Direct care is a subtype of concierge medicine. A direct care clinic accepts a small group of members into the practice. Members make a small, monthly membership investment that allows them access to unlimited medically necessary care at no additional cost beyond the monthly membership investment.
There is no insurance involved. No pre-authorizations or authorizations, co-payments or deductibles, denied treatments or benefit limits for the patient to worry about. Likewise, the health care provider does not have to employ a small army of staff to contend with the insurance company's' red tape or wrestle reimbursement from them. This produces better care at lower costs.
We believe that for basic health care--which a physiotherapist’s care certainly constitutes-- insurance hurts more than it helps. Just as it does not make sense to have your car insurance cover gasoline and oil changes, so, too, do we think that basic health care can be made less expensive and better independent of a 3rd party.
Without the “sting” of co-payments and deductibles which make people hesitate to seek medical care (and use their insurance), people can come in as soon as needed instead of trying to “wait and see” or “tough it out”. The problem can be addressed quickly and effectively before it has snowballed into something that requires far more care.
Most people will save significantly by receiving care at our office. An adult membership at Optimum DPT starts at $100/month ($1,200/year). The vast majority of people have either silver or bronze metal-tiered health care plans with average deductibles of $3,500 and $6,100, respectively. Insurance-based physical therapy clinics bill about $150 per visit for an hour of care, so a patient would owe the same $1,200 out-of-pocket after only 8 treatments, falling short of their deductible (and actual insurance benefits) by thousands of dollars ($2,300 to $4,900). Conversely, for the same price (which is less than a daily latte at your local coffee shop), Optimum DPT members would receive unlimited access to a physiotherapist for their musculoskeletal care for the entire year.
Similarly, patients who have already met their deductible but are paying $20-50 dollar co-payments for continued care at insurance-based clinics will also find incredible savings after transitioning to a direct care practice.