Wednesday, December 14, 2016

Direct practices lose 3 percent of patients statewide

Each year, the OIC reports to the Legislature on the status of direct health care practices in Washington state. In a direct health care practice, a health care provider charges a patient a set monthly fee for all primary care services provided in the office, regardless of the number of visits. No insurance plan is involved, although patients may have separate insurance coverage for more costly medical services. Direct practices are sometimes marketed as “retainer” or “concierge” practices.

The December 2016 report contains data from July 1, 2014 through June 30, 2016, two fiscal years’ worth of information.

Some highlights from this year’s report, as of June 30:
  • There were approximately 11,272 direct-practice patients in Washington, a 3 percent drop from fiscal year 2015. That figure represents .016 percent of the state’s population. 
  • There were 30 practices in the state. Two new practices opened in Battle Ground and Edmonds. Five clinics in Seattle, Richland, Spokane and Colville reported they no longer participate in direct practices. 
  • Monthly fees at direct practices ranged from $25 to more than $1,082. The average monthly fee weighted by the number of patients was $154.65, a 15 percent increase from fiscal year 2015.
  • The OIC received no consumer complaints regarding direct patient practices. 
The Affordable Care Act requires consumers to purchase a health insurance plan or pay a tax penalty. Direct practices do not meet the requirements of the ACA and therefore do not qualify as a health insurance plan. That may explain why the number of consumers who purchase direct practice plans has dropped since 2014. However, the incoming federal administration has vowed to alter the ACA, which may drive more consumers to direct practices for primary care. At this point, it’s too soon to tell.

View the full report.