Description: Direct Primary Care (DPC) is a newer model of primary care delivery in which patients or employers pay for care directly on a membership basis; insurance and other third-party payment is not used. Early studies show significantly improved patient health outcomes and lower expenditures for DPC patients compared with similar patients receiving traditionally delivered primary care. Additional research is needed to better understand physician perspectives about the model and the role of patient selection in early results.In this session we discuss research projects that may shed light on the DPC model and on whether early results indicate more about the model or about the patients who use it.We discuss an SoA research project that interviews DPC physicians to better understand their views about the model and its early results. We also discuss a paper that analyzes characteristics of patients who receive primary care from a DPC physician and compares them to characteristics of patients who receive primary care in more traditional ways. This cross-sectional study surveys all adult patients of a convenience sample of several DPC practices. Variables include demographics, socio-economic status (SES), type of additional coverage (if any), whether DPC fees are paid by an employer, and self-reported health status. The Medical Expenditure Panel Survey is the main source of comparison data. For a given cohort of demographics and additional coverage, we determine whether DPC patients have similar health status, demographics and SES as non-DPC patients. This study will provide insight into the degree of selection into DPC by observable patient characteristics.

Description: The Society of Actuaries (SOA) commissioned Milliman to develop this report to provide health care stakeholders—patients, payers, policymakers and actuaries—with a comprehensive description of DPC as well as an objective actuarial evaluation of certain claims made about the DPC model of care.

Description: The presenters will provide updates on research being conducted under SOA sponsorship. This includes projects on the topics of Direct Primary Care and Patient Centered Medical Homes.

Description: Can Direct-to-Provider Contracting Achieve Value-Based Care for Employer-Sponsored Plans? Direct-to-provider contracting is a strategy in which a self-insured entity negotiates a contract directly with a provider of healthcare services rather than through a third-party administrator (TPA), often with the goal of driving value-based care. This article discusses the considerations for employers and providers with direct-to-provider contracting.

Description: Article describes enhanced primary care models and provides citations on whether or not health care savings have been achieved.

Description: As value-based solutions evolve, it is more important than ever for providers to understand their performance and how it is measured, along with the drivers of success. Presenters will cover the evolution of past risk-transfer programs such as Medicare Shared Savings Program and Next Generation ACO. They will also discuss the new Primary Care First and Direct Contracting models recently announced by CMS.

Description: Third in a series giving an overview of direct marketing.

Description: Essay of using microeconomics and Embedded Value concepts to evaluate direct marketing programs.

Description: This article evaluates findings from a new LIMRA focus group consumer study that examined the decision-making process that consumers follow when buying life insurance including their use of direct channels, including direct mail, the internet and call centers.

Description: Align carrier, agent, and consumer definition(s) of DTC to establish a collective understanding for the affected parties. Understand why a direct-to-consumer approach may be important for carriers’ and distributors’ growth and development goals, tactics and strategies. Use the agreed-upon baseline and understanding of DTC’s importance to establish and agree upon reasonable expectations for its role in marketing, distribution, and product development and performance. Position carriers and distributors together to align sales, marketing and performance expectations and incentives for all parties to increase the possibility of outperforming in (and outside of) the DTC space; design sales, marketing and distribution systems and approaches to meet consumers where they are at; and expand current sales and cultivate new markets to remain relevant and magnify profiles in an ever-changing industry.