Better Employee Health Benefits at a Lower Cost

Better Employee Health Benefits at a Lower Cost

The purpose of insurance is merely to protect us from low probability, high-cost events.

The Golden Rule of insurance admonishes that we should never use insurance to pay for things for which we can afford to pay ourselves.  The worst violation of this rule has been with health insurance.  The “greatest heist in American history,” as dubbed by Dave Chase, has been the fact that large insurers have duped employers for 70 years into paying them to pay their low-cost predictable claims.  Smart, forward-thinking employers are beginning to realize that they can’t actively manage their health benefits costs unless they follow the golden rule: pay for primary care directly; self-insure all the predictable, low-cost care; and use insurance only for its intended purpose, the high-cost care.

Enter Direct Primary Care (DPC).  In 2014 Dr. Eric Crall eliminated the insurance middleman between himself and his patients by adopting the direct primary care model: unlimited primary care for his patients for a low monthly membership fee, and no administrative burdens from dealing with insurance.  In 2016 he founded a community of DPC physicians throughout Florida to bring the same valuable primary care benefit to employers.  Persona Healthcare Direct has nearly 30 providers in Florida, allowing larger employers to leverage the model.   Employees get unlimited primary care, much of it virtually through phone or video, at no out-of-pocket cost to them, so they don’t delay seeking care for acute problems or put off care of chronic problems such as diabetes, hypertension, asthma, depression/anxiety, insomnia, obesity, or any other problems that constitute the 85-90% of problems that can be managed by a primary care physician.  

The employer truly gets happier, healthier employees and the overall costs of the plan go down by removing the barriers to primary care.  When employees are less likely to use urgent care, specialists or high-cost imaging, the cost of the plan is typically 20-40% less for the employees who have a DPC physician.  In addition, the DPC benefit can typically be added in a cost-neutral way.  Employers take the primary care costs out of the plan, pay for primary care directly, and actively prevent utilization of the most expensive care by encouraging the employees to see the DPC doctor whom they are already paying at a low monthly rate.   

Following the Golden Rule allows employers to have a simpler, cost-effective healthcare solution for their company. It empowers them to provide “coverage with care,” a health benefit their employees love because it actually benefits them. There are many DPC communities throughout the country that network with each other, so coverage with care is available to employers throughout the country today. 

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