On this episode of the Startup DPC Show, I sit down with Dr. Chad Savage of YourChoice Direct Care in Brighton, Michigan. Dr. Savage and I practice about 45 minutes away from each other - he’s in Brighton, MI and I’m in Detroit, MI. We’ve gotten to know each other well because we attend the same conferences and sometimes end up on the same flights to and from these conferences!
We both spoke during the opening main-stage session at the DPC Nuts and Bolts Conference in November 2018, hosted by the Docs 4 Patient Care Foundation. Dr. Savage is a relentless advocate for his patients, for his profession, and for the broader DPC movement.
Paul Thomas MD, Lee S. Gross MD, Ellen McKnight MD, Chad Savage MD, and Josh Umbehr MD at the DPC Nuts and Bolts Conference in Orlando Florida. Drs. Gross, Savage, and Umbehr are also involved in the DPC Action organization.
Dr. Savage is also a Board Member of the new DPC Action organization. In this Startup DPC Episode 8, we talk about direct primary care, the legislation that's impeding the DPC model, and the opportunities for future legislative changes that could improve health care options for individuals, families, and businesses.
What is DPC ACtion?
DPC Action is a non-profit organization dedicated to promoting and advocating for improved access to affordable health care through independent Direct Primary Care practices.
There are several political advocacy groups for medicine, but none were focusing on the independent direct primary care doctor. DPC Action speaks for the independent DPC doctor. The organization is largely self-funded, but does take donations on their website, here.
Dr. Savage talks about adding value, both for his patients, and in changing the legislation. The current legislation isn’t designed perfectly for the practice of direct primary care medicine.
DPC Action and Dr. Savage are working with Congressional leaders, Senators, the White House, and representatives from the Treasury Department and the IRS. One of their first meetings was with the Secretary of the Treasury and Dr. Savage worked with some adversarial forces during this meeting.
This meeting bore fruit, however, and it affected future legal changes affecting HSA spending and direct primary care practices.
Current Legislation Affecting DIrect Primary Care practices
Currently, the use of HSA funds to pay for direct primary care practice is debatable and murky. There is not a clear answer on this issue. We discuss the IRS Code 213(d) and 223 and how these are a barrier for the direct primary care model at this time. Here are the basic definitions of these IRS Codes:
HSA-qualified medical expenses are defined by IRS Code, Section 213(d) and include amounts paid for the diagnosis, cure, mitigation, treatment or prevention of disease for the purpose of affecting any structure or function of the body.
Internal Revenue Code (IRC) Section 223 allows individuals who are covered by a compatible health plan, often referred to as a High Deductible Health Plan (HDHP), to set aside funds on a tax-free basis up to the contribution limit to pay for certain out-of-pocket medical expenses.
Legislative Solutions to our current challenges in direct primary care
As a solution to these barriers, Dr. Savage and I discuss S 3112. Dr. Savage is a prolific writer, and he penned this opinion in Real Clear Politics regarding S 3112:
S. 3112 — which has a companion bill in the House, Congressman Chip Roy’s HR 5596 — would lift unnecessary HSA restrictions, let Americans spend HSA dollars how they see fit, liberate employers, and unleash Direct Primary Care.
Furthermore, this legislation would help HSA owners take full advantage of an incredibly low-cost and high-service care model: Direct Primary Care (DPC). These clinics offer substantially reduced medications, imaging, labs and other services. Though President Trump’s June 2019 Executive Order partially addressed and expanded HSA use for DPC providers, S. 3112 would solidify these corrections in law. This step would make HSA dollars go farther and provide more quality services.
HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?
If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have begun compiling some of the best content available on this blog and in our courses.
The best place to start is to take our Direct Primary Care Business Plan course, available here. From there, you can learn how to attract new patients to your direct primary care practice and how to find the perfect location or build out the practice of your dreams.
Thanks for reading and watching, and best of luck in your direct primary care journey!
- Dr. Paul Thomas with Startup DPC