New Study: Home Visit Doctors Reduce Emergency Room Visits
By over 40 percent — and could lower your health-care bills, too.
August 18, 2020, 12:02 AM
Have you visited an emergency room lately? They’re
practically empty thanks
to the COVID-19 pandemic, even
though people aren’t any healthier. In fact, America may see an increase in
deaths related to strokes, heart attacks, and other critical issues because of
missed emergency care.
It doesn’t have to be this way. A new study shows that you can avoid
the emergency room without risking your health by using primary care
doctors who don’t take insurance, are incentivized to get you
healthier, and charge far less than insurance-based doctors.
The model is called Direct Primary Care (DPC), the study comes from
the Society of Actuaries, and the results are stunning. DPC
patients went to the emergency room 40 percent less than
traditionally insured people, sought medical care 12 percent less
often, and saw their doctor either from home or after spending just
four minutes in the waiting room. Doctors often visited patients at
their homes after scheduling a same-day appointment.
Avoiding the emergency room for the right reasons means real
differences for Americans and their families. The UnitedHealth
Group estimates that
an ER visit is 12 times as expensive as an average primary care
physician visit and 10 times more expensive than an urgent care
visit. The group also estimates that two-thirds of insured Americans
who go to the ER don’t need to – which means 18 million people could
save $32 billion in unnecessary spending, almost $1,800 per
The study found that DPC doctors spend an average of 38 minutes with
patients — not the 14 minutes most primary care physicians spend —
because they only have one-quarter of the patients. Text messaging
between doctors and patients was common, as were home visits. Fully
88 percent of doctors provide telemedicine and other additional
services at no cost.The DPC model gets these results by creating the
right incentives for everyone involved in the continuity of care.
Patients pay a monthly membership fee and see a price list for
additional care options like X-rays provided by their doctors, so
they know exactly how much their care costs and what’s included.
Doctors are paid by results, not per service provided, so they are
incentivized to provide true preventive care.
All of it is meant to create a true patient–physician relationship —
and it works. Even though the study found that most DPC doctors make
less than their insurance-based counterparts, they were happier and
felt that they were back to practicing real medicine. And patients
spent less time traveling to and from appointments without
sacrificing their health.
The study did find that since most DPC doctors require a small
up-front fee, there was a 1.3 percent increase in initial costs to
get on the patient rolls. My patients view this as an investment in
their future because emergency room visits are obscenely expensive —
avoiding the emergency room and seeking less care overall far
outweighs these small initial fees. And during the coronavirus
pandemic, avoiding busy waiting rooms and receiving
high-quality care is like getting a Jaguar for the price of a used
Emergency room prices
have skyrocketed in recent decades, putting patients in the
position of paying
too much and doctors in the position of working too long. Many
efforts have been made to fix this, such as Oregon’s 2008 Medicaid
expansion. Unfortunately, that experiment led to more
people going to the ER because they didn’t have a trusted PCP.
The solution to getting Americans great preventive care is
high-quality, personalized attention. This is what is provided by
DPC doctors like me, and the Society of Actuaries proved that it
works. There’s no need to have worse care because of the pandemic.
You can save money, spend more time with your loved ones, and be
healthier simply by finding the right doctor for your needs.
Dr. Josh Umbehr is a
board-certified Family Physician and the Founder of Atlas MD, a
Direct Primary Care medical practice.