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Risks and Benefits of a Hybrid Practice
Some physicians elect to transition their current private FFS practice to a hybrid DPC practice, meaning that part of their practice is made up of pure DPC patients and the other part is still insurance-based fee-for-service. Some physicians elect to continue Medicare contracts only in order to both keep Medicare patients as well as keeping the ability to moonlight in more traditional settings. Other physicians prefer to keep all or part of their commercial insurance contracts. Still, others use hybrid as a stepping stone to eventually become a pure DPC practice over the course of months to years.
Some of the reasons people give for wanting or needing to do a hybrid practice:
- Some insurance contracts can take 90 days or more to cancel. Ignoring this requirement leaves a physician liable to a breach of contract allegation.
- The physician may be the sole breadwinner of their family and they fear that losing most of their patients all at once will put them into a difficult financial position
- The need to continue moonlighting opportunities which are more limited when you opt-out of Medicare.
- Concern for abandoning patients or losing patients they have seen for years
- Wanting to continue seeing a large portion of patients over 65 who may not be able to afford services not covered by Medicare
The potential benefits of running a hybrid practice include:
- The ability to drop insurance contracts at a slower pace allowing the practice to continue a more steady revenue stream during the transition
- The ability to support family and lifestyle while transitioning, including having the flexibility to moonlight for extra income
The potential disadvantages of running a hybrid practice include:
- Potentially competing against yourself. It may be difficult to recruit patients to DPC when you are continuing to support their using insurance to pay for your care.
- The need to differentiate care for DPC patients vs. Insured patients (It can create a perverse incentive. You would want to enroll DPC patients but are financially incentivized to pack your schedule with insured FFS patients.)
- The need to continue administrative tasks and inability to lower overhead due to the need to continue maintaining the staff and software to deal with insurers and meet data collection requirements.
If you’d like to read a little more about hybrid DPC practice, this is a great article by Dr. Lee Gross.
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Risks and Benefits of a Hybrid Practice
Some physicians elect to transition their current private FFS practice to a hybrid DPC practice, meaning that part of their practice is made up of pure DPC patients and the other part is still insurance-based fee-for-service. Some physicians elect to continue Medicare contracts only in order to both keep Medicare patients as well as keeping the ability to moonlight in more traditional settings. Other physicians prefer to keep all or part of their commercial insurance contracts. Still, others use hybrid as a stepping stone to eventually become a pure DPC practice over the course of months to years.
Some of the reasons people give for wanting or needing to do a hybrid practice:
- Some insurance contracts can take 90 days or more to cancel. Ignoring this requirement leaves a physician liable to a breach of contract allegation.
- The physician may be the sole breadwinner of their family and they fear that losing most of their patients all at once will put them into a difficult financial position
- The need to continue moonlighting opportunities which are more limited when you opt-out of Medicare.
- Concern for abandoning patients or losing patients they have seen for years
- Wanting to continue seeing a large portion of patients over 65 who may not be able to afford services not covered by Medicare
The potential benefits of running a hybrid practice include:
- The ability to drop insurance contracts at a slower pace allowing the practice to continue a more steady revenue stream during the transition
- The ability to support family and lifestyle while transitioning, including having the flexibility to moonlight for extra income
The potential disadvantages of running a hybrid practice include:
- Potentially competing against yourself. It may be difficult to recruit patients to DPC when you are continuing to support their using insurance to pay for your care.
- The need to differentiate care for DPC patients vs. Insured patients (It can create a perverse incentive. You would want to enroll DPC patients but are financially incentivized to pack your schedule with insured FFS patients.)
- The need to continue administrative tasks and inability to lower overhead due to the need to continue maintaining the staff and software to deal with insurers and meet data collection requirements.
If you’d like to read a little more about hybrid DPC practice, this is a great article by Dr. Lee Gross.