Sen. Colbeck Proposes Direct Primary Care Services Medicaid Pilot

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Lansing, Mich. – Improving the quality of care and reducing the cost of care: these are the objectives of a Direct Primary Care Services Medicaid Pilot proposed by state Sen. Patrick Colbeck, R-Canton.

“It is time to unlock Michigan’s capacity for innovative, high quality, and low-cost healthcare on a broader scale,” said Colbeck. “Medicaid enrollees and the population at-large deserve the best opportunities for good health and addressing treatable conditions before they require expensive treatments or hospitalization.”

Medicaid is the single largest item in the Michigan state budget at $17.5 billion. Roughly one in four of Michigan’s 10 million residents are enrolled in Medicaid. Colbeck’s proposed pilot project would enroll 2,400 Medicaid recipients in Direct Primary Care Services (DPCS). The DPCS healthcare model would eliminate the need for government and private sector involvement between a doctor and patient for primary care services. Individuals would still be covered by “wraparound” insurance for all services not specific to primary care.

“By reducing overhead and providing real access to preventative care, DPCS has been demonstrated to significantly reduce claims against the wraparound insurance, resulting in significant cost savings,” said Colbeck.

The success of the pilot, which Colbeck is proposing as part of the FY17 Michigan Budget process, is based on a reduction in the number and severity of non-primary care claims (i.e. patients are healthier). The pilot will prove financially successful if claims are reduced on the order of 35 percent or more, although any reduction in the number of claims below current figures means that the health of enrollees has improved. If fully deployed to all 2.4 million Medicaid enrollees, the potential savings to the state would be $3.4 billion.

“It is my desire that this pilot project opens the door for Direct Primary Care access to all individuals in the state, and perhaps eventually the country,” said Colbeck. “Local units of government, such as schools and municipalities, could also benefit from the additional funds made available through the displacement of previously high healthcare expenditures. I believe the cost-savings and high quality healthcare fostered by Direct Primary Care Services would benefit our state in immeasurable ways.”

Official testimony in support of the pilot is scheduled for April 12 in the Senate Health and Human Services Appropriations Subcommittee hearing. You can find more information on Direct Primary Care Services at www.MorninginMichigan.com.

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