Business

Restrepo: Direct Primary Care Helping North Carolina Public Sector Save Big On Health Care Claims, Part II.

In Union County, NC, fortunately, the hard work is paying off in just one year’s time.

Katherine Restrepo, Forbes, Contributor | I cover North Carolina health policy and Obamacare

DPC Consumer Guide cover_2017 FULL copy1000Jul 19, 2016 @ 01:09 PM – Mark Watson, executive HR director for Union County, will openly admit he is the ultimate skeptic. Naturally, he was pretty skeptical when his colleague, friend, and debate partner, Bill Webb, pitched to him the idea of integrating a direct primary care (DPC) option for county workers — an option that would guarantee them 24-hour access to a board-certified family doctor. Patients can text, Skype, email, and call their doctor whenever. They can schedule same-day appointments. Doctor visits don’t require co-pays or co-insurance. Waiting rooms are mostly unnecessary. Not only would the patient-doctor relationship be restored, but the employer who pays for those health benefits would also gain a relationship with the doctor. It just seemed too good to be true.

After meeting upon meeting, some more skepticism, and a few years’ worth of convincing colleagues that it would work, the idea came to fruition in April 2015 when Union County secured a contract with Paladina Health to establish one of its DPC clinics central to the sheriff’s office, Human Services, and other government buildings.

I’ve written a lot about how DPC saves money on health claims because these doctors can spend more time effectively managing patient care since they don’t participate with insurance. There are many different DPC models. Entrepreneurial-minded physicians are hanging their own shingles. Others are running their practices as non-profits in which patient membership fees offset the cost of charitable care provided to low-income patients unable to pay. And then there are larger organizations such as Paladina whose salaried physicians care for employees of large self-insured employers – like Union County.

The Paladina Clinic located at 1640 Campus Park Drive in Monroe, NC emits a different vibe than most physician offices. The walls are painted with warm orange hues, and the spacious examination rooms don’t give that sterile, austere feeling. You also won’t find the receptionist greeting you behind a sliding glass window. No barriers to care, literally.

After meeting with Mr. Watson, Mr. Webb, representatives of Paladina Health, and Dr. William G. Martin III, one of the clinic’s family doctors, I learned about the heavy lifting that went into laying the DPC foundation for county workers. While it took time for Watson and Co. to devise a way for the additional DPC benefit option to come out as budget neutral, working with a stable high-deductible health plan played to their advantage. Budget neutrality was achieved by simply unplugging certain plan features – like an employee’s $750 health reimbursement account (HRA) – and reallocating those funds to plug in Paladina’s direct care services. Workers are now paying less out-of-pocket, and Union County is able to provide a value-added benefit at a fixed cost – a dream for any CFO.

Fortunately, the hard work is paying off in just one year’s time. Patients are posting positive feedback about Paladina’s services on Union County’s Facebook page. Dr. Martin says he is most professionally satisfied now, knowing that after 20 years of private practice, he no longer gets paid to “chase paper” from insurance carriers. The only paper he is chasing is his patients’ charts.

CONTINUE READING FULL STORY …

SOURCE: http://www.forbes.com/sites/katherinerestrepo/2016/07/19/direct-primary-care-helping-north-carolina-public-sector-save-big-on-health-care-claims-part-ii/#180c5072151b

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