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Restoring the Doctor-Patient Relationship: How Entrepreneurship Is Revolutionizing Health Care in Maine

July 6, 2016
By Liam Sigaud

This report by Liam Sigaud of the Maine Heritage Policy Center analyzes the current direct primary care landscape in Maine.

As Maine’s broken health care system continues to offer excessive prices and poor outcomes to dissatisfied patients, lawmakers and consumers alike would do well to consider a promising health care innovation that is rapidly gaining supporters nationwide: direct primary care.

Direct primary care (DPC) is an innovative medical practice model in which physicians charge patients a regular fee to provide routine health care services including screening, assessment, diagnosis, and treatment. As a result, insurance companies and government payers are entirely cut out of the primary care equation, simplifying the doctor-patient relationship and cutting administrative costs.

Six DPC practices operate in Maine, and all have opened since 2013. This report analyzes the current DPC landscape in Maine, evaluates how DPC is benefiting patients, highlights some of the challenges DPC practices face, and offers policy recommendations to promote this type of practice in the future.

The findings of this study reveal that direct primary care in Maine:

  • Is reducing preventable hospitalizations and emergency services by providing better preventive care and chronic disease management.
  • Reduces patients’ out-of-pocket expenses.
  • May help to mitigate the primary care physician shortage.
  • Is burdened by unnecessary government regulations.

Recommendations include:

At the federal level:

  • Loosen restrictions on health savings accounts.
  • Define Affordable Care Act-compliant wraparound health insurance 

At the state level: 

  • Explicitly exempt DPC practices from insurance regulation.
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Health Care