Sun Sentinel Palm Beach Edition
Health care options
Direct Primary Care aims to streamline services.
What if you could pay for access to primary care physicians with a flat monthly fee, similar to how you pay for access to a health club?
Like a gym membership, your primary care membership would entitle you to a menu of services while freeing you from the headaches of long waiting room stays, co-pays, deductibles, pre-approvals, and authorization codes associated with the traditional “fee for service” health care model.
Under the radar, a concept known as “Direct Primary Care” is slowly finding favor among patients and physicians alike.
“It works best for people who want a personal relationship with their physician,” said Dr. Oscar Hernandez, founder of a small practice in Miami-Dade County called MetroMed — one of only two Direct Primary Care practices in the tri-county region. “If they’re happy with a cattle-car environment, go for it. We offer an oldfashioned country doctor-type relationship.”
Working with just one other physician and two nurse practitioners, Hernandez has signed up 150 Direct Primary Care patients who pay monthly fees starting at $80 for individuals up to $120 for families of four. Members get office visits for $10 and most diagnostic services, such as xrays, PAP smears and EKGs, for $25 to $50.
But Floridians might start seeing the concept expand, if proponents succeed in making it easier to offer Direct Primary Care in Florida. They’re promoting legislative bills that would define what Direct Primary Care is, and protect physicians who adopt the model from oversight by the state Office of Insurance Regulation.
Similar legislation failed to get through the committee process in 2015 and 2016.
This year’s bills are the focus of workshops Tuesday and Wednesday at the state capitol in Tallahassee. The Senate Committee on Banking and Insurance will hear presentations on the issue Tuesday at 10 a.m. and the House Insurance and Banking Subcommittee meets on the topic Wednesday at 3:30 p.m.
Sponsors hope to rally support early, and the Florida Medical Association has made adoption one of its top priorities for the session that begins March 7.
The bill’s Senate sponsor, Tom Lee, RBrandon, said that state leaders, including Gov. Scott, want “to create additional options to drive down the cost of health care, and to make the system more flexible.”
“We think this is a good year to get it done,” said Jeff Scott, general counsel of the Florida Medical Association.
The bills include protections for physicians and patients, including requiring that primary care agreements be in writing, signed by both patients and providers, allow either party to terminate the agreement by giving at least 30 days advance notice, and state that the agreement is not health insurance and that providers will not file claims against the patient’s health insurance policy.
Agreements would also spell out what services would be provided for the monthly fees — which typically range from $50 to $100 a month for adult members — and which services would require additional fees.