The state of primary care in the U.S. has grown increasingly complex. According to research published in the American Journal of Managed Care, coverage under the Affordable Care Act (ACA) has caused an uptick in patients receiving primary preventative care from 59 percent to 73 percent.
While this is certainly a positive trend in lowering cost barriers for individuals who need to see a doctor, challenges still remain. Self-employed individuals looking for Texas primary care coverage must often dedicate significant time researching plans on the exchange, some of which include hidden costs and high copays. We look at the state of Texas Primary Care and how self-employed people can choose the best plan for their needs.
In general, primary care is a term that refers to day-to-day or routine healthcare offered by a healthcare provider. A primary care physician is typically the first point of contact and primary point of continuing care. Where patients need specialized services, they often first meet with their primary care physician who can then refer to and coordinate with a specialist.
Primary care is important because it creates better health outcomes and lower spending overall. According to the American Academy of Family Physicians (AAFP), primary care shifts the focus back to patient-centered care. In fact, the AAFP notes that increasing one primary care doctor per 10,000 people can:
Primary care is an essential component in the healthcare system, though the focus of primary care has shifted. In Texas, there are groups that are advocating for more patient-centered primary care initiatives. One of these groups is the Patient-Centered Primary Care Collaborative (PCPCC), a not-for-profit group that was founded in 2006. Its primary care-focused goals include providing better care, enabling better health, lowering costs, and ensuring greater joy for providers who deliver care.
While more people have access to primary care under the ACA, the US is facing a shortage of doctors. New data from the Association of American Medical Colleges (AAMC) shows that the U.S. could experience a shortage of up to 120,000 physicians by 2030.
The traditional primary care model already has doctors seeing as many patients as possible, leaving many patients feeling rushed. Doctors beholden to the rules of big health insurance companies face a substantial amount of paperwork, patient quotas, and red tape, making it difficult to focus where it matters: on the patient.
The increasing requirements of the government and added administrative work like record-keeping, data submission, and claims have made primary care expensive and the delivery of care has suffered. As a result, many primary care physicians are switching to a direct primary care (DPC) model that allows them to focus more on their patients.
DPC removes the unnecessary middlemen from the equation and centers solely on fostering the doctor-patient relationship. In lieu of fee-for-service insurance billing, the patients are charged a fee (either monthly, quarterly, or annually). The fee covers primary care services like routine checkups, clinical services, lab work, consultations, and care coordination and management.
DPC offers substantial benefits to patients by providing increased savings and better access to their primary care doctor. Physicians are able to spend more time with each patient and provide a more holistic care. Since the payment is tied to a fee that covers all primary care services, doctors are incentivized to provide the best care possible, reducing the number of times a patient must see them in order to reduce costs. It’s a simplified revenue model that can lower practice overhead and reduce time spent on administrative tasks. Those benefits translate to better patient care and a lower cost to the patient.
While improved access to primary care is a great stride, other things do come up. In addition to choosing DPC practices, many patients choose to carry a high-deductible or catastrophic policy to ensure coverage in case of emergencies.
Finding health insurance if your self-employed doesn’t have to be a burden ...anymore. Decent realized that health insurance for the self-employed was a major problem, so we decided to solve it. We offer a Pathfinder bronze plan and a Trailblazer silver plan specifically designed for freelancers and other people who work for themselves.
Since we understand the importance of an affordable Texas primary care plan, we also wrap DPC into both our plans at no cost to the insured. That means members can access their direct primary care (DPC) doctor as much as needed with $0 out-of-pocket costs. No fee-for-service. No third party billing. Just better access to high-functioning healthcare.
Our members gets unlimited, extended monthly visits with the same doctor, with no extra charges or hidden fees. Access care via same or next-day appointments, telemedicine (video calls), and 24/7 phone, texting, and email support. If your primary care doctor isn’t already a part of our network, just send us their contact info and we’ll do our best to get them into our network.
We believe in the importance of the doctor-patient relationship. Get your free quote today to see if one of our plans might be right for you.