Direct primary care grows in the Lake Travis area

Direct primary care is a growing health care business model, including in the Lake Travis-Westlake area.

Direct primary care is a growing health care business model, including in the Lake Travis-Westlake area.

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A health care model sometimes described as “a gym membership to your doctor” is growing in the Lake Travis area, according to local medical practices and insurance brokers.

Direct primary care is an alternative to the traditional insurance billing model that allows patients to pay a monthly, quarterly or annual fee for primary care services and negotiated rates on laboratory tests and prescriptions.

Proponents of the model, which include the American Academy of Family Physicians, describe it as a meaningful alternative to fee-for-service insurance billing that covers most primary care services, and benefits include coverage of clinical and lab tests, as well as a system that eliminates oversight from administrators that are nonmedical.

“It’s about having a more meaningful relationship between the patient and doctor and moving away from a third party that is trying to tell the doctor how to treat the patient,” said Neer Patel, medical practice manager for DirectMed in Bee Cave, which offers direct primary care.

DirectMed works with individuals, families and about five businesses in the Lake Travis area, according to Patel. He said he believes the direct primary care trend will grow exponentially in Austin and across the country.

“It doesn’t make any sense to file insurance claims every time you need primary care,” Patel said. “It’s like an oil change—you don’t file an insurance claim every time you need an oil change.”

Angel Saucedo, an Austin-based benefits consultant with AG Insurance who brokers packages that include direct primary care, said there is increasing interest in the insurance alternative.

“It’s a trend that is growing, so we’re seeing that in the Lakeway area,” he said. “It’s really about transparency, understanding where that cost is going and taking control of it.”

Saucedo said direct primary care packages are more popular with small businesses and companies in the trade and service industries, but he believes larger companies will soon follow suit.

Direct primary care can also come with limitations. According to information from the Medical Group Management Association, some of the model’s disadvantages include a lack of coverage for hospital stays and specialists, as well as the possibility of limited access due to physicians with DPC practices seeing fewer patients.

But for Mark Crowell, owner of LT Plumbing in Lakeway, the benefits outweigh the limitations. Crowell said he began offering a direct primary care option for his employees more than two years ago in addition to traditional insurance and catastrophe plans.

“Insurance these days is very expensive, and we are a small- to medium-sized company. [Direct primary care] is way more affordable,” he said.

Crowell said about half of his 22 employees participate in the program and have shared positive feedback about the personalized attention and opportunities for telemedicine and remote care available through the direct primary care plan.

“Knowing you have a doctor on call and you can call her and she returns your calls quickly—they love it,” he said.