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Direct Contracting for Direct Primary Care
Direct Primary Care (DPC) represents a healthcare delivery model where employers contract directly with local primary care providers to deliver comprehensive primary care services at a predictable, flat monthly rate. This approach bypasses traditional insurance for primary care visits, creating a more streamlined and cost-effective healthcare experience for employees.
How Direct Contracting Works
In a direct contracting arrangement, employers pay a fixed monthly fee per employee for comprehensive primary care services. Employees access their assigned primary care provider with no co-pays, no deductibles, and no insurance claims for primary care visits.
This model creates a direct relationship between the employer, employees, and healthcare providers, eliminating administrative complexity and reducing overall healthcare costs while improving access to care.
Key Benefits for Employers
Predictable Costs
Fixed monthly per-member fees create budget certainty and eliminate surprise healthcare expenses for primary care services.
Improved Access
Employees receive same-day or next-day appointments when health issues arise, reducing emergency room visits and urgent care needs.
No Administrative Burden
Direct relationships eliminate claims processing, pre-authorizations, and insurance paperwork for primary care.
Enhanced Recruitment & Retention
Comprehensive primary care access demonstrates employer commitment to employee health and wellbeing.
Preventive Focus
DPC model emphasizes preventive care and chronic disease management, improving long-term employee health outcomes.
Stronger Provider Relationships
Extended appointment times and continuity of care foster meaningful patient-provider relationships.
What DPC Typically Includes
Unlimited office visits
Same-day or next-day appointments
Extended appointment times
Direct communication with providers (phone, text, email)
Preventive care and wellness visits
Chronic disease management
Basic lab tests and procedures
Care coordination and referrals
Medication management
Annual physicals and health assessments
Implementation Considerations
Complementary to Major Medical: DPC works alongside traditional health insurance for hospital stays, specialist care, and other services outside primary care scope.
Geographic Availability: Consider provider availability in your area and whether services can accommodate remote or distributed workforces.
Employee Education: Successful implementation requires clear communication about how DPC works and its benefits to ensure employee adoption.
Contract Structure: Review contract terms carefully, including services covered, provider availability, and termination provisions.
Ready to Transform Your Employee Health Strategy?
Explore how Joyn Health can help you implement direct primary care, comprehensive wellness programs, and self-funded health plan strategies tailored to your organization.