Alignment of the Business Interests of Self-funded

Employers and DPC Model Practices

Jed Constantz, William Short, Paul Grundy, MD, and Michael Thompson

Activity DisclaimerThe material presented here is being made available by the DPC Summit Co-Organizers for educational purposes only. This material is not intended to represent the only, nor necessarily best, methods or processes appropriate for the practice models discussed. Rather, it is intended to present statements and opinions of the faculty that may be helpful to others in similar situations.

Any performance data from any direct primary care practices cited herein is intended for purposes of illustration only and should not be viewed as a recommendation of how to conduct your practice.

The DPC Summit Co-Organizers disclaim liability for damages or claims that might arise out of the use of the materials presented herein, whether asserted by a physician or any other person. While the DPC Summit Co-Organizers have attempted to ensure the accuracy of the data presented here, these materials may contain information and/or opinions developed by others, and their inclusion here does not necessarily imply endorsement by any of the DPC Summit Co-Organizers.

The DPC Summit Co-Organizers are not making any recommendation of how you should conduct your practice or any guarantee regarding the financial viability of DPC conversion or practice.

Faculty DisclosureIt is the policy of the DPC Summit Co-Organizers that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflict of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity.

All faculty in a position to control content for this session have indicated they have no relevant financial relationships to disclose.

The content of this material/presentation in this CME activity will not include discussion of unapproved or investigational uses of products or devices.

Learning Objectives• Discuss the business needs of self-funded employers

interested in offering a higher quality, more affordable health plan for their covered individuals

• Define the type of DPC model practice best suited to contract with a self-funded employer

The Primary Care Innovators Network (PCIN)

Strengthening Primary Care to Improve the Health of America

What is the PCIN?• The Primary Care Network (PCIN) works with self-

funded organizations (non-profit, for-profit and public), and the primary care practices serving their employees, to:– Enable self-funded employers to improve the health of

their employees by building systems and supports needed to provide enhanced primary care solutions to them.

– Ensure that primary care practices working with those employees are compensated for the value they provide through comprehensive primary care payment

Who is part of the PCIN?

Primary Care Innovators

Network (PCIN)Family Medicine for America’s

Health (FMAHealth)Employer Advantage Health Care

Solutions (EAHCS)

Family Medicine Education Consortium (FMEC)

What each member of the PCIN provides • FMEC– Brings access to family physicians and their practices around the country along with tools and methods designed to help physicians and employers make the transition to comprehensive primary care payment (one of which is through direct primary care).• FMAHealth– Brings access to family physicians and their practices around the country along with tools and methods designed to help physicians and employers make the transition to comprehensive primary care payment (one of which is through direct primary care).• EAHCS– Brings services and programs that help self-funded employers reduce spending on healthcare while improving the health of their employees—using a direct primary care payment framework.

Today’s Focus• Today, we would like to focus on engaging self-

funded employers to ensure they see the benefits of operating in a direct primary care payment framework. – Introducing Jed Constantz, MHRA, Chief Strategy

Officer and SVP Client Relations of Employer Advantage Health Care Solutions

Today’s Focus

Primary Care Innovators

Network (PCIN)

Family Medicine for America’s Health (FMAHealth)

Employer Advantage Health Care Solutions (EAHCS)

Family Medicine Education Consortium (FMEC)

Key Upcoming PCIN Conference Dates• Chicago – October 5th • Cleveland – November 9th • Dallas – TBD • Seattle – TBD

If you would like to stay engaged with the PCIN after today’s event, please be sure to contact Laurence Bauer of the Family Medicine Education Consortium (FMEC) at laurence.bauer@fmec.net

Alignment of the Business Interests of Self-funded Employers

and DPC Model Practices

Jed Constantz, William Scott, Paul Grundy, MD, & Michael Thompson

Self-funded Employers and DPC Model Practices

• Session Contributors– Primary Care Innovators Network

• Family Medicine Education Consortium• Family Medicine for America’s Health• Employer Advantage Health Care Solutions• Accresa/Ameriflex

Self-funded Employers and DPC Model Practices

• Panel Participants– Union Hospital/Union Physician Services

• Chris Beck, VP Operations• Tina Myers, Director Human Resources• Kevin Milligan, Director, UPS• Dr. Jeffrey Burrier, UPS

– Dr. Meghan Gannon, All Access Primary Care– Nelson Griswold, Bottom Line Solutions

Self-funded Employers and DPC Model Practices

• Pop Quiz:– DPC is the acronym for

A. Deferred Procedure Call B. Dutch Power Cows C. Dom Perignon Club D. Direct Primary Care

Self-funded Employers and DPC Model Practices

• What does the purchaser want?• What can the clinician offer?• What’s the best model to create an affordable,

accountable, sustainable connection?

Self-funded Employers and DPC Model Practices

• Pop Quiz:– Insurance Companies don't work for self-funded

employers A. Yes B. No

Self-funded Employers and DPC Model Practices

• Pop Quiz:– Self-funded employers must have their benefits

approved by state / federal regulators A. Yes B. NoC. It depends

Self-funded Employers and DPC Model Practices

Final Thoughts/Summary

Questions?Submit your questions to: aafp.cnf.io