Taking a Hybrid Approach to 
Direct Primary Care to Drive Growth and Patient Satisfaction

A vision to institute DPC to improve patient care and practice economics

Dr. John Bender and his wife, Teresa, have owned and operated Miramont Family Medicine since 2002, originally as a traditional fee-for-service (FFS) practice in Colorado with two locations. In 2015, Dr. Bender learned about Direct Primary Care (DPC) at a conference and was excited by the patient-centric approach and the financial opportunities it presented.

Caring for 20,000 patients and supporting 90+ employees, they knew they would have to take a well thought out transition strategy to transform the practice from a FFS model to DPC. For them, a hybrid approach was the answer, made possible through the technical support of HintOS™.

Managing two practice models and supporting new DPC workflows

Practicing in communities where there were no other doctors, Miramont Family Medicine had an ethical obligation to continue to operate as FFS for their many patients relying on government payor programs such as Medicaid or Medicare. They also required a steady volume of patient visits to keep employees and providers working as the practice built up its DPC membership numbers. Going 100% DPC from Day One was not an option.

Introducing DPC was an exciting opportunity, but it posed a challenge at each touch point with the patient. Staff would need to be cross trained for a seamless patient experience.

There was the logistical challenge of serving both DPC and FFS patients, with their differing requirements for billing, payment, scheduling, coding—even how the patient is roomed as they enter the practice. Traditional Electronic Health Record systems were not made for DPC billing and enrollment. And a manual process requiring posting thousands of member transactions a month was not realistic for the Miramont finance staff. Dr. Bender’s team knew that finding the right partner was critical to make DPC a success for its practice.

As a large multi-location independent practice, Miramont knew clearly defined responsibilities for the DPC portion of their practice would be crucial for its success. They decided to designate certain doctors, physician assistants (PA), and nurse practitioners (NP) as DPC-only, with input from those practitioners. Initially only Dr. Bender saw DPC patients, but in 2020, 5 doctors, 1 PA, and 3 NPs saw DPC patients.

In HintOS, they can link DPC providers to specific offices so that only providers from that location show up. New DPC patients can view and select providers based on their location and the age range of patients they serve. Using HintOS, hybrid practices can offer innovative billing and payment options. Miramont has had success converting FFS “bad debt” into new DPC patients, as they offered patients the option of applying their pay-off towards a membership. Dr. Bender shared, “It gives them a way out. We can leverage the fact that we are hybrid into sales. Of our 1,200 members, about half of them were bad debt situations. It turns it into a win/win.”

• Miramont has over 1,300 DPC members out of over 20,000 total patients
• 5.4% growth in DPC memberships over the last 12 months
• Direct contracts with 5 employers including trade groups, nursing homes and dental offices—the largest with 75 employees
• 33% reduction in staff thanks to streamlined back office operations

Dr. Bender added, “DPC is our biggest source of growth. I can sell to one employer and get their whole book of business.”

Dr. Bender concluded, “As we added in more DPC patients, our operation became more efficient. My experience is that 1,000 DPC members equals 6,000 FFS patients. It takes a lot less staff to take care of those patients even though it’s equivalent revenue.”

But it’s not just about the revenue. It also improves provider satisfaction and patient experience. Chaela Laffan, Clinical Operations Director, stated, “We have providers here that prefer DPC patients. They focus on making the experience great for the patient. We pay special attention to DPC patients. It’s a privilege for us to serve them.”

Thanks to HintOS, Miramont Family Medicine is able to focus on providing a great patient experience while improving the practice’s financial performance, and also supporting their traditional FFS patients.