DPCS Medicaid Pilot

doctor_patient“Improve quality of care and reduce overall healthcare costs”

The Opportunity: Medicaid is the single largest item in the Michigan state budget at $17.5 billion. Roughly one in four of Michigan’s 10 million residents are enrolled in Medicaid. If Direct Primary Care Services were fully deployed in support of Medicaid enrollees, the state could free up to $3.4 billion per year from its $54.5 billion state budget and provide improved and more accessible healthcare services to the Medicaid population.

The DPCS Pilot Project: As part of the FY18-19 Michigan budget process, a DPCS Pilot Project will allow up to 2,400 Medicaid recipients to enroll in Direct Primary Care Services. The DPCS healthcare model seeks to eliminate much of the need for government and other unnecessary bureaucratic involvement between a patient and their primary care physician during regular appointments and when receiving treatment for routine healthcare needs. Individuals would still have full  “wraparound” coverage for their other Medicaid healthcare needs for things such as surgery, cancer-treatments, and accidents. You can read Sec. 1913 and Sec. 705 of the budget’s DPC related boilerplate language by clicking HERE and HERE.

The success of the pilot is based on a reduction in the number and severity of claims (i.e. patients are healthier). The pilot objective is to reduce the number of catastrophic claims by 50%.

Learn More about the Pilot

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