The Augusta Metro Chamber of Commerce kicked off its 2025 Third Thursday series with a look at a different option for receiving health care.
Dr. Rob Lamberts of Welcome Health presented Cut Costs, Not Care, a way individuals can access healthcare, and business owners can provide benefits to employees.
Lamberts leads an Augusta area medical practice that provides what is called Direct Primary Care (DPC). It is a membership-based alternative payment model that uses a flat, monthly, or annual fee to access unlimited primary care and preventive services.
“There are three legs to the chair,” he explained. “The first is that it’s primary care, but it’s not specialty care, necessarily. It’s just primary care, family medicine, pediatrics, internal medicine, and a variation of those. Second is that it’s direct meaning we don’t accept money from insurance companies. We have taken away that insurance company layer. The third is that we’re paid on a monthly subscription basis, not by volume of patients.”
The Direct Primary Care Coalition (DPCC) says there are more than 2,300 practices in 48 states and Washington, D.C. caring for 30,000 patients. It is offered for individuals and with Medicare Advantage plans. It can also be offered as a benefit by employers to their employees.
“The DPCC believes Americans of all ages and incomes should have access to high functioning, affordable, comprehensive, accessible, personal primary care. We think a pivotal part of the effort to promote choice and competition is to place a greater emphasis on primary care and preventative services by putting patients back in control of their care with the assistance of a trusted personal primary care physician who knows the patient, and therefore can be that patient’s guide through the often complicated and expensive healthcare system,” the organization details on its website.
Lamberts said there are two types of employers who can benefit from offering a DPC to employees.
“Number one is those who do not offer health benefits to their employees. Smaller businesses, the ones under 50 employees, because the mandate goes 50 and higher you have to, by law,” he said. “Then there are those who do offer health benefits, but they’re trying to control the cost, and that’s not an easy thing to do.”
He added that offering a DPC plan can also help employers retain employees while attracting new hires.
Lamberts said using a DPC has several advantages for patients, including eliminating the need to deal with insurance companies for primary care doctor visits. It also means a layer of privacy for patients.
“Whatever happens in the office stays in the office,” he said. “So, insurance companies, if I code based on the complexity of care and how sick the person was, they can audit my charge. So, in other words, other people, including the government and insurance companies, have access to your medical record.”
Lamberts told his audience DPC should not be confused with concierge medical care. One of the largest differences is cost. Concierge medical care is more costly. Studies show it can have an annual retainer between $2,000 and $6,000. By comparison, Welcome Health month fee ranges between $50 to $90 a month, based on age. Concierge medicine is also paired with insurance and carries many of the same co-payment fees for services.
Learn more at https://welcomehealth.net/
