Do you get a sick feeling in your stomach every time you have to prepare for benefits selection or plan design/renewal?  Over the past 10 years, healthcare costs have risen on average 4.15% per year, according to Mercer.  This average increase would be more had employers not made a number of plan changes, the most common of which have been raising deductibles and offering less generous plans. Smaller employers have seen a much higher percentage increase than large employers. Listen to the full podcast here:

Save on Healthcare

Albert Einstein once said that the definition of insanity is doing the same thing over and over again and expecting a different result. Is this what your organization has been doing with its healthcare planning? I would suggest that you consider Direct Primary Care (DPC) when you design future healthcare plans. This basic healthcare delivery has been around for a while and I remember being approached about “concierge medicine” around 20 years ago.  Concierge medicine was expensive and only higher income earners could really afford it.  I did not partake of this novelty.

Today, many doctors, fed up with the requirements of the hospitals they work for and the relentless paperwork required by insurance companies and the federal government have formed DPC practices. I recommended a DPC to my employer and we have now had one for the past two years. Here are the basics of a DPC:

  1. A small group of doctors with differing specialties, including perhaps pediatrics.
  2. Patients pay a monthly fee (employee, employee plus one, employee plus family).
  3. While monthly fees are negotiable, they typically range from $50-$60, for an employee and approximately $150 per month for a family.
  4. A DPC is not covered by insurance and a DPC is not health insurance —- it is healthcare!
  5. For the monthly fee, an employee and his family can go to a doctor every day, if need be, at no charge, without a deductible or co-pay.
  6. The wait to see a doctor is usually less than 10 minutes, since the patient load per doctor is typically, 200 to 300 and not the 1,000 plus most doctors affiliated with hospital groups are required to have. 
  7. DPC doctors spend time with their patients and work with them on wellness initiatives.
  8. With a DPC, there is rarely a need for an onsite medical clinic or nurse, particularly if the DPC is located near the employer’s location.
  9. Often, DPCs offer x-rays and drugs for free, or at a significantly reduced price.
  10. DPCs often refer patients to the low cost, high quality service provider and not just those affiliated with the local hospital.

Every employer has to do what is right for their particular organization, so a DPC may not be what you need.  However, I believe DPCs will be the next big advancement in healthcare, since the patient truly has the individualized attention needed, at a reasonable cost.  I would recommend that organizations consider a DPC with a high deductible healthcare plan.  Doing away with a PPO plan and going with the DPC/high deductible healthcare, could actually save organizations enough money to either fully pay for the DPC, or pay a larger portion of the deductible for the high deductible plan.  Over 50% of my organization’s employees are currently utilizing the DPC and love it.  Consider this option, and perhaps you will find a cure for that sick feeling in your stomach each year during plan design/renewal and benefit selection process.  All the best,


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Steve Nail is currently the Dean, College of Business, at Anderson University. He is a labor and employment attorney who began his career with the National Labor Relations Board. Thereafter, he served as Assistant General Counsel for Michelin, including two stints in France, where he worked on the structuring of the European Economic Community and served in the HR and Legal Departments. Later he served as the Vice President of Labor and Employee Relations before moving on to Hubbell where he served as the Vice President of Human Resources. Steve was appointed by Governor Nikki Haley to serve on the SC Healthcare Planning Committee and was reappointed by Governor McMaster in 2018. Steve was named the 2012 South Carolina HR Professional of the Year and awarded the Lifetime Achievement Award in 2016, by the Greenville SHRM chapter. He is a frequent speaker, a published author, and mentor to many in the HR profession. He often coaches individuals and consults organizations on strategic matters. He is a Register Corporate Coach, certified by the Worldwide Association of Business Coaches and holds SPHR and SHRM-SCP certifications.