We've been reviewing information about Direct Primary Care and Direct Family Medicine for a couple months now. Tonight on the Dr Synonymous Show, we'll review more numbers and information relative to DPC and DFM. The charts and forms below are the work of Sonia Bennett, MPH a Wright State University second year medical student, with some input from Dr Jonas. This is information for discussion and not perfectly organized or totally factual, but darn close.
Direct Family Medicine & WSU Sonia Bennett, MPH Interview 06/26 by Dr Synonymous | Blog Talk Radio http://bit.ly/MlQB0I 9PM ET
Family Health Connections, Inc in Beavercreek, OH intends to add Direct Family Medicine to their practice offerings in July, 2012.
v
What is
Direct Family Medicine?
Direct Family Medicine (DFM), a Family Medicine version of
Direct Primary Care (http://www.dpcare.org/difference) refers to care that is
directly offered to patients without involvement of traditional insurance. It is not health or medical insurance. It allows people who do not have insurance to
have access to medical care. It is a way
for patients to have a regular source of medical care, develop a relationship
with their family physician, and work together to maintain their health and
manage acute illness and chronic conditions.
The physician-patient relationship is the foundation of family medicine
and DFM allows those without insurance to have access to such a relationship
and medical care.
v
Who is
Direct Family Medicine for and how does it work?
DFM is for people without insurance or people in career-transition
who may temporarily be out of insurance to be able to receive medical care
through monthly payments. It is also for
persons with a high deductable health savings account (HSA) in some
states. After enrolling in DFM, patients
can have access to family medical care.
People with insurance or Medicare are not eligible for DFM.
Type of fees- Example
|
Infant (0 to 1yr)
|
Child (1yr to 17 yrs)
|
Adult (18 yrs and over)
|
Registration
|
$60
|
$40
|
$80
|
Monthly fee
|
$60
|
$50
|
$60 ($720/yr)
|
Co-payment per visit
|
$20
|
$20
|
$20
|
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Do I need
insurance to enroll in DFM?
No. DFM is for
uninsured patients or patients such as those with a high deductable health
savings account (HSA) or who may be in between jobs. Many who wish to cover their catastrophic
medical costs with insurance, but keep their family medical care out of it will
enjoy DFM
.
v
What
services are included with Direct Family Medicine?
Preventive services, sick visits, chronic disease management
(asthma, diabetes, high cholesterol, hypertension, hypothyroidism, depression,
etc.), Saturday appointments, after-hours on-call physician access and other
services listed in the Summary of Services are covered by the monthly fee.
Services that are covered by the monthly fee
|
Services not covered by the monthly fee
|
Visits for general wellness and preventive care from infancy to
maturity
|
Hospitalizations
|
Infant, child, adolescent health (well-child checkups, school
physicals, sports physicals)
|
Specialist care
|
Women’s health (annual checkups, pap smears, family planning
discussion, menstrual issues, menopause, sports injuries )
|
Outside laboratory procedures such as pathologic exams, X-rays, heart
monitors, etc.
|
Men’s health (sports injuries, prostate problems, erectile
dysfunction)
|
Some immunizations and injections (vitamin B12 shot)
|
Acute sick care for all ages including routine office tests
(urinalysis, strep test, pregnancy test)
|
Prescription medications. Blood tests
|
Chronic disease diagnoses and management (hypertension, diabetes,
heart disease, high cholesterol, depression, thyroid diseases, asthma)
|
Surgeries and surgical procedures
|
Flu shot and injections for some infections
|
Obstetric procedures
|
Dermatological health (acne, rashes, skin cancer screenings)
|
|
Ear, nose, and throat health (ear irrigation, strep test)
|
|
Musculoskeletal problems (arthritis, joint pain/stiffness, back pain)
|
|
Gastrointestinal problems (GERD, diarrhea, vomiting, Irritable Bowel
Syndrome)
|
|
Stress and psychological problems (anxiety, grief, situational
reactions, depression)
|
|
Brain related problems (dizziness, headaches, numbness)
|
|
Weekdays and Saturday morning office hours
|
|
After-hours emergency telephone access
|
v
Is there
a co-payment?
Yes. Co-payment for
every visit is $20.
v
Is there
a registration fee?
Yes. The registration
fee is $80 for adults and $40 for children (0-17 yrs) and establishes care with
a family physician.
v
What are
the monthly fees?
Monthly fees are $60 for adults, $60 for infants (0-1yr),
and $50 for children (1-17 yrs).
v
How do I
pay the monthly fees?
You can pay by direct deduction from checking account,
credit card, or debit card on the 25th day of the month
.
v
How do I
cancel membership?
You can cancel anytime with, written notice, effective at
the end of the month.
v
Can I re-enroll
in the program at a later time if I cancel?
Yes. You may re-enroll
after a 6-month wait for up to 2 times but you will have to pay the
registration fee each time you re-enroll.
Re-enrollment will also depend on whether we are accepting new DFM
enrollees at the time.
v
Do I pay
the monthly fees even if I don’t need to see the doctor every month?
Yes. The monthly fee allows
access to medical care and covers 24 hour on call physician coverage, preventive
services and appointments for sick visits as well as chronic disease management.
v
What
about the cost of prescription medications?
The cost of prescription medications is the patient’s
responsibility.
v
What if I
need to see a specialist?
Referrals to specialists for further evaluation can be discussed
with your physician and together you can decide the course of action.
v
What
about other services such as specialist care, x-rays, and hospitalizations?
In-office lab work such as urinalysis, strep test, and
pregnancy tests will not incur any charges, labs sent out of the office will
incur a separate charge. However,
services such as x-rays and some vaccinations can be obtained from outside
laboratories and will not be covered by the monthly fee. Prescriptions, services provided by
specialists, and hospitalization expenses will not be covered.
v
Will the
physician see my family?
Yes. At Family Health
Connections, we believe in taking care of the family/ household and all members
of the family are seen by our physicians and nurse practitioner.
Superficial Comparison of Direct Primary Care Sites
Qliance
|
Health
Access RI
|
Medlion
|
Physician
Care Direct
|
Family
Health Connections, Inc. NEW
|
|
What/cost
|
Level 1: $59-89/mo
Level 2: $ 54-129/mo
Level 3: $ 60-169/mo
Registration: $ 99
Copay: $0
|
$25/mo
Exam: $0-10
Sick: $0-10
|
Adult: $59/mo
Seniors: $39/mo
Child: $19/mo
Visit: $ 10
|
Copay: $20
Adults: $ 49/mo
|
Adult: $60/mo
Child: $50/mo
Infant: $60/mo
Enrollment: $40-80
Copay: $20
|
What/ outside services
|
On-site dispensary for prescription medication
|
Affiliation with labs, radiology, women’s care, drug discount card
|
Partners with labs, imaging, and specialists
|
Partners with medical supply and labs.
|
Lab relationship
Massage therapy
Behavioral Therapy
|
Who
|
Anyone with or without insurance, no Medicaid/ Medicare patients
|
Differs by practice, no Medicaid/ Medicare patients
|
Anyone with or without insurance, no Medicaid/ Medicare patients
|
Anyone with or without insurance, no Medicaid/ Medicare patients
|
People without insurance, no Medicaid/ Medicare patients
|
Where
|
Seattle, WA
|
RI
|
Various in CA, WA, FL, OR
|
CA, GA, NC, NE, NJ, TX, VA, WA
|
Dayton, OH
|
When
|
Weekdays and weekends
|
Differs by practice
|
Depends on practice
|
Depends on practice
|
Weekdays and Saturdays
|
Why
|
Shorter wait times, longer appointments, lower cost
|
Direct access to care
|
Because everyone deserves healthcare
|
Spend quality time with physician
|
Offer affordable medical care to the uninsured
|
How
|
Appointments, phone consultation, email
|
Contact participating practice for specifics
|
Contact participating practice for specifics
|
Access card plan, bundled services for primary care available through
participating practices
|
Appointments, physician on-call 24/7 (as with other family medicine
practices)
|
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