How employers could use Direct For many large companies, they're the Primary Care… Business Insider ones ultimately paying out their employees' claims. Insurance companies are there in the middle to Direct Primary Care is a small but fast- handle the logistics of getting the growing movement of doctors who don't claim from one place to another, accept insurance and instead charge a which means you might not realize monthly membership fee. At a time when your employer's footing the entire bill many are feeling pressure from high on the other end. healthcare costs, direct primary-care models can be a cheaper alternative that "I tell people, JPMorgan Chase already offers perks like quick access to doctors buys a $1.5 billion of medical, and we and sometimes wholesale prices on self-insure," JPMorgan CEO Jamie medications or lab tests. Dimon told Business Insider. It's why his company, along with and And it could be a model employers — , two other massive including JPMorgan, Amazon, and self-insured employers, are looking for Berkshire Hathaway, who on new options through a healthcare Wednesday picked Dr. Atul Gawande venture. On Wednesday, the trio tapped to lead their new healthcare venture — surgeon and professor Dr. Atul Gawande could tap into as a way of lowering to be CEO of the new venture, which will costs. be based in . "Think of this, we're already the insurance company, we're A new kind of doctor's office that charges already making these decisions, and we a monthly fee and doesn't take insurance simply want do a better job," Dimon said. has been spreading around the US. The practices are part of a movement known Finding ways to "do a better job" could as direct primary care. Instead of mean a number of things, from accepting insurance for routine visits and leveraging the number of people they drugs, these practices charge a monthly cover to negotiate lower rates, to digging membership fee — often between $50 in and upending the way healthcare's and $150 a month — that covers most of done entirely. what the average patient needs, including visits and drugs at much lower And it's possible Direct Primary Care prices. The movement's been gaining could be a consideration. Amazon chief momentum at a time when high- was an investor in Qliance, a deductible health plans are on the rise. Direct Primary Care system based in Washington state that got its start in 2007 In most cases, the practices recruit and closed in 2017. Amazon in January patients on an individual or on a family- also reportedly hired a doctor who had by-family basis. But often, employers run Iora Health's Seattle practices. who cover their employees’ healthcare "They certainly know who they have here have turned to practices as well. in the community to tap into," Qliance cofounder Dr. Erika Bliss said.

The potential for employers to tap adding in an employer who covers the into Direct Primary Care cost adds a middlemen that complicates the simplicity and the motivation of the Here's how that might look: An employer direct primary care arrangement. could cover the monthly direct primary For example, if an employer is covering care fee — either directly to the practice the monthly fee, there might be less or as a reimbursement to the employer — incentive to actually use it since it's not or cover a certain amount. The direct coming out of your own pocket. If too primary care practice could be heavily many members of a direct primary care involved in that process or relatively practice come from one employer or hands-off. another, that could make the practice too For the majority of the practices Business dependent on the employer's business. Insider spoke with, employers make up a Should the employer shut down or go small portion of their business. Often, a another direction with healthcare, that relationship with an employer was could be detrimental to the practice. The sparked by someone who first came to same goes for if the employer decides to the practice for their family's healthcare pay less because of how many members and decided they want their part-time or the employer's sending a particular full-time employees to have the service doctor's way. as well. Bliss, who now runs a practice called The direct primary care practices could Equinox Primary Care, sees the benefit be located within the community or of incorporating direct primary care into a housed on-site at the company's offices. better health plan for employers working For example, Dr. Kim Corba, who runs the best not through on-site clinics, but Green Hills Direct Family Care in instead by tapping into existing practices Allentown, Pennsylvania said she's been and potentially helping other practices asked to set up a clinic situated between get off the ground. "In a perfect world, two employers to cover their needs. they would see this as an opportunity to strengthen primary care in all the Carolyn Long Engelhard, a public-health communities where they exist by asking expert and professor at the University of for and paying for this kind of primary Virginia School of Medicine — who has care," Bliss said. But that won't be easy her concerns about Direct Primary Care to get to. "The challenge is going to be and its lack of connectivity to the larger them having the imagination and the guts healthcare system — said that this is one to include that in their portfolio." area where she could see direct primary care thrive because it'd be attached to Lydia Ramsey Jun. 21, 2018, 7:38 AM employer-funded plans.

While some doctors are excited about the premise of employers getting more invested in direct primary care, not everyone's on board.

Dr. Vance Lassey, who runs Holton Direct Care in Holton, Kansas, told Business Insider that he has exactly one person whose direct primary care is covered by their employer. To him,