Beyond being a solid entrant to the DPC (direct primary care space) market, First Primary Care founder, Dr. Geetinder Goyal, and his team are on their way to forming a physician led insurance company that solves for healthcare industry’s terminal illness, the mega-carriers.
“Deep Dive″ or uncut version of our video podcast. Drs Jeff Brown and Jeff Cole interview Dr. Goyal, Founder of First Primary Care.
First Primary Care (FPC) grew both its membership and its revenue by more than 100% between 2023 and 2024. The vast majority of the 6000 members have onboarded through self-funded employer plans. These plans are comprised of a vertical stack of solutions designed to optimally benefit the patient, the employer, and the physician care team.
While many direct primary care (DPC) businesses are emerging, we are not aware of another DPC company has built a full stack health plan that includes a strong primary care base with integrated partners for cash pay specialists and services, a pharmacy benefit manager, TPAs (third party administrators), PPO network access, stop-loss insurance and distribution through brokers who are becoming more of a benefit advisor.
With a focus on price transparency, healthcare can become more stream-lined, and value can be measured. The incentives of the FPC physicians are aligned with that of the patient, health and prevention. The original role of insurance is restored to cover catastrophic issues, and not day-to-day needs.
Consistent results show a savings of $200K – $300K for a company with 100 employees. First Primary Care accomplishes this with a tiered service line beginning with a solid foundation of primary care. This base layer represents 65% of care and is free to the patient, without copays or other expenses. Generic prescriptions are free. The second level, 25% of care, is Guided Healthcare and demonstrates price transparency and cash pay by the plan for specialists, imaging, outpatient surgery and more. The final 10% is “Guided to Network” care for hospitalizations, ER visits, or catastrophic events.
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Timestamps:
03:40 –A STRONG FOUNDATION
06:30 – PRICE TRANSPARENCY
06:45 – TIERED APPROACH
07:28 – SELF-FUNDED EMPLOYERS
08:35 – THE ORIGINAL ROLE OF INSURANCE
11:25 – COST SAVINGS TO EMPLOYERS
15:20 – COST VS VALUE
16:05 – 65% BASE LAYER OF FREE HEALTHCARE
17:45 – GUIDED HEALTHCARE
19:30 – GUIDED TO NETWORK
21:05 – PLAN ADMINISTRATION
24:20 – EMPLOYER’S RISK
26:55 – STOP-LOSS CLAIM FUND SURPLUS
29:55 – WHY NOT REDESIGN INSURANCE?
34:30 – STARTING A PHYSICIAN LED INSURANCE COMPANY
40:50 – THE CHANGING ROLE OF BROKERS
47:18 – TPA (THIRD PARTY ADMINISTRATOR) AS PARTNER
48:55 – PHARMACY SERVICES
54:30 – TEAM
57:25 – RPM (Remote Patient Monitoring)
59:45 – WHO IS YOUR CUSTOMER?
102:15 – GROWTH / NATIONAL FOOTPRINT
103:50 – THE BIG INSURERS: ARE THEY TOO BIG TO FAIL?
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DISCLAIMER: Merge Medical and the podcast hosts are providing this content for informational and entertainment purposes only and are not broker dealers or registered investment advisors. We are not providing investment or legal advice.
