Direct Primary Care: Bridging the gap in preventative care

Updated: Jun 21

When you think of going to your primary care provider what comes to mind?


Here is what we have gathered from others:

1. Waiting weeks for appointments

2. Long wait times

3. Short visits

Diabetes and cardiovascular disease account for the most death in upper- and middle-class incomes, which surpasses deaths due to infectious disease, malnutrition, etc. Did you know that the United States is one of the wealthiest countries with the highest rate of disease burden! How is it that we live in such a great country but, we are plagued with chronic illness burden?


Lack of preventive care is the root cause!

Why the gap?


The gap in primary care services is complex, but one of the leading causes is the United States does not invest in primary care services. According to the Primary Care Collaborative, the U.S spends about 5-7% on primary care and a whopping 38% on in-patient hospital care.



This under-investment leads to patient access issues and thus increasing chronic illness in our communities. The Affordable Care Act has reduced the number of uninsured Americans and has helped protect those with pre-existing conditions, but without increasing the amount of government investment in preventative care we will continue to have a poor distribution of health.


The U.S healthcare system is extremely complex due to the multiple systems it has within it. When you think about it healthcare in the U.S is like being down the cereal aisle. We have Medicaid, Medicare, private insurance companies, healthcare.gov, etc. This leaves healthcare systems with high administrative costs because there needs to be a dedicated department to navigate the billing, regulations, pre-authorizations, etc.


Moreover, the cost of drug prices continues to rise and there is no government oversight. Americans pay nearly four times the amount for prescription drugs compared to citizens in other countries. Only private insurers can negotiate prescription prices with manufacturers which leaves our government-funded programs (Medicaid and Medicare) with hefty prescription drug prices.


What is preventable care?


The definition of preventable care varies depending on who you ask. In general, preventable care services include annual check-ups, patient counseling, and screenings to prevent illness or disease. Each insurance company will have varying definitions and will only cover certain “preventable care services” AND the care provided must be by a provider within your network.

The problem with no universal definition of preventative care and the services it entails is it leaves patients vulnerable to gaps in care. No two people are alike and therefore their plan of care will vary.


Why is preventative care important?


Preventative care (regardless of the definition) has the same goal which is to aid in maintaining health, aid in chronic disease reduction, and early detection of health-related problems. Many of our chronic illnesses and leading causes of death are preventable!


How can Direct Primary Care fill the gap in preventative health care?


By breaking free from third-party insurance restraints direct primary care providers can create a partnership with our patients. We have the time to be educated by our patients on their conditions and lifestyle and collectively we can develop a plan of care that is tailored to your specific needs and goals.


Direct primary care providers can reduce their patient loads, thus increasing accessibility to your provider, what a concept! We are also able to contract directly with pharmaceutical and diagnostic centers for wholesale prices; saving you money. Patients also gain the benefit of convenience to their primary care provider via Telehealth, texting, email and after-hour visits.


We make primary care hassle-free!

Take charge of your health and partner with Reform ABQ so, we can help you reform your health! To learn more call, text or email our office or to schedule your appointment click the link below.





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