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Direct Primary Care vs Advanced Primary Care: What’s The Difference?

June 5th, 2023 | 4 min. read

By Everside Health

nurse taking blood pressure of patient sitting in a chair

Healthcare costs will rise in the future because of several factors. Is your organization shocked by the ongoing increases in healthcare costs? You can start now to seek ways to provide high-quality care while keeping your budget in mind. In this day and age, managing the expense of offering quality medical coverage can seem daunting. Enter the Direct Primary Care (DPC) and Advanced Primary Care (APC) models, which are changing the face of healthcare as we know it.What’s the difference between DPC and APC? Is one better suited than the other for your organization? In short, Direct Primary Care is a healthcare model that allows patients to pay providers directly, eliminating the insurance middle-person. Advanced Primary Care, which builds on the foundation of DPC, provides deeper analytics, population health management, and reporting to better help organizations reduce the total cost of healthcare while improving health outcomes.

Still unsure about the differences? We’re exploring in-depth comparisons of Advanced Primary Care vs Direct Primary Care, highlighting their differences and benefits as strategies to reduce healthcare costs. Keep reading to find out which option will best fit your organizational needs.

What is Direct Primary Care?

DPC is an alternative method of healthcare delivery where patients or employers pay providers directly for primary care services. DPC is based on a monthly or annual membership fee that covers primary care needs including office visits, preventive screenings, and oftentimes discounted lab tests. 

By eliminating fee-for-service healthcare, the DPC approach lets providers concentrate on giving top-notch care instead of handling administrative tasks related to insurance billing.

The DPC model can effectively reduce the expenses associated with more conventional healthcare options. 

Essentially, DPC offers a convenient, superior patient and provider experience. 

What is Advanced Primary Care?

APC builds on the foundation of DPC, combining the best of the provider-patient relationship and building on top of it with advanced technology and data-driven insights. APC uses evidence-based practices, predictive patient care, population health management, and claims-based analysis and targeting to optimize patient outcomes and reduce an organization’s healthcare spend. 

APC can often support up to 90% of a patient’s healthcare needs in the primary care setting.  The model, like DPC,  gives patients more time with providers and greater access to resources like virtual healthcare visits (telehealth). In addition, it also encourages seamless digital communication of providers and patients between visits. Patient engagement is driven by segment and clinical quality metrics to drive desired health outcomes, improving health and saving money. 

Organizations searching for ways to offer workers better access to healthcare or lower costs may find the answer in Advanced Primary Care. APC often produces better patient outcomes, lower spend for both organization and worker, and superb patient satisfaction, making it a win-win on many levels.

What are the benefits of Direct Primary Care?

The Direct Primary Care model offers several potential advantages over traditional healthcare for patients, including:

    • Smaller patient panels so patients have more time to spend with their personal doctor 

    • Improved continuity of care and health outcomes as patients establish long-term relationships with a personal doctor

    • Increased flexibility when scheduling appointments

    • Greater convenience with same- or next-day appointments for urgent issues

    • Higher patient satisfaction

DPC, while sometimes offered by organizations, is more of a direct-to-consumer model.

What are the benefits of Advanced Primary Care?

Advanced Primary Care is a transformative healthcare model that builds on the concept of DPC. Offering Advanced Primary Care has become increasingly popular over the last few years. As of mid-2022, researchers estimated that new care models (like APC) would capture up to 30% of the US Market by 2030.

With DPC, there is typically a single primary care practice or smaller regional footprint, whereas APC can provide greater national coverage with bricks and mortar and virtual offerings. 

APC has broader, more scalable offerings for organizations including tech-driven analytics, predictive modeling, and insightful reporting, combined with the deeply personal provider-patient relationship. 

By providing access to a complete primary care solution, Advanced Primary Care can reduce costs associated with traditional organization-sponsored health benefits while improving overall patient outcomes. Other benefits include:

    • Increased productivity

    • More targeted, data-driven healthcare strategy 

    • Organizational savings resulting from risk stratification and population health-focused care delivery

Comparing DPC v APC

No fee-for-service model X X
Per member per month (PMPM) pricing structure   X X
Comprehensive primary care services at an affordable price point  X X
No insurance premiums and little to no co-pays X X
Unlimited office visits, same- or next-day appointments, extended appointment times, 24/7 access to provider via phone or email, discounted lab test & medication costs X X
Smaller patient panel so providers have more time to spend with patients  X X
High ROI X
Integrated model of healthcare with additional analytics and reporting    X
Advanced technology and analytics tools to guide and stratify care    X
Deep focus on population health    X
Targeted, data-driven patient engagement and education   X
Insightful reporting for organizations   X

Which is better for your organization?

Both models of healthcare delivery offer organizations distinct benefits. When considering which is suitable for your needs, look at both short- and long-term costs to see how each model fits into your overall benefits strategy. 

There are clear advantages to Direct Primary Care, from cost savings to improved access to strengthened patient-doctor bonds. However, Advanced Primary Care offers a more robust solution that builds on the doctor-patient relationship including population health management, advanced analytics and reporting to drive actionable insights and predictive analytics from aggregated data. The technological and data insights offered through APC are unparalleled when it comes to ensuring the best, most proactive care possible. 

Ultimately, both models can provide cost savings for organizations, but the best option depends on your specific needs.

Understand the power of Advanced Primary Care in your organization

With healthcare costs rising and budgets decreasing, reducing the cost of healthcare is a critical effort organizations struggle to manage. Fortunately, there are options. Choosing between DPC and APC should come down to what works best for your organization’s budget and goals in terms of providing quality healthcare coverage to your workforce. Contact us today to learn more about how Advanced Primary Care could impact yours. 

Advanced Primary Care: A quick overview ebook