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Why All Self-Funded Employers Should Integrate Direct Primary Care in their Benefits

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Why All Self-Funded Employers Should Integrate Direct Primary Care in their Benefits

The sometimes-unpredictable cost of claims accrued over the business year is a huge consideration for self-funded employers. To account for this unpredictability, many self-funded employers have stop-loss coverage. You can make healthcare spend more predictable when you eliminate an entire category of claims.

Self-funding is the option for many employers because it benefits their bottom line. Instead of a guaranteed expensive insurance pay, you bet on saving money when you pay for the claims directly. It’s an even better wager if you integrate Direct Primary Care (DPC) in your offerings.


Self-funded employers become more competitive in the labor market with Direct Primary Care.

DPC offers more affordable healthcare and also guarantees employees better healthcare access. And the real kicker is that it’s unlimited, too. There’s typically an increase employee satisfaction with their health benefits when DPC is integrated.

They’re also more productive – they can text, call or video chat with their provider anytime from anywhere. That means instead of taking PTO when they have a concern, they can first text their provider to see if they can get their question answered or get the proper prescription that way. They’ll decide with their provider – with a same or next-day appointment – if it’s more serious and they need to come in.

Yes, employees more productive and happier when they have an option for Direct Primary Care. Let’s get back to cost savings and predictability for employers.


Self-funded employers can eliminate an entire category of claims with Direct Primary Care.

Direct Primary Care is a healthcare membership. In the membership, patients contract directly with their provider for a low, flat, monthly fee for access. In the traditional insurance fee-for-service world, resources may be wasted, and patients can be nickeled-and-dimed. In DPC, patients have unlimited access to their provider. The membership covers most of their healthcare needs.

For an employer, this eliminates 100% of primary care claims for exchange of the predictable monthly fee. Urgent care claims can significantly decrease, too.

When we actually encourage patients to see their provider often, they develop better relationships with them. All because their access is unlimited. This access allows the provider a deeper understanding of the patient’s history, genetics, lifestyle and more. The main focus becomes prevention and lifestyle change, versus a 10-minute appointment and quick prescription write-up.

This means a significant increase in long-term health, not only managing but reversing chronic conditions, and an overall, long-term decrease in healthcare costs (for you and them).

And, through Direct Primary Care, patients often get access to negotiated cash prices for services like imaging, labs, tests and even specialists. The prices are usually a fraction of what they could get it for with insurance.

DPC requires no copays and patients don’t work to meet a deductible for primary care.


How to encourage employees to opt-into your high deductible health plan.

Those who are proponents of Direct Primary Care believe that insurance shouldn’t be involved in every healthcare transaction. Taking insurance out of primary care saves money, decreases paperwork, and fosters patient-provider relationships. That applies to the self-funded high-deductible option you provide, too.

Direct Primary Care works best with a wrap-around high deductible health plan (HDHP). Consider the Direct Primary Care as the everyday health “coverage.” Paired with DPC, the high deductible health plan acts as catastrophic coverage – something you hope they won’t ever have to use. When employees understand that Direct Primary Care saves them money and gives them more convenience, they’re going to choose it. And since you’ve paired DPC with a HDHP, that means they’re opting into the HDHP, which saves you money, too.


Start with an employee education program.

As aforementioned, employee education is extremely important for uptake and success in a DPC program. It’s hard to dump that on HR, so it’s a great idea to partner with a DPC organization that can handle the administration services, too.

That should include employee education and enrollment, payment processing, hotlines to answer questions, key performance indicator (also written as KPI, measures success in particular activities) reporting and analytics, and more. You also need to choose a DPC organization with experience, a wide network of providers, and relationships with specialists and imaging services to get the best cash prices.

You might consider partnering with Strada Healthcare, the Nebraska-based national leader in Direct Primary Care, with affiliated clinics across the country. Learn more about how we help businesses succeed in their health offerings here.