Innovative model offers cost-effective way to get healthcare services.
NFIB-Backed Direct Primary Care Bill Awaits Governor’s Signature
The Virginia insurance industry isn’t happy about a new model that patients can use to obtain primary care from doctors, but for consumers and small business owners, this healthcare innovation could be a game-changer.
The model is called direct primary care, and it’s essentially a healthcare subscription model: People would pay primary care doctors a monthly fee to get an agreed-upon set of healthcare services in return. With direct primary care, doctors could also contact directly with employers to provide primary care services to their employees.
Legislation that protects the direct primary care model passed both the House and the Senate and now awaits the governor’s signature. Gov. McAuliffe has 30 days from March 11 to sign, veto or amend the bill. If he does nothing, the bill becomes law.
House Bill 685 makes it clear that direct primary care agreements are not insurance and that the state’s insurance laws do not apply to them. Therefore, the Daily Press reports, the agreements can’t be regulated by the state and don’t require licenses to sell. They will also come with disclaimers stating that patients should buy insurance for services that aren’t provided by the primary care doctor and that the agreement alone won’t meet the Affordable Care Act’s insurance requirement.
However, with the combination of a major medical policy and a direct primary care agreement, employers can satisfy the ACA’s employer mandate while saving thousands of dollars per month and still providing cost-effective healthcare to employees and their families.
The bill also states that patients can terminate agreements at will and get back any money paid in advance, and doctor offices may not bill insurance companies for any services performed that are covered under the agreement.