The COVID-19 Pandemic was one of the most destructive and chaotic global events in human history.COVID-19 has caused massive disruption in almost all economic sectors, besides the obvious human toll of death and illness.One sector, however, proved to be resilient: direct primary care.These low-cost, membership-based primary care practices (from 49 to $89/month), generally offer copayment-free primary healthcare with extended medical visits and next-day availability.They can derive their income from fixed payments from patients and reduce overhead. This also helps to limit the restrictions that have limited traditional medical practices that are dependent on insurance.Many fee-for-service, insurance-based practices suffered severe losses due to the mandatory coronavirus shutdowns. Many were forced to fire staff, or close to it, because they were not compensated for in-office visits.Others had to adjust to a new world. These insurance-based practices were based on centrally controlled billing and coding rules, which were dependent upon face-to-face visits. They longed for emergency rules to recognize the arrival of the telephone.Even in an emergency situation, the bureaucracy of both public and private insurances failed to create the codes and rules necessary for remote billing.This took place in a time when the pandemic was constantly changing. Many patients were unable to access care completely, with many others being redirected to already overcrowded emergency rooms.Direct primary care patients were able to continue accessing care throughout this period. These practices could continue to function as long as their income stream, which was predictable and low-cost, remained intact. Patients did not lose their jobs if they lost their doctor.Because they were already practicing telemedicine for many years, it was easy for direct primary care to transition seamlessly to remote care.They offered several months of unrestricted primary care, including telemedicine visits for less than one insurance-based telemedicine consultation. Because the physician's time was already paid for by the membership dues, this was possible. The physician was willing to help the patient in any format (in-person, virtual) that would best address their needs.Direct primary care practices did not have to wait for the coding rules from an inexplicably unreliable bureaucratic system, unlike their insurance-reliant counterparts. Instead, they were able adapt to their patients' needs in real-time, working together online and innovating new ways of addressing the complex pandemic.Many direct primary care practices also shifted to driving and parking lots, where they dispensed medication directly to patients and made house calls. They also performed point-of–care testing at their homes and even at their workplaces.Many arranged for IV fluids and oxygen at home for coronavirus patients, which allowed hospitals to provide care for the most sickest patients. They also treated non-coronavirus diseases, which kept them out of the overcrowded emergency rooms.Direct primary care has survived and thrived in the most severe health crisis that the world has ever seen in over a century.Direct primary care's flexible model of practice allowed mass customization of healthcare, while the rest of the system was locked in a production mode. This flexibility was crucial for the success of a dynamic world.Their success was largely due to the fact that physicians no longer have to deal with a lot of regulatory burden. However, there are still significant obstacles to widespread adoption of this model.We have created a detailed roadmap for the adoption of patient-centered direct primary care reforms by implementing regulatory and legislative changes at all levels. This paper was published for The Heritage Foundation.These recommendations, if implemented, could transform American healthcare from an impersonal, expensive medical care system to one that is more efficient, responsive, and personal. This would be the silver lining to an otherwise terrible pandemic.The Daily Signal offers a wide range of perspectives. This article is not meant to represent the views of The Heritage Foundation.Do you have a comment about this article? Send us an email at [email protected] with your comments. We may publish them in our We Hear You section. Include the article's URL or headline, along with your name and the address of your town or state.
