What is Direct Care?

Direct Care is a medical practice model where providers contract directly with patients. For almost all of America’s history, Americans paid their doctors directly for care. It was only in the 20th century that health insurance outpaced out-of-pocket pay as the primary revenue source for medical practices. 

The complexities of contracting with insurers have tremendously increased healthcare costs for patients and placed more demands on physicians in recent years. This direct care payment model has helped strengthen the relationship between patients and physicians in many communities, allowing physicians more control over their patient panel sizes, practice staffing, and care delivery.

For patients, direct care can mean a greater degree of access to, and time with, physicians. Improved communication and more regular, engaged care leads to fewer unnecessary tests, less frequent hospital visits, and lower total cost of care.

Direct care providers generally function outside the traditional insurance system. Thus in direct care, patients or employers pay fees directly to practices. This medical practice model means that physician contracts are not with insurers but directly with patients or with businesses as a benefit for employees, which can result in large savings for employers.  Good examples of direct care practices who utilize this model are Nextera Healthcare and Palmetto Health, both of whom provide care directly to consumers and sponsored employees.

The Direct Care model will continue to see enormous growth as Americans recognize that it can offer a better, more efficient way to deliver more patient-centric healthcare.