Indiana company grows ‘no health insurance’ model
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Direct Primary Care (DPC)—which eliminates the insurance “middleman”—may be unfamiliar to Hoosiers, but expanding the health care model in Indiana and the U.S. is the mission of two Indianapolis entrepreneurs.
Brothers Chris and Adam Habig founded Indianapolis-based Freedom Healthworks in 2014, and they say two market forces are driving “incredible” growth: physician burnout and patient frustration. They believe DPC is the cure for both, and the small company will soon open its second Freedom Healthworks-branded clinic—and the first in rural Indiana—to give Batesville residents a new option for care.
Instead of paying for a traditional health insurance plan, patients using the DPC model pay their physician directly, typically a flat monthly fee. The American Academy of Family Physicians says DPC gives patients longer visits, enhanced services over conventional fee-for-service medicine and real-time communication with their doctor, such as texting.
Chris Habig says many people have the misconception that DPC is only for affluent areas.
Freedom Healthworks co-founder and CEO Chris Habig says most physicians come to them because “our nation’s doctors are totally burned out.” Research has shown 100 to 300 doctors commit suicide each year, and a recent JAMA Psychiatry study says doctors’ suicidal ideation is associated with high workload volume.
“The best solution for burnout is you become your own boss. It’s the return to private practice where you get to make the care decisions your patients need; not some administration telling you that you have to see more people,” says Habig. “From patients’ side, they no longer feel lost or abandoned. [DPC] treats patients like people again and not just a number.”
A doctor with Freedom Healthworks will have 500 to 600 patients max, whereas a “traditional insurance-based practice needs 2,000 to 4,000 patients to even be remotely viable,” says Habig. A daily patient load for a Freedom Healthworks doctor is six to eight patients, says Habig, compared to a doctor working within a hospital system who sees 20 to 40 people per day.
Habig says the company is actively recruiting “outstanding physicians who value the doctor-patient relationship and want a healthier lifestyle.”
The company says DPC is growing “incredibly quickly.” Freedom Healthworks has opened about 125 practice startups throughout U.S. In Indiana, nearly 20 doctors in various specialties are working with the company.
Habig describes two basic options for doctors when joining Freedom Healthworks: they can start their own self-funded, independently-branded private practice, “and we help them run the front and back office”; or a physician can join the FreedomDoc Physician Network, and “they get to strictly focus on seeing patients and being a doctor, while we handle the business side of it.”
Freedom Healthworks launched its first FreedomDoc clinic earlier this year in Zionsville with “aggressive expansion” planned in Indiana. A second clinic will open this fall in Batesville—a strategy the company believes is the antidote for physician shortages in rural Indiana.
“A lot of big hospital systems are vacating rural areas; there’s just not the population to support it,” says Habig. “We only need a few hundred patients to make [a clinic] viable; we don’t need thousands and thousands like a typical insurance-based hospital model would.”
Freedom Healthworks believes DPC also spurs innovation by addressing a chief concern for employers: huge health care costs, which Habig says are a barrier for entrepreneurs, startups, small companies and contractors.
“We have a lot of success with these groups that need some type of health care access,” says Habig. “Many companies are too small to be self-funded. Instead of traditional health benefits that you’re paying through the nose for, why not give your employees a doctor they can access any time, then we can look at other health plan alternatives that fit your budget?”
To cover major emergencies or trauma, Freedom Healthworks encourages patients to have a financial backstop, such as purchasing coverage through healthshares or association plans.
Habig believes DPC also provides better mental health services. Because Freedom Healthworks doctors spend 45 to 60 minutes with each patient per visit, he says they have time to “dig deeper into [patients’] mental and emotional status” and provide “far more comprehensive counseling services.”
“[DPC] changes the incentive from quantity of care to quality of care,” says Habig. “We’re giving physicians the ability to enjoy practicing medicine again. From the patients’ side, they get somebody…who will listen and…give them a quality of life they’ve given up on in any other type of health care setting. That’s how our cup is filled every single day—making an impact in peoples’ lives that actually matters.”