In the face of the constantly changing healthcare landscape, alternative healthcare models become more crucial to providers and networks looking to remain competitive. More than ever, patients are searching for affordable, transparent, and empowering health plans, and providers want to deliver high-quality and hassle-free care with price transparency. Subscription and membership-based healthcare models are proving to be effective solutions to the needs of both parties.
Direct Medical Care Arrangements (DCMA)
A Direct Medical Care Arrangement (DCMA) is a monthly membership that an employer or patient can set up directly with a physician. Physicians can build an IRS-compliant plan that includes a defined set of medical services for a fixed annual or periodic fee. Patients can use pre-tax accounts, such as Flexible Spending Accounts (FSA), Health Savings Accounts (HSA), or Health Reimbursement Accounts (HRA) to pay the membership fee. Because DCMAs are HSA, FSA, and HRA compliant, they require adherence to IRS substantiation regulations. Accresa is the only platform that can auto-substantiate HSA, FSA, and HRA transactions for DCMA memberships.
DCMAs benefit all parties involved. Physicians gain wider access to the market, reduce operational costs, and bypass the administrative burden of dealing with insurance companies. Employers experience more control over insurance premiums and claim costs, save on monthly fees with pre-tax funding, and improve employee experience by replacing ineffective care management and programs with a benefit employees will use. Patients no longer worry about surprise costs and can be more proactive about their health.
Patients can already use their FSA or HSA funds to pay for DCMA membership fees, but we’re always looking to further improve the healthcare landscape and empower employers and employees to take control of their healthcare journey. Our sister company, Ameriflex, now offers the Ameriflex HRA+DCMA Program, which allows HRAs to pay for DCMAs.
Ameriflex HRA + DCMA Program
The HRA is already primed for customization and saving. The employer decides how much money they will put into the HRA and designates what expenses are eligible to be reimbursed. With no IRS max, the HRA allowance set by the employer can be tailored to the company’s specific needs, making it more cost-effective. Employees benefit from a 100% employer-funded, tax-free account that they can use to pay for eligible expenses. Unused funds may also roll over year to year if enabled by the employer, which can help employees save over time.
When the HRA is paired with the DCMA, employers and employees can enjoy the benefits of both. Employers can control insurance premiums and claim costs, become more competitive with higher-quality benefit offerings, and save on the monthly fees paid to physicians. Employees can be confident about medical costs, build a more sustainable relationship with their providers, and be proactive with their health. As a result, employees are more likely to get the most out of their benefits.
Together, the Ameriflex HRA and DMCA build an accessible bridge (that employers can more easily regulate) between employees and their providers. The HRA payment maintains the exact audit trail of employees’ purchases to fulfill the IRS’ substantiation requirements for HRA expenses. Employees also benefit from additional preventative care benefits that can be provided by a High Deductible Health Plan (HDHP).
Interested in learning more about DCMA programs and how that can better serve you? Contact us today.
