Growing health care model skips past insurance, expanding in Tennessee

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Dr. Erin Chambers of Healing Hope Family Medicine in Erin, Tennessee opened a Direct Primary Care clinic to reduce paperwork and lower cost for patients.
Anyssa Roberts | USA TODAY NETWORK – Tennessee

Subscription model allows patients to work directly with doctors, leaving insurance for crisis situations.

After more than 10 years in outpatient medicine, Dr. Erin E. Chambers was burning out.

She was buried under mounds of paperwork, which took hours to complete, and she felt she needed to reevaluate how her role as a doctor fit with her role as a wife, mother and woman of faith.

In her search to balance her life, she discovered “direct primary care,” a medical model that’s revolutionizing the health care industry.

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research study. And clinics generally offer email, phone or online video visits. 

“DPC is for anyone who wants to have a good, strong relationship with their primary care provider,” said Alex Tolbert, founder of Bernard Health, a company that provides non-commissioned, expert advice on health care. 

How payments work

Currently, DPC fees cannot be paid by Medicare or Health Saving Accounts. All membership fees have to be paid out of pocket.

Last year, the Primary Care Enhancement Act of 2016 was introduced to allow such payments, and without a tax penalty.

Although all DPC clinics have a membership payment system, and additional costs for tests or medicine shouldn’t exceed the price of the membership fee, each clinic differs slightly in offerings.

Most DPC clinics do not offer hospitalization, surgery or pregnancy and delivery services; although a few do, said Dr. John Meigs, president of the American Association of Family Physicians.

People with chronic illnesses, such as hypertension and diabetes, still qualify for DPC clinic memberships. And using a DPC clinic could actually lower the cost of their prescription medications, Umbehr said.

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Dr. Erin E. Chambers checks patient Suzanne Hopkin’s eyes during an appointment on August 30, 2017. (Photo: Erica Brechtelsbauer/The Leaf-Chronicle)

He said insurance companies pay retail price for medicine through pharmacies, while doctors can buy wholesale and distribute at a lower cost. Some prescriptions will still need filling at a local pharmacy, but most DPC doctors can find a generic alternative, Meigs said.

Specialists and lab work are also generally outsourced, however, some clinics might arrange for discounted fees in exchange for on-site payment, he said.

It is still recommended that DPC patients have insurance for catastrophic events and services DPC clinics won’t cover, Meigs said, such as injuries that require emergency room treatment or severe illnesses.

The future of DPC

Many physicians and healthcare professionals are optimistic about the growth and expansion of DPC.

“Direct primary care is kind of going back to the doctor-patient relationship and putting that priority number one, and then your insurance companies — your third parties — are out of the picture,” Chambers said.

Healing Hope Family Medicine is accepting patients and has partnered with the HOPE Pregnancy Center in Clarksville to offer pregnancy counseling. Healing Hope will conduct a free pregnancy test for women without a membership.

For more on Healing Hope Family Medicine, go to www.healinghopefamilymedicine.com or call 931-289-4325.

To locate a DPC near you, go to www.dpcfrontier.com/mapper.

Visual Journalist Erica Brechtelsbauer contributed to this report. Reach regional features reporter Anyssa Roberts at 931-217-1827 or aroberts2@gannett.com.

Where are the DPCs?

DPC Frontier, a direct primary care advocacy group, lists “pure” DPCs in the following 16 Tennessee cities:

  • Chattanooga: 1
  • Erin: 1
  • Franklin: 2
  • Jackson: 1
  • Johnson City: 1
  • Kingsport: 1
  • Knoxville: 3
  • Lebanon: 1
  • Maryville: 1
  • Murfreesboro: 1
  • Pulaski: 1
  • Spring Hill: 2
     

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