Before Chris Larson became a doctor, he earned a degree in finance and worked in investment banking and natural gas trading. Armed with this fiscal knowledge, and a medical degree, he decided he had worked hard for too many years to operate within the labyrinth of the health insurance system and see 35 patients per day who would feel like strangers.
The solution came in stages. During his residency he moonlighted in an urgent care clinic; meanwhile, he familiarized himself with a pre-cursor of the Direct Primary Care, the “Robin Hood” model, which allowed payments from concierge patients to subsidize care for others who couldn’t afford it. When he read about Direct Primary Care (DPC) in 2013, Larson saw an opportunity to have the best of all worlds and jumped in. He opened Euphora Health, a DPC practice, and now he is able to know his patients and their stories, give them access to quality care, and do it in a manner that is financially sustainable.
One year later, he attended a summit event for Direct Primary Care providers and realized that in order to make bigger changes in the system, he needed to pivot his focus from the clinic’s individual patients to employers and self-funded programs. “The math is simple,” Larson says. “Nationally, employers are paying for 60 percent of all health care costs. Medicaid, Medicare, the VA and other uninsured pay some percentage, but employers are the major players. So I recognize that to change the industry, I needed to work with employers and invite them to pay for primary care in a different way. I needed to demonstrate the benefits of moving away from what they had, historically, always done.”
If you want to make change that’s bigger than your clinic, you have to be open to work with employers because they are paying the bills in America; and if you want the system to change, you have to get the people with the purse strings to change it.
Euphora Health operates from a menu of opportunities; from virtual and telemedicine to integrated DPC and major medical. “It’s the simple realization that ‘because it’s always been done that way’ isn’t the rule any more. In many instances, patients don’t have to see a doctor face to face. I can triple my client access by managing care over the phone. That’s the beauty of DPC. I get to know my patients and their stories so we can agree, in a conversation, if it’s time for a refill or if another test is called for. Even then, there’s no requirement for an office visit that means more time to wait. I can call in a lab test and the patient is seen there.”
Dr. Larson says he is working to replicate his DPC model with other physicians. “I see bi-modal growth curves for many providers. Some grow rapidly, having converted from a fee-for-service clinic and some have started from scratch. The first group grows quickly by converting prior patients, but for both, it is important to establish a rate schedule that is economically viable and is scaled for age and wellness vectors.”
As a business owner, Larson believes it all comes down to utilization percentage. Employers may pay less per person for membership, but bundled fees for groups who don’t go to the doctor often will provide more revenue than fewer individual patients who see unlimited access as a bargain. “It is also about workload,” he says. “I can double or triple my patient load with employer groups and virtual medicine, provide quality care to all of them when and how they need it, and still maintain my business.”
Dr. Larson emphasizes that the industry is in the early stages, and he and his fellow DPCs are pioneers. “We all feel strongly about this, and people can soon expect to see doctors who don’t care so much about the old models but just want a sustainable living and a better lifestyle than insurance-based medicine could ever provide. And, for employers, health benefits are among the best ways to retain employees. DPC benefits are an incredible asset to that retention.”