Providers testing direct primary care model for Medicaid, Medicare

January 13, 2016

A growing number of primary care doctors are experimenting with direct primary care to middle-income, Medicaid and Medicare populations. If those experiments work - and save money and improve health - they could mitigate concerns about who can afford direct primary care. In Seattle, Qliance, which operates a network of primary care doctors, has been testing how to blend direct primary care with the state's Medicaid program. So far, about 15,000 have signed up. Qliance has a contract with Centene. Medicaid pays the monthly fee, which covers primary and preventive care, and for other specialty and emergency services. If patients need a specialist, they'll get referred to one who accepts Medicaid. Advocates in other states are watching the outcomes and costs while considering rolling out similar programs. Direct primary care is also finding traction with Medicare Advantage. Iora Health, a direct primary care system that contracts with unions and employers, a year ago launched clinics in Washington and Arizona catering to Medicare Advantage patients. Iora's setting up similar clinics in Colorado and Massachusetts.