By Jonathan Nelson
Direct primary care practices are cropping up across the country as physicians grow more frustrated by administrative burdens inherent in a fee-for-service third-party insurance market. But some regulatory obstacles block many people from joining DPC practices. The Direct Primary Care Coalition — of which TAFP is a steering committee member — has called on physicians to ask their representatives in Washington D.C. to sign on to federal legislation that would remove those obstacles.
In DPC practices, physicians charge patients a monthly, quarterly, or annual fee — like a retainer or membership fee — that covers a broad set of primary care services and patients typically enjoy greatly enhanced access to their physician. IRS rules interpret these DPC payments to be like paying premiums for health insurance rather than just a different way to purchase a set of services. Even though Texas and 17 other states have passed laws defining DPC arrangements to be outside of state insurance regulation, the IRS interpretation bars individuals with health savings accounts paired with high-deductible health plans from using their HSA funds to pay DPC fees.
Rep. Erik Paulsen, R-Minnesota, and Rep. Earl Blumenauer, D-Oregon, recently penned a letter to Congress asking members to sign on to their legislation, H.R. 365, the Primary Care Enhancement Act of 2017, which would permit individuals to pay for primary care service arrangement costs from their HSAs.
You can use AAFP’s Speak Out to contact your U.S. representative and ask him or her to sign on to the bill. Check out the Direct Primary Care Coalition site for more information and for talking points on the bill. And if you’re interested in learning more about DPC, AAFP has lots of information at www.aafp.org including a DPC Toolkit complete with a plan to convert your practice.