The first things you need to do to start a direct care practice

The number of direct care practices is growing, as more independent physicians decide to return to the concept of patients paying their physicians directly for their care, with no insurance involved. The direct care model has helped strengthen the relationship between patients and physicians, allowing physicians more control over their patient panel sizes, practice staffing, and care delivery.

For physicians, adopting a direct care model can improve work-life balance, reduce practice overhead, bring higher per patient revenues, and maintain physician autonomy. Starting a direct care practice involves research and preparation, to ensure that the independent physician is providing the quality of care patients expect in a manner that optimizes the practice for success.

The first step for the independent physician is to learn as much as possible about the structure and management of a direct care practice. Resources such as DPC Frontier and Elation Health’s Direct Care Resources abound for the independent physician who wants to learn more. The independent physician should also:

• Make sure the direct care practice is viable. Budgeting for a practice that runs on patient membership fees instead of relying on insurance reimbursements can be a challenge.
• Plan the practice structure, including pricing for membership fees, office location, and a name for the practice. Basic business items such as determining the legal formation of the practice and writing a detailed business plan will help the independent physician prepare for success.
• Research and adhere to the legalities of running a direct care practice. There are a number of legal considerations involved, including deciding whether to opt out of Medicare for older patients, complying with applicable regulations, hiring a lawyer, and securing malpractice insurance.
• Market the practice to existing and potential clients. For the independent physician currently operating in a traditional practice, transitioning to a direct care practice will require educating patients on the change and reaching out to a new client base to build the practice.
• Implement technology, including electronic health records (EHRs). A direct care practice has to operate efficiently. Technology that enables secure patient communication, ease of patient data input and review, and coordination with specialty physicians is key to starting a direct care practice designed for success.