Over the past few years, there have been numerous trends in the health industry. One trend that doesn’t seem to be getting as much attention is the shift in the healthcare payment models.
Traditional practices that used to be dominant, like the fee-for-service, are now becoming less prominent. After all, this payment model incentivizes the strategy of boosting a patient’s medical bills by increasing the number of visits. Simply put, it’s a model that doesn’t have the patient’s needs in mind. Naturally, consumers will look for other payment models that can solve this issue, and subscription-based healthcare seems to be the best possible answer at the moment.
A Breakdown Of Subscription-Based Healthcare
Subscription-based healthcare is basically a healthcare model where patients must pay a fixed amount every month, quarter, or year. That payment will cover all the services the medical practitioner may have to render. These include tests, visits, and other more intensive services and offerings. There are several ways to opt for this payment model, but the most common approach is to find physicians with the help of Community Healthcare Partners (CHPs).
Right away, you can imagine the potential benefits this can bring to consumers such as yourself, and it indeed has numerous benefits. With that said, let’s take a look at some of these benefits.
Pros Of Subscription-Based Healthcare
The Services Are More Accessible
Perhaps the most apparent benefit of subscription-based healthcare is that you’re able to visit your provider at your own convenience. That means no more waiting in line at the office for several hours or waiting for weeks to receive a response to your appointment. That’s because primary care physicians in traditional practices often handle 1,200 to 2,000 patients. Meanwhile, a direct care physician (those assigned to subscription-based healthcare) handles 200 to 600 patients.
That means they receive fewer calls, so they’re more likely to answer your calls promptly. In addition, direct care physicians (DCPs) tend to give their telephone line number to patients.
If you have their phone number, you can easily contact them to ask questions about your health. These calls or consultations may help increase your knowledge of common medical issues.
It’s also particularly useful to people who have trouble visiting the doctor, like elderly people. You can also schedule visits quickly, though you must keep in mind that there’s a limit to the number of visits per month. It depends entirely on the provider or your subscription, but this limit mostly prevents patients from scheduling visits for even the most minor health issues.
You Can Finally Pay Attention To Preventive Care
Not many people are willing to schedule an appointment with a doctor and pay hundreds of dollars for an illness they may not have. However, that doesn’t mean it’s not an important practice. It’s what experts call preventive care, and it’s when you take steps to prevent or detect a major medical problem before it becomes severe. Examples of preventive care services include annual checkups, mammograms for women, colonoscopies, vaccination, and flu shots.
Granted that some of these are not available for free if you opt for subscription-based healthcare, but your payments should cover checkups and monitoring. Not to mention, your insurance provider is more likely to cover preventive services like colonoscopy if your DCP is in-network.
For your reference, when a healthcare provider is in-network, that means they accept payments from insurance. So, they may charge you less and get the remaining payment for the specialized services (services not covered in the subscription payments) from the insurance company. To sum it up, with subscription-based healthcare, you have more access to preventive care services.
Patient Care Tends To Be Higher Quality
One of the bad habits of healthcare providers is focusing on quantity over quality. As stated earlier, in a fee-for-service model, medical practitioners receive payment for every service they render to patients. That’s why they tend to render as many services to as many patients. They do this since they won’t have a constant stream of income to maintain their annual salary.
Hence, popular medical practitioners tend to have a lot of patients in line, and they only spend a couple of minutes with each one. The most you can spend with them is 15 minutes.
For most people, that’s not enough time to discuss the details of your medical concern. The good news is that it only applies to fee-for-service and similar payment models. That’s not the case with subscription-based healthcare. Since they receive payments from patients monthly, the healthcare provider doesn’t have to worry about having a stable source of income.
As a result, they become more eager to spend time actually caring about the patient’s health needs. But as always, it depends on the provider, but that’s where another pro comes into play.
It’s Easy To Opt In Or Opt Out
You could always opt out if you didn’t like your first few months or weeks with the DCP. It’s as easy as how you opted in. Of course, you wouldn’t need to do that if you took your time looking for the best DCP in the first place. Still, it helps since it would also encourage the provider to ensure the best quality service and care. After all, since opting out is rather quick and easy, they can lose patients as quickly as they got them, so they have more reasons to step up their game.
You’ll Often Need Specialist Referrals From Your Direct Care Provider
Though it’s not common, it’s also not impossible to receive a diagnosis from your DCP that you have a serious illness. If you have yet to receive a diagnosis, then perhaps you just suspect it.
Either way, if the illness is outside of your provider’s expertise, you’ll need the help of a specialist. In that case, you need a referral—a letter from a doctor that asks for a specialist’s treatment or diagnosis. The issue here is that not every doctor can and would give you a referral.
They must either know enough about your condition or they have a close doctor-patient relationship with you. Thankfully, that’s exactly what subscription-based healthcare is all about.
If you have a DCP, you wouldn’t have to worry about getting a specialist referral. It becomes even more appealing once you realize that most insurance companies won’t cover specialist services unless you get a referral first. Simply put, subscription-based healthcare can help you get specialist referrals more easily, making it easier to get your insurance provider to cover the service. The DCP can also help coordinate your visit to the specialist.
It’s Generally More Cost-Efficient
The monthly fee for subscription-based healthcare is typically around USD$100. That covers all or most of the services of the direct care provider. These include routine monitoring, regular checkups, comprehensive care, consultations, and tests. Urgent care and specialized services are often not included, but those are things most people rarely need. The lower costs are often associated with the lack of insurance from this payment model, which takes us to the next section.
Cons Of Subscription-Based Healthcare
There’s A Lack Of Insurance Coverage
Health insurance typically covers urgent care for catastrophic events like car accidents and specialized treatments for major medical problems. That’s why it makes sense for subscription-based payment healthcare services from direct care providers to lack insurance coverage. The payment model only covers minor issues like consultations, tests, and checkups.
For this reason, experts would often advise patients of DCPs to pair their medical subscriptions with either a health savings account (HSA) or a high deductible health plan (HDHP).
You Must Have A Constant Stream Of Income
Since you’ll have to pay premiums on your insurance monthly, you must have a constant stream of income if you want to add another monthly expense. This applies to you even if you’re not particularly prone to medical issues. You still need to make the monthly payments even if you haven’t made a call with your direct care provider. That’s perhaps one of the biggest advantages of fee-for-service over the subscription-based healthcare payment model.
It’s Not Suitable For People With Major Health Issues
As stated earlier, subscription-based healthcare models with direct care providers mainly consist of routine monitoring and checkups. That means if you’re someone with major or complex health issues, you won’t benefit as much. The services you most likely need are probably not covered by the subscription payments. The subscription-based healthcare payment model is catered specifically to those who are generally healthy with only minor health issues.
The subscription-based healthcare payment model definitely has better fanfare than traditional payment models like fee-for-service. Hence, it makes sense why you’d prefer it over others.
However, one must keep in mind that there are numerous payment models for a reason—every model caters to different healthcare needs. Just because subscription-based healthcare worked for others doesn’t mean it’ll work for you. That’s why it goes a long way to know the pros and cons of subscription-based healthcare so you can make your own decision, hence this guide.