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Ashley PoynterDec 4, 20205 min read

Secret sauce part I: making health insurance affordable with free primary care

Updated: Dec 8, 2020

We’re finally doing it. After some debate, we’ve decided to release the special ingredients to our secret sauce. We started out offering health insurance plans in Austin in 2019 and have expanded throughout Texas over the last year. At every step along the way, we’ve made sure to keep the good health of our members top-of-mind. Wondering what makes Decent health insurance so affordable? Read on.

For starters, we have re-imagined health insurance from the bottom up to provide the most comprehensive, affordable, and ACA-compliant plans to those who might not ordinarily be able to access them. Our revolutionary structure allows us to offer small businesses and the self employed comprehensive plans at prices closer to those previously only enjoyed by large self-funded company plans.

We know that small businesses rely on affordable, tax-advantaged health insurance. Not only does it help to protect their employees, but it also helps to safeguard their own future. Great health insurance options allow businesses to attract and retain talent while simultaneously protecting employees from exorbitant out of pocket medical costs.

The reality is that more than half of Americans work for a small business or themselves. Decent is here to make sure they have the affordable care options they need to keep the American economy in motion.

Direct Primary Care keeps costs in check

Part of how we do that is by offering free primary care. We’ve centered all our plans around Direct Primary Care (DPC) because your health insurance coverage should not dictate your health care decisions. Healthcare decisions should be between you and your doctor. Decent is here to support that model with Direct Primary Care options that are designed to keep your staff healthier than they’ve ever been.

The DPC model eliminates the old fee-for-service model that required co-pays for patients to see their primary care physician (in addition to any costs of treatment that occurred during the visit, depending on the specifics of the patient’s health plan). The old way of doing things meant that physicians were reimbursed by insurance companies based on the number of services the physician provided. This incentivizes doctors on the wrong things; rather than focusing on providing the best care that minimizes the frequency of visits to a doctor or specialist, doctors were focused on quotas and squeezing in as many patient visits as possible.

On top of the bad incentives, the experience on the patient end was wanting. Patients were often left to their own devices when it came to coordinating care with multiple doctors and specialists. Under the fee-for-service model, doctors don’t really have a reason to help coordinate patient care along the way (and often lack the technology to do it, even if they did). This led to a less-than-ideal experience for patients -- and an expensive one.

This terrible experience with standard primary care physicians has led to a lot of people skipping them entirely. One of the major cost centers in modern insurance is people using the urgent care and emergency room for issues that primary care is intended to catch early, minimize, or treat in their entirety. This is a huge, huge cost center for health insurance plans everywhere simply because when people need help, their first instinct is no longer to see their doctor.

Fast-forward to the way Decent does things with DPC. With our model, members have free primary care included in their plans. With a traditional DPC subscription, patients pay a monthly flat fee around $50 to $150 to access a wide array of services through their primary care doctor. With Decent plans, we wrap that fee right into your monthly premium. This means that the curated network of doctors that participate in our plans are incentivized to keep you in good health -- and your costs in check.

Even where a referral to a specialist is required, it’s in your primary care doctor’s best interest to set you up for a good outcome because it ultimately keeps their costs lower. At the end of the day, this aligns doctors’ and patients’ interests, facilitating a positive relationship between the two (while drastically cutting down the amount of time these doctors have to spend on paperwork, so they spend more with their patients).

Why is DPC so rad?

DPC is rad because you never have to pay anything out of pocket to see your doctor. You have 24/7 access to your primary care physician -- whether you prefer to see them in-person or remotely. Better yet, you’ll have access to half-hour-long, same-day appointments.

The best part? You have an ongoing, positive relationship with your doctor. If you need to talk to them or see them, they make time that day. Gone are the days of waiting weeks for an opening only to sit in a waiting room longer than you actually get to talk to your doctor. With DPC, your doctor greets you in the waiting room and meets with you for at least a half an hour to listen to your needs and concerns. Then, you make a plan to address those needs and concerns together.

If you’re ready to see what all the excitement around Decent’s DPC-centered small business plans is all about, get your free quote today.