By Matt Kuhrt
Doctors who are frustrated by increased administrative overhead may find relief by providing services directly to patients, but they would be wise to proceed with caution, according to a position paper published in the Annals of Internal Medicine by the American College of Physicians.
The paper concerns itself with "direct patient contracting practices (DCPCs)," a catch-all term for the range of alternative medical practice models that offer services directly to patients either for direct payment or in some combination with administrative fees. Such practices include the concierge model, which has seen a recent boomlet in popularity, as FiercePracticeManagement has previously reported.
The attraction for physicians comes in the form of decreased administrative overhead, leading to more time spent one-on-one with patients. In theory that should mean better access and greater cost transparency for patients, but it's too early in the game to tell whether this will prove true in practice.
In particular, the overall impact on the quality, cost and access to care remains unknown, so it's possible that healthcare consumers who lack the ability to pay upfront fees or retainers would be disadvantaged by a move to this type of system.
For physicians considering a move to a direct-to-consumer model, the paper provides a set of practical recommendations, summarized in an announcement as follows:
- Ensure your practice is set up in a way that allows it to serve all in need without discrimination, keeping in mind how practices such as retainer fees may affect access to healthcare, particularly for patients with limited financial resources
- Be as transparent as possible with your patients in regard to the services you provide, applicable fees for those services and patients' payment obligations
- Before you change your practice model, consider the impact such a change might have on your current patient community, including those who might be forced to look elsewhere for their healthcare
- If you're considering a model that does not deal with healthcare insurance, be aware of the hardships this can present for your patients, and look for ways to reduce them
- Look to practice models that have proven successful at improving patient outcomes and lowering costs, such as patient-centered medical homes