Picture this: you are officially fed up and done with the inconvenience and mediocre patient care that traditional, insurance-based healthcare offers.
You start looking into retainer medicine arrangements, such as concierge medicine and direct primary care (DPC). You want to understand how retainer fees in direct primary care work. In that case, you have come to the right place.
This blog post gives you a lowdown on DPC membership benefits, how the DPC retainer fee structure works, as well as what patients can expect from retainer-based healthcare.
Unlike the traditional, fee-for-service model where patients pay for each individual service via a combination of copays, deductibles, and coinsurance, retainer fees in direct primary care are a recurring monthly or annual payment.
In retainer-based healthcare, all transactions are settled exclusively between doctor and patient. No third parties are involved, making coordination much easier and more streamlined.
In exchange for retainer fees in direct primary care, patients receive comprehensive, personalized care that is unprecedented in American healthcare.
Direct Primary Care (DPC) retainer fees typically include unlimited appointments, 24/7 physician access, standard specialist referrals, low-cost procedures, and discounted lab work.
Retainer fees in direct primary care is reminiscent of a subscription service, much like how your Netflix or Apple Music subscription works.
Most DPC practices now offer tier pricing to better accommodate patients from all walks of life, each with health requirements that are unique to their own.
According to the John Locke Foundation, direct primary care (DPC) retainer fees range from $25 to $125.
While the comprehensiveness of services may vary depending on what kind of DPC retainer a patient subscribes to and what a DPC practice is able to offer, most membership fees in DPC cover a set of standard services.
If you are wondering what services are included in a primary care retainer fee, here is a detailed scenario.
For instance, a patient joins a retainer-based healthcare arrangement and pays for a $75 subscription. In exchange for this fee, the patient gains access to the following retainer-based primary care services:
One of many great things about retainer fees in direct primary care is that patients have unlimited access to these DPC membership benefits, without accumulating additional costs or copays.
As for what is included in a DPC retainer fee, retainer-based healthcare is quickly growing to be a preferred option among patients due to several important benefits:
Physicians in DPC and concierge medicine are also the conductor in each patient’s medical orchestra. They take the lead in coordinating care across specialties, ensuring that all treatments and medication prescribed are in harmony and in sync.
A study by the Peter G. Peterson Foundation in 2020 shows that traditional healthcare in America spends over $1,000 per person on administrative costs.
That is higher than what it spends on preventive care at $973, and five times more than the average administrative spend of other countries like France, Switzerland, and Germany.
With administrative tasks out of the equation in retainer fees in direct primary care, patients and their physicians can fully focus on long-term health and wellness.
Significant medical savings: If you are thinking, “how do retainer fees compare to traditional healthcare costs”, subscribing to a DPC practice can be a great investment
With traditional insurance plans at $328 per month, direct primary care retainer fee costs save patients as much as $190 a month.
This is compared to membership fees in DPC at $25-$125 a month, plus a barebone premium for a high-deductible plan at about $110.
Apart from savings in retainer fees in direct primary care, patients accrue long-term savings as well via discounted lab work and medication at wholesale cost.
Read more about: What is Direct Primary Care (DPC)?
By weighing the pros and cons of retainer fees in primary care, this side-by-side comparison can help you make an informed decision about whether this model is right for you.
Ultimately, the decision to invest in retainer fees in direct primary care depends on your individual needs and priorities.
|
Pros |
Cons |
|
Reliable personalized medicine costs: You know exactly how much you need to pay each month or year. |
Out-of-pocket expenses: Patients may still incur additional expenses for services not covered by their retainer fees in direct primary care. |
|
Comprehensive care: Direct Primary Care (DPC) retainer fees cover a range of primary care services, including routine check-ups, sick visits, and lab tests. |
In-patient services not included: While retainer fees in direct primary care cover comprehensive primary care services, DPC subscriptions do not cover emergency care, in-patient treatments, and hospitalization. |
|
Personalized attention: Smaller patient panels allow for more personalized care and attention. |
Limited provider options: While retainer-based healthcare is quickly becoming the preferred patient arrangement, not all health providers offer this benefit universally across the U.S. at the moment. |
|
Reduced administrative burden: Patients avoid dealing with insurance claims, copays, and other administrative tasks. |
No insurance coverage: Retainer fees are typically not covered by insurance, so patients must pay out-of-pocket |
|
Improved health outcomes: Because of its focus on preventive care and better doctor-patient relationships, primary care retainer fees lead to improved health outcomes and patient satisfaction. |
Because retainer fees in direct primary care are classified as an expense related to ‘health provider access’ and not a ‘medical service’, HSA/FSA typically does not cover DPC retainer fees.
The good news here is there is a way to work around this arrangement. Many concierge medicine clinics are able to restructure—in many instances, rename—the retainer fees in direct primary care.
This is done so that the DPC retainer fee structure covers annual physical or blood tests or other necessary tests. In this manner, patients are able to use their HSA/FSA to pay the primary care retainer fees.
Make sure to bring this up with your DPC or concierge medicine provider to see if this is an arrangement they can do for you.
More importantly, legislation updates in Washington, D.C. are underway, which might allow patients to use their HSA/FSA to pay the retainer fees in direct primary care without having to undergo any prior arrangements.
Yes, DPC subscriptions offer a range of payment schemes and subscription packages based on your financial budget and health requirements. Some clinics even offer a discount on yearly subscriptions.
Yes, primary care retainer fees do not usually cover the following services: medication, diagnostics (blood tests and imaging), ER visits, hospitalizations, and consultant visits and related procedures, like colonoscopies, etc.
Yes, DPC doctors charge a retainer fee in exchange for a set of services. Most practices offer scale pricing wherein you get to choose the DPC subscription that works best for your budget and health requirements.
It is crucial to partner retainer-based healthcare with a high-deductible insurance plan or healthshare plan. One does not replace the other. DPC will take care of routine health while insurance will cover ER visits, hospitalizations, and other in-patient services.
Primary care retainer fees for individuals are a key component in direct pay models. The DPC retainer fee structure offers patients a unique approach to healthcare that emphasizes comprehensive, personalized care.
While there are benefits and drawbacks to consider, many patients find that primary care membership models provide a more dependable, cost-effective, and patient-centered version of healthcare.
If you are considering investing in retainer fees in direct primary care, be sure to do your research, ask questions, and carefully review the terms of the retainer fee.
With the right DPC practice and the right mindset, you can take control of your health and take advantage of the benefits of retainer-based healthcare.
Previous Post
