Post
Ashley PoynterJul 164 min read

How Does Texas Direct Primary Care Work?

Updated: Jul 16

We’ve written before about the movement behind Direct Primary Care (DPC). DPC focuses on the doctor-patient relationship and offers patients the option to get unlimited access to a doctor for a flat, monthly fee. This model upends the traditional fee-for-service model by injecting value into the healthcare system and incentivizing doctors to keep patients healthy (rather than incentivizing doctors to pack in as many patients as possible each day).

DPC is paving the way toward better healthcare quality and access while driving down administrative busy work and costs. Since patients simply pay a monthly fee, doctors no longer need to cut through the red tape of claims and insurance companies and mounds of paperwork. This frees doctors up to spend their time where it counts: with their patients.

Texas direct primary care will help self-employed people in the Lonestar state get access to more affordable primary care -- and build the foundation for a solid doctor-patient relationship.

Texas direct primary care: the history

President Obama signed The Medicare Access and CHIP Reauthorization Act, on April 16th of 2015. This act provided Medicare patients the option of DPC. Texas direct primary care became a reality on May 28th, 2015, when Texas became the 13th state to enact DPC legislation via House Bill 1945: "An Act Relating to the Provision of Direct Primary Care". When the governor signed this bill, Texas direct primary care became a reality and Texas residents (and physicians) had a new option in health care.

Why Texas direct primary care is important

The gig economy has taken off in the U.S., and Texas is a big part of that growth. A study by Fiverr and Rockbridge Associates notes that Dallas-Fort Worth (DFW) houses one of the biggest communities of skilled freelance workers in Texas -- and the country. According to the study, DFW has roughly 154,617 skilled freelancers. Those freelancers generated almost $6.38 billion in revenue in 2018 alone.

DFW isn’t the only Texas locale with a booming freelance workforce. Austin had about 67,044 skilled freelancers in 2018, who produced roughly $2.7 billion in revenue that year -- up 7.5% from the year prior. That would place Austin as the 18th locale across the country in terms of population and revenue of the skilled freelancer pool.

What does DPC have to do with that? A lot, actually. While the freelancer pool and gig economy has grown quite a bit across the nation over the past several years, these populations remain largely underrepresented when it comes to benefits that their self-employed counterparts enjoy. Health insurance is a big part of those benefits. Finding health insurance as a self-employed person is difficult. Finding affordable and comprehensive health insurance coverage is even harder. A DPC option means this vulnerable group can get access to better, less expensive care.

Texas direct primary care changes the game

With “normal” health insurance, freelancers must purchase a plan on the exchange and pay a slew of copays (and sometimes hidden costs) for everything under the sun. It can be tough to find in-network doctors that are a good fit. Even then, those doctors are bound by the rules of mega health insurance companies. They face patient quotas and loads of administrative tasks and paperwork. In short, it’s really hard for those doctors to spend quality time with patients. Both the patients and the doctors pay.

DPC changes the game because it supports the doctor-patient relationship. It takes the bureaucracy out of the equation and enables doctors to spend their time where it counts: with patients. It incentivizes doctors to offer value-driven care that keeps patients healthy. The old fee-for-service model only incentivizes doctors to see as many patients as possible.

Decent has mastered Texas direct primary care

At Decent, we knew the doctor-patient relationship would be central to our plans. We believe in this value so much that we’ve made primary care free with all our plans. That means that freelancers and self-employed people who sign up for one of our plans get personalized care with a primary care doctor at no out of pocket cost. Members can see their primary care physician as often as they’d like via same- or next-day appointments either in person or through virtual options.

We offer a large -- and always growing -- network, and we’ll also reach out to your current primary care doctor if they’re not already a part of our network. Just provide their contact information so we can get them on board. We want our members to enjoy the peace of mind that comes from being in the care of someone who knows you and your medical history.

For more information on how our plans work, visit our plans page or get your free quote today.