Study Conducted By the Society of Actuaries | Released May 19, 2020
- Date Published: May 2020
The Society of Actuaries (SOA) commissioned Milliman to develop this report to provide health care stakeholders (patients, payers, policymakers and actuaries) with a comprehensive description of Direct Primary Care (DPC) as well as an objective actuarial evaluation of certain claims made about the DPC model of care.
Our friends at The DPC Coalition pulled out some relevant data points that jumped out:
Virtual Care and Telehealth are at the core of DPC service offerings:
- 99% of all DPC practices surveyed were doing virtual consults via text/phone as a part of the membership fee (two years prior to COVID-19).
- 88% said they provided “telemedicine” benefits (meaning expanded video or additional digital communications assets).
Enrollment in DPC is associated with a reduction in overall member demand for health care services outside primary care:
- DPC members had 19.90% lower claim costs for employers on an unadjusted basis and 12.64% lower claim costs on a risk-adjusted basis during the two-year period.
- DPC members experienced approximately 40% fewer ER visits that those in traditional plans.
- DPC members experienced a 53.6% reduction in ER claims cost.
- DPC members experienced 25.54% lower hospital admissions. (This number may be statistically small but verifies the downward trend)
DPC is Affordable Primary Care
- The average adult monthly DPC Fee is $73.92. (DPC fees are paid on a monthly subscription basis).
- The median age for DPC patient was 31.8 years old, v. 36.1 for traditional insured (PPO). The survey finds the member mix did not vary materially between the DPC option and traditional option.
Questions Or Comments?
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Session 116: Health Research Update
This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes. Research … Research, Patient Centered Medical Homes, Direct Primary Care, Health Care Cost & Utilization Trends, Characteristics …
- Authors: Fritz Busch, Dustin Grzeskowiak, Achilles M Natsis , Casey Hammer
- Date: Feb 2020
- Competency: External Forces & Industry Knowledge
- Topics: Health & Disability; Health & Disability>Health insurance
Categories: Editor's Picks