FREE GUIDE:
Demystifying Healthcare Costs: Understanding What You’re Paying For
Healthcare and insurance billing can be complex and expensive, often leaving people confused about the true cost of their care.
Your guide to the direct primary care model, it’s benefits, and why you should choose Summit Medical Specialists.
Direct Primary Care (DPC) is an innovative alternative payment model improving access to high-functioning health care with a simple, flat, affordable membership fee. No fee-for-service payments for things like blood draws, skin biopsies, follow up visits, and urgent care visits. No third party billing. The best part of DPC for our patients is the long-lasting and trusting relationship between us and our patients. Our patients have unrestricted access to their providers, little or no wait time, and longer appointments to discuss their health concerns.
We feel that Direct Primary Care is the way that medicine should be practiced. I worked in large healthcare groups for many years and became increasingly more frustrated and unhappy with my practice. I was spending less time with patients and more time on my computer. I decided to switch gears 9 years ago and joined a unique practice where local employers paid the physicians directly to care for their employees. I have expanded this model to offer this service to all members in my community. There are so many examples as to why this practice is so satisfying for me. I am able to treat my patients for anything from tick bites, to elevation sickness to ear infections without sending them to Urgent Care, even when they are out of town. Recently I had a patient with a painful and itchy rash on their arm. They sent me a picture Saturday morning, I diagnosed Shingles and started them on an antiviral medication immediately and helped them manage their pain.
If you are frustrated with the current healthcare system like I was and are interested in learning more about DPC, please contact us for more information.
-Dr. Jean Ibric
The monthly membership fee covers the Direct Primary Care services including all office visits, procedures, access to same day/next day visits, 30-60 minute appointments, and the options to call, email, text, or video with your provider. Approximately 80% of all healthcare is done by primary care providers. Visits to specialists, surgeries, hospitalizations, and prescriptions are not included in the monthly fee. To prevent facing these high medical costs, DPC is often paired with high deductible health plans (HDHP) with low premiums, catastrophic plans, self-funded plans, or health share funds.
How many times have you been sick and didn’t go to the doctor because it cost too much and was inconvenient? I am definitely guilty of this and will only seek help if I am desperate because an office visit with my doctor costs over $100 and urgent care over $300 on top of the monthly insurance premium I am already paying. With our DPC model, patients can be seen for visits, call or text whenever they want with no extra charge. I believe your health is too important to be based on how much it costs, what the co-pay would be, and how much work or school will I have to miss?
I don’t want to just see you at your worst, but also your best! I want you to visit us, call us, text us, ask us questions. Our primary goal is to get you healthy and keep you healthy!
-Lauren Talatzko PA-C
Direct Primary Care has the potential to drastically reduce costs while simultaneously improving the quality of care. We are asked the question, “I already have good insurance, why should I also pay for Direct Primary Care?” We refer to this as the “Good Insurance Fallacy”. Here is an example of a patient who saved money with DPC and their insurance.
Bob is a 50-year-old who has Diabetes and over one year had pneumonia and chest pain.
If Bob used his “bronze” insurance plan without DPC, his annual visit and labs, quarterly diabetic visits and labs, medications, and flu shot cost him $2,890 out of pocket.
His initial pneumonia visit, medication, and follow-up visit cost him $752 out of pocket.
Bob’s chest pain visit and follow-up visit was $715 out of pocket.
Totaling $4,357 out of pocket for the year with insurance and no DPC.
If Bob used his “bronze” insurance plan with DPC, his membership cost, labs, follow-up visits, medications, and flu shot would cost him $1,324 for the year.
His initial and follow-up visit for pneumonia was included in the DPC membership.
Bob’s chest pain visit, labs, and follow-up visit cost $11.63 out of pocket.
Totaling $143.63 out of pocket for the year with insurance and DPC.
Bob saved $4,213.37 for the year by paying a $100/month DPC membership and utilizing his “bronze” insurance plan!
Bob was seen immediately by his care team before anything got worse, appropriate tests were ordered, and all follow-up visits was included in his membership
Whether the patient perceives it or not, they do pay for their care even with insurance. It’s just obscured in a complex maze of taxes, premiums, deferred wages, and direct costs. The money flows from the patient to these third parties (government, hospitals, and insurance companies) who then shuffle the money around, take a big cut for themselves at each step, and put their own stipulations on how the care can be provided. How many times have you been told a procedure or medication recommended by your provider was not covered by insurance? When the provider is being paid by the third parties, their attention is on completing the paperwork to justify the procedure or medication and not on the doctor-patient relationship.
Even a healthy person with a sore throat can save over $1,000 in healthcare costs per year with Direct Primary Care.
Any questions? Contact us!
Choosing a primary care physician is an important decision. Meet with Dr. Jean Ibric and Lauren Talatzko PA-C for a complimentary visit to make sure Summit Medical Specialists is the right fit for you and to learn more about our approach to wellness and medical care.
Demystifying Healthcare Costs: Understanding What You’re Paying For
Healthcare and insurance billing can be complex and expensive, often leaving people confused about the true cost of their care.