Earlier this year, the (Direct Primary Coalition) DPCC Steering Committee met on 2/26/2024 to discuss a number of issues, the most prominent of which was active legislation about DPC in Congress. This meeting was unique for DPCC because it was open to the entire DPC community, thanks to live streaming courtesy of Hint Health (as always, many thanks to Zak Holdsworth for his support of this movement since the early days of this movement). This was a big challenge for DPCC and certainly overdue, but it came together nicely. If any of you want to see the Livestream, it can be found at: http://tinyurl.com/DPCINDC. The meeting is about 2 hours long. If you are interested, I encourage you to listen to the whole meeting, but feel free to fast forward through parts that don’t excite you. I strongly encourage you to listen to Jay Keese’s discussion of the current politics affecting DPC. The efforts of all the DPC doctors in attendance and the hard work leading up to this session truly paid off. The week after our visit to Washington, the full House of Representatives passed H.R. 3836, the Medicaid Primary Care Enhancement Act in a rare bipartisan unanimous vote. I’ll discuss more about that bill below.
At that meeting, we were pleased to see a wide range of DPC believers:
Dave Chase (CEO of Health Rosetta) gave a quick summary of his longstanding relationship with DPC. Health Rosetta, in only 7 years, has positively affected the lives of roughly 10 million patients by offering employers access to Dave’s many years of study regarding the many workarounds in our healthcare system that actually improve care, lower cost and improve patient and physician experience in healthcare. He has written multiple books on healthcare subjects. Health Rosetta is the culmination of those efforts and is focused on revolutionizing self-insured employer benefits packages to include the most effective of these discoveries. His data has confirmed that DPC is the basic tool that allows many of the other strategies to work. He has also created his own army of health insurance brokers who have committed themselves to working only for employers and employees, NOT for the insurers whose products they sell.
Maryal Concepcion MD (Big Trees MD DPC from Arnold, CA, My DPC Story Podcast emcee and DPC’s nuclear energy source) was at the meeting advocating for a serious social media campaign to get the word out about what our doctors and DPC patients think about this movement. Accompanying her was Jeannine Rodems MD of Santa Cruz DPC.
Also present was Fritz Busch of Milliman. Milliman is a highly regarded consulting group known for unbiased research and reliable data evaluation. Fritz authored a report on DPC in May 2020. This report was requested by, and paid for by, the Society of Actuaries (NOT by any DPC organization). Milliman studied some of the effects of DPC on Primary Care Physicians and on measures of healthcare costs. This is some of the most solid and encouraging data we have seen about DPC. The report included a case study of a moderate sized employer with a DPC option in its benefits. If you want more information about it, please read at least the summary in the report: https://www.dpcare.org/actuaries-report . The good news from Fritz is that Milliman wants to do a much larger and more definitive evaluation of the capabilities of DPC as requested by the Society of Actuaries. These independent studies are critical to the success of DPC in the future and to make our case to those who doubt our motives and effectiveness.
Bethany Burke and Natalie Williams were there from AAFP. They are preparing for the upcoming DPC Summit – I hope you will all attend.
Front-line DPCs at the meeting:
- Matthew Haden MD – Modern Mobile Medicine in Washington DC (yes, he is DPC)
- Ricky Houg MD and Paul Yerkes MD – Core Family Practice (started 2016, with 5 physicians and 2 locations in Pennsylvania).
- Troy Burns MD (early adopter of DPC and author of “Medical Answers Now – How Direct Primary Care Guarantees Fast Access to Your Doctor”). He founded ProPartners Healthcare in 2001 in Overland Park, KS. He brought with him his most recent recruit Lincoln Andreasen DO who joined in September 2023, fresh out of the military and excited about DPC.
- Ben Aiken MD – Founder of Lantern Health in Asheville, NC. He is an innovator and has recently been working with Decent, a DPC friendly health plan that is trying to reduce healthcare costs by improving access to Primary Care (and particularly DPC).
- Tanner Moore MD – Recently started Clearwater Direct Primary Care in Port Liberty, NC – Directly after his military service.
- Michael Freedman MD – Evolve DPC in Annapolis and a longstanding supporter of DPCC.
Other Participants:
Mark Tamasulo DO – Founder and CEO of PeakMed DPC who sold his multiple DPC Colorado clinics to One Medical (as an effort to help both of these models scale) before it was acquired by Amazon, which also acquired Iora, also a real DPC design. Mark is a dyed in the wool DPC who is passionate about his current job as head of Direct Primary Care Strategy and Innovation at Amazon. He is also passionate about scaling DPC care, not to put you out of business, but to give medical students a reason to go into Family Medicine. For those of you who think he is a DINO, I suggest that you listen carefully to his remarks (1 hour and 2 min into our meeting). He oversees over 150 DPC practices and the care of 10s of thousands of patients.
Michelle Neblett – Government Affairs for Boeing. She has been working with the DPC Coalition for many years to solve our issues with the use of Health Savings Accounts (HSAs). Boeing discovered the benefits of DPC long ago. Boeing is a powerful partner with us in terms of making DPC available nationwide to their employees (and every other company that offers HSAs to employees). Boeing has employees in 50 states and wants to offer all of them DPC docs. Currently only those WITHOUT HSA plans can use DPC. They also know that employees with DPC docs are 56% more productive than those without DPC docs, which is pretty amazing.
Our Bills:
This year we are pitching 2 bills that would blow open access to DPC nationwide if passed:
- The Primary Care Enhancement Act H.R. 3029 and S. 628 – This would allow the more than half of all Americans currently enrolled in High Deductible Health Plans linked to Health Savings Accounts to also have a DPC doc. See the summary we have been sharing with Congress. This bill has already made it through the Ways and Means Committee but has yet to make it to a floor vote of the House. See a copy of our handout and a link to the bill itself below.
- The Medicaid Primary Care Enhancement Act H.R. 3836 – This would allow any state an opportunity to sit down with DPC doctors and devise a DPC agreement with those docs in their state without requiring a federal waiver from CMS. This bill does NOT require any changes in your practice, price or services. It only allows your state to consider using your services at a price you agree on without getting permission from the federal government. This bill could open opportunities for the roughly 78 million Medicaid enrollees to have a DPC doc. See a copy of our handout and a link to the bill itself below. The week after our visit to Washington, the full House of Representatives passed this bill in a rare bipartisan unanimous vote.
On the day after our meeting (and a great dinner at Bistro Bis in DC), we hit Capitol Hill for roughly 40 meetings with Senate and House offices. We focused this set of meetings on Congressional leaders who can put together the coalitions we need to pass the bills. Our bills are bipartisan, but there are still some potential blockades to success. We are currently considering strategies that would allow DPC docs to rally support from their patients to get final passage of the legislation. If any of you would consider helping us with this process, please let Jay Keese or me know.
Garrison Bliss MD
425-591-4775 Cell
[email protected]
Jay Keese
Capitol Advocates
Washington DC
202-624-1450
[email protected]