why this type of plan is often utilized as an alternative to having a health insurance benefit or as a complement to it. However, it’s important to note that DPC is not insurance and does not typically cover medical procedures or medications.

If an employer only offers the DPC program and not regular health insurance, employees may still need to get regular insurance coverage on their own because this type of program doesn’t cover things beyond standard primary care visits.

Bridget Miller is a business consultant with a specialized MBA in International Economics and Management, which provides a unique perspective on business challenges. She’s been working in the corporate world for over 15 years, with experience across multiple diverse departments including HR, sales, marketing, IT, commercial development, and training.