SEATTLE, WA--(Marketwire - Jun 3, 2011) - The Direct Primary Care Coalition today announced their support for language in the Family and Retirement Health Investment Act of 2011, sponsored by Sen. Orrin Hatch (R-UT) and Rep. Erik Paulsen (R-MN), which would allow monthly fees for direct primary care services to be treated as "qualified medical expenses" under Section 213(d) of the Internal Revenue Code. The bill marks another example of growing federal recognition of the importance of the flat-fee direct primary care model, which was also included in the Patient Protection and Affordable Care Act last year.
The legislation introduced last week would make it easier for Americans to take advantage of direct primary care, a transformational health care model in which patients and/or employers pay one low flat monthly fee in lieu of insurance directly to a primary care provider for all primary and preventive care, chronic disease management and care coordination throughout the health care system. Under the bill, patients and employers would be able to use health reimbursement arrangements (HRAs), health savings accounts (HSAs) and flexible spending accounts (FSAs) to pay for these services.
Direct primary care medical homes (DPCMHs) already exist in more than one-third of U.S. states, offering affordable health care alternatives to nearly 100,000 Americans, according to the Direct Primary Care Coalition (www.dpcare.org).
"The Direct Primary Care Coalition commends Senator Hatch and Representative Paulsen for their forward thinking, and for giving patients greater flexibility to elect flat-fee primary care," said Garrison Bliss, MD, co-founder of the Direct Primary Care Coalition, who is also co-founder and Chief Medical Officer, Qliance Medical Management Inc., which operates clinics in Washington State. "Direct primary care is reinventing the way health care is delivered in this country by focusing on the patient. This legislation, which clarifies that patients have the ability to pay for the primary care provider of their choice using pre-tax funds, is a significant step in the growth of direct primary care in America."
Dr. Bliss pioneered the DPCMH in Washington State more than a decade ago. Today, DPCMHs offer affordable, high-quality health care at up to 50 percent less than the cost of traditional insurance, even when combined with a lower-cost "wrap-around" insurance plan that covers what direct practices do not.
Benefits of direct primary care membership can vary by provider, but often these practices charge a low monthly fee -- between $49 and $129 per month -- in lieu of insurance for unrestricted access primary care, preventive and chronic care management. There are no deductibles, co-pays or limits for pre-existing conditions. Many offices are open for extended hours and on weekends, and patients enjoy same- or next-day appointments for urgent care needs. Direct primary care practices generally handle all routine care including vaccinations, routine blood tests, women's health services, pediatric care, on-site procedures (suturing, casting, colposcopies, etc.) and provide ongoing management of chronic diseases like diabetes, hypertension and obesity. As a "medical home" model, these practices also coordinate any needed specialist and hospital care.
Clarifying the ability to pay for direct primary care fees using funds from HRAs, HSAs and FSAs will further enable employers to reduce costs while providing better care options for employees. Already, employers who elect a direct primary care model combined with a "wrap-around" insurance plan that covers everything primary care does not are saving up to 50 percent from traditional insurance-only plans.
"By allowing direct primary care fees to be paid for with money from health savings accounts, the Family and Retirement Health Investment Act is giving employers and employees important new options," said Neil Trautwein, Vice President and Employee Benefits Policy Counsel of the National Retail Federation. "It would enable businesses to provide significant new high-quality health care options to their employees without breaking the bank. Employers everywhere are faced with rapidly increasing health coverage costs, and they are in need of positive proposals like this. We see the language in this bill as a very positive development for patients and employers alike."
"The Family and Retirement Health Investment Act language further validates the direct primary care medical home model, and would give patients more access to high quality primary care," said Dr. Vic Wood of Primary Care One in Wheeling, West Virginia. "We are thrilled to see Congress continue to support patient-centered primary care by crafting legislation that will enable the continued growth of our model -- and allow us to bring high-quality care at an affordable price to more Americans."
This new legislation follows important flexibility afforded in the Patient Protection and Affordable Care Act of 2010, which enables DPCMHs to operate in the insurance exchanges beginning in 2014 if bundled with lower cost wrap-around insurance plans. Many major insurance carriers are already in discussions with direct primary care providers about how to design these wrap-around insurance plans.
For more information about the benefits of flat-fee practices for patients and doctors, visit the Direct Primary Care Coalition at www.dpcare.org.
NOTE TO PRODUCERS: B-roll of direct primary care medical home practices that includes interviews with a doctor, patient and employer is available by contacting pr@qliance.com.