Virtual Direct Primary Care vs Telemedicine: What Employers Need to Know
Michelle* stood outside the emergency room. The pain in her lower abdomen was getting worse. She didn’t want to wait several hours or pay the high co-pay, but wasn’t sure what else to do. Then she remembered that she’d recently enrolled in a virtual direct primary care program through her workplace. The program gave her access to a primary care doctor via phone, text, email or video chat.
She called and was able to speak to the direct primary care doctor immediately. He reviewed Michelle’s medical profile already on file and talked with her about her symptoms. After determining she had a severe bladder infection that required some testing, the doctor took a look at her employer-sponsored health plan. He gave her the address of an in-network urgent care clinic just a few miles from where she was. Michelle got the care she needed at a lower out-of-pocket cost — and her employer paid around $250 instead of an estimated $4,000.
If you’re thinking, “that sounds like telemedicine,” you wouldn’t be alone. But there are big differences between virtual direct primary care and telemedicine that employers looking for a way to provide high-quality yet less expensive health care need to understand.
Advantages of Virtual Direct Primary Care
Employees have access to their primary care doctor instead of “a” primary care doctor.
In telemedicine, the patient contacts an anonymous bank of doctors. The doctor next in queue assesses the patient through a series of questions and provides a treatment recommendation or prescription. That information is sent to the patient’s named primary care doctor. The next time the patient calls in, they’ll get a different doctor and the get-to-know you process begins again.
With virtual direct primary care, patients connect with the same primary care doctor every time — their doctor. A doctor who knows their complete medical history and understands their unique health concerns. When Michelle next uses her virtual direct primary care program, the same doctor who guided her to the urgent care clinic will be waiting to treat her. A relationship has been established. Not only will that give Michelle a better experience, many studies show that continuity of care reduces health care complications and lowers health care costs.
Virtual direct primary care doctors work to reduce unnecessary spending.
Telemedicine doctors write prescriptions and provide treatment advice. What they don’t do is help the patient compare treatment options or find the best-priced care available within a patient’s healthcare plan. Virtual direct primary care doctors aren’t tied to insurance companies or part of a publicly traded company. Instead, their biggest incentive comes from providing conservative, evidence-based patient care because they’re directly accountable to you.
They partner with you to understand your plan design and pharmacy benefits. They work to ensure that tests aren’t duplicated, prescriptions are managed cost-effectively and that specialist visits are more efficient or avoided altogether — potentially saving you tens of thousands of dollars for a single employee.
Cost-saving chronic disease management is part of the package.
Both telemedicine doctors and virtual direct primary care doctors can treat acute health care problems, such as coughs, sore throats, allergies, rash, joint pain and headaches. But telemedicine doctors don’t provide ongoing treatment for patients already diagnosed with a chronic disease. And effectively managing chronic diseases is one of the biggest returns on investment that virtual direct primary care offers.
Take Linda*, who suffers from a lung condition called chronic obstructive pulmonary disease. Linda called her virtual direct primary care doctor because she was having more difficulty catching her breath than usual. She wondered if she should go to the emergency room. The doctor, who’d treated Linda’s condition for the past year, spoke with her at length and determined that a more precise and proper use of medication could reduce her breathlessness. He now monitors her virtually twice a day via text – at no additional charge to her or her employer – to make sure that her breathing is under control. Thousands of dollars are being saved in avoidable hospital, emergency room and specialist fees.
Comprehensive care is unlimited and prepaid.
The fact that there are no extra fees for Linda’s highly personalized care is a direct result of the affordable direct primary care model. Regardless of whether the program an employer chooses is virtual or brick-and-mortar, unlimited contact with the doctor is prepaid at a set amount. While there are many different telemedicine payment models, a common one has employers paying a one-time joining fee as well as a monthly flat fee. In addition, employees pay a fee each time they access their acute-care-only telemedicine program.
And while largely thought of as an inexpensive way to reduce employer healthcare costs, telemedicine may not be that cost-effective after all, according to a 2017 study in the journal Health Affairs. The study suggests that while telemedicine may increase access to physicians, it doesn’t necessarily reduce healthcare spending. The researchers noted that a single telehealth visit for a respiratory illness costs less than an in-person visit, but often results in more follow-up appointments, lab tests and prescriptions — all costly elements that a virtual direct primary care program can help manage and mitigate.
“Wellcare” gives you yet another way to protect your employees and your bottom line.
Comprehensive and cost-effective healthcare means treating the cause of a disease as well as its symptoms. If a patient calls in because of high blood pressure issues caused by obesity, a telemedicine doctor may only prescribe a medication to lower blood pressure. A virtual primary care doctor can go a big step further and design a personalized wellness program designed to get the patient off costly medication and prevent bigger, more expensive health problems down the road.
That’s a cost-saving strategy that can really add up, considering that 22 percent of health care expenses are related to modifiable risk factors such as depression, high blood sugar, high blood pressure and obesity.
Is Virtual Direct Primary Care Right for Your Company?
There’s only one way to find out. MyMD Connect, a coalition of DPC doctors that work together to provide virtual direct primary care to businesses that have employees spread across Texas or the nation. Contact us at to learn more about the benefits of direct primary care and we’ll figure out if the program is right for your employees.
*Stories based on real patients. Names changed to protect their privacy.