Direct primary care bill introduced

Members of the Banking, Commerce and Insurance Committee heard testimony Feb. 9 on a bill that would specify the requirements of a direct primary care agreement and clarify that direct primary care agreements are not insurance.

Ralston Sen. Merv Riepe introduced LB817 and has made it his priority bill for the session. He said the proposal would provide clear legislative guidance for the state Department of Insurance that direct primary care agreements do not constitute insurance or function as a qualified health plan pursuant to any federal mandate.

“Fee for service health care is not working in the United States, and that includes Nebraska,” Riepe said. “One part of the fix for health care delivery is direct primary care.”

Direct primary care is a medical care delivery model involving a contract between a patient and a primary care practitioner in which the patient pays a monthly retainer for unlimited office visits and an annual physical exam, he said.

The bill would not mandate that practitioners engage in primary care practices, Riepe said, but merely would establish the concept in state law and provide clarity moving forward.

Under the bill, a practitioner in a direct primary care agreement would be prohibited from billing a patient in any form for primary care services provided under the contract. It also would require a practitioner to provide 60 days’ notice in advance of any changes to the contract.

Robert Wergin, board chairperson of the American Academy of Family Physicians, testified in support of the bill. Surveys suggest that physicians who practice direct primary care have much higher job satisfaction, he said.

“I think it really brings the joy of practice back to family physicians,” Wergin said. “They’re back [to being] focused on the patient—not on paperwork, not on rules and regulations.”

Clint Flanagan, a direct primary care physician in Colorado, agreed. Testifying in support of the bill, he said physicians currently spend as much as 30 to 40 percent of their time on billing and administrative work related to fee for service practice, which leads to low job satisfaction.

Patients who use direct primary care supplement it with a high-deductible health insurance plan, he said, which can be used for things such as a hospital stay, hip replacement or extensive cancer treatment. He said the average per month fee across the country for direct primary care is approximately $60.

“If you can afford a cell phone, you can afford what we do,” Flanagan said.

No one testified in opposition to the bill and the committee took no immediate action on it.