Leveraging Analytics for Employer-Focused Growth in Direct Primary Care

Leveraging Analytics for Employer-Focused Growth in Direct Primary Care

Primary Care Physicians from any delivery system look to achieve the Quadruple Aim of healthcare; improve patient outcomes, improve the patient experience, improve the clinician experience, and provide care at a lower cost that is both fair to the patient and sustainable to the practice. Direct Primary Care (DPC) physicians and practices are no different, and pride themselves on being able to achieve the Quadruple Aim of healthcare at a greater level compared to traditional fee-for-service models.1

Although DPC practices are growing at a rapid rate, from 429 practices in March, 2016, to now 898 in September, 2018 (47% increase per year)2, one of the largest challenges these practices can still face is bringing in more clients willing to switch from their traditional fee-for-service, insurance-based plans to the subscription-based plans offered through DPC. One of the key markets, then, for DPC practices to offer services to are local employers. If a DPC practice can provide evidence that their plan and service delivery model is better for the overall health outcomes and cost of an organization and its employees, the practice can acquire a large number of new patients and revenue in a relatively short amount of time.

Some components of DPC are easy to sell to employers, and are supported through existing research:

  • Increased access to care; whether via in-person appointment, text, email, phone, or virtual visit, DPC practitioners are often available to patients in more ways and for more hours throughout the day, with fewer limits on how often a patient can see their physician3
  • More face-to-face time with physicians; around 35 minutes per visit compared to 8-20 minutes in traditional fee-for-service models4
  • Reduced ER visits, inpatient days, and expensive specialist visits5
  • Reduced medical costs and prescription costs for both employers and patients3,5

That said, employers are still looking for more, asking “What will adding a DPC plan do for our organization in the next year,” often offering DPC practices access to historical claims data for review and assessment. Unfortunately, due to limitations in time, knowledge, or skill-sets required to analyze an employer’s prescription and medical claims data, DPC practices may not be able to gather sufficient evidence or proof that their service plan is one that employers should add to their benefits options, which can hinder the growth and sustainability of a DPC practice.

However, KPI Ninja can bridge this gap by assisting DPC practices and physicians build quality- and cost-related reports that provide evidence of their plans’ potential benefit to employers. Through KPI Ninja’s Employer Claims Analysis, DPC practices receive succinct yet detailed reports describing the patient population, including demographics, diagnoses, service types, and chronic conditions, their potential impact on PCP access, patient utilization, prescriptions, and, of course, a thoroughly detailed Total Savings Opportunity report. KPI Ninja works with each DPC to ensure the report is personalized to each practice’s services and rates, and includes any additional metrics or components requested. By leveraging KPI Ninja’s analytics capabilities and the information provided in these reports, DPC practices are better prepared and able to provide strong justification to potential employers.

Through the Employer Claims Analysis, KPI Ninja has assisted numerous DPC practices secure new employers. Interested in learning how we can help your practice? Contact info@kpininja.com.

 

References

  1. DPC Coalition. https://www.dpcare.org/. Accessed September 7, 2018
  2. Eskew P, DPC Frontier. DPC Mapper. http://www.dpcfrontier.com/mapper. Accessed September 7, 2018.
  3. Katherine Restrepo & Julie Tisdale, “Direct Primary Care for Local Governments.” John Lock. December 2, 2016. https://www.johnlocke.org/research/direct-primary-care-for-local-governments/
  4. Philip M. Eskew, & Kathleen Klink, “Direct Primary Care: Practice Distribution and Cost Across the Nation.” Journal of the American Board of Family Medicine. November-December 2015. 28:793-801 http://jabfm.org/content/28/6/793.full.pdf+html
  5. “QLIANCE: New Primary Care Model Delivers 20 Percent Lower Overall Healthcare Costs, Increases Patient Satisfaction, and Delivers Better Care.” The Direct Primary Care Journal. January 15, 2015. https://directprimarycare.com/2015/01/15/qliance-new-primary-care-model-delivers-20-percent-lower-overall-healthcare-costs-increases-patient-satisfaction-and-delivers-better-care/

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