The average annual premium for employer-sponsored family health insurance nationally is almost $27,000. It’s a little bit lower in our state, coming in at about $25,000. This is a big expense for business owners and a group of South Carolina physicians decided to build an alternative. Mike Switzer interviews Dr. Spence Taylor with TPC Direct Care in Greenville, SC.
TRANSCRIPT:
Switzer: Hello and welcome to another edition of the South Carolina Business Review. This is Mike Switzer. The average annual premium for employer sponsored family health insurance nationally is almost $27,000. It's a little bit lower in our state, coming in at about $25,000. But this is a big expense for business owners and a group of South Carolina physicians has decided to build an alternative. Dr. Spence Taylor is with TPC Direct Care. He joins us by phone now from his office in Greenville, South Carolina. Spence, welcome to the program.
Taylor: Mike, great to be here.
Switzer: Tell us how this got started and what it is the company does.
Taylor: I've been in healthcare at least 40 years as a vascular surgeon, as a medical school dean, as a healthcare executive. About the time of COVID we started up this public benefit corporation looking at how to improve medical care for people and looking at areas in the medical care world that needed to be addressed. And this came up this idea of employer sponsored health care which as you know has been mandated if you have more than 50 employees the cost of that care has gone up literally 300% since the year 2000. And employers are just incredibly sad because they can't supply quality care for their employees and they can't afford it. And so when we started looking at ways to improve medical care, so we created a company that provides what we call advanced primary care where in essence we'll work directly for an employer and come into the company and provide a per member per month m dollar amount care for their employees who are literally on a phone, there's an app and our panel of doctors work online. Is the ping paid for by your employer. And we will take care of all your health needs, primary care health needs, from wellness physicals and your wellness physicals to episodic care to any kind of semi emergent that you have. And so we will do all that virtually and then if you need to be seen in person, we send you to one of our urgent cares that we contract with. We currently contract with doctor's care, the Novant urgent cares. We will also add other urgent cares and if there's inpatient or in person needs there, you're taking care of there. And then our doctors take back over on the on the online service and we write prescriptions, send it to your pharmacy and we do that for a single price, for that the employer pays for the employees, no deductible, no copay. And what we end up doing is taking a lot of the current, the expense off the employers cost you we reduce their emergency room visits by, you know, 50% or so and avoid, specialty care in many instances because, you know, right now in our current system, as you know, the visit time per patient in the current system is extremely short. And a lot of times primary care docs just end up referring patients to specialists.
Switzer: What is the average percentage, I guess cost savings that you are seeing employers receive for something like this?
Taylor: So this model was started in 2020 in Houston, Texas. The average savings per employee is roughly 30% of savings to their healthcare plan.
Switzer: Okay, and so this started in Texas then. Does that mean this is a sort of a franchise thing going state by state?
Taylor: It is sort of a franchise thing. We are white labeling the product from Houston and TPT Direct Care uses their software, uses their physician platform of which we've added to it because we use South Carolina physicians, including my and Dr. Crumpler, who works on the platform itself along with some others.
Switzer: Okay, and so what does this plan not cover and what would need to be done to have coverage for these? I'm assuming they still would need some level of insurance and it would be through the employer.
Taylor: What the companies do, they will maintain an insurance policy on top of this other policy covers everything else, just as it would in any, any type of a regular policy. That's correct.
Switzer: And so the major health insurance companies then have policies that carve out for something like this.
Taylor: We don't participate with any insurance companies. We go direct to the employer. And what we're able to demonstrate is we can show the avoidance of, all the urgent care visits that they would have had. So in other words, we keep the cost of the urgent care off their plan.
Switzer: You said basically you become the patient's primary care doctor. But what if they don't want to change their primary care doctor?
Taylor: They 100% can still use their primary care doctor. This is just an add on, on top that in essence that the employer has made the commitment to add for their employees. But if you go to your doc, you're going to have to get in the car and you're going to have to pay a copay and you can miss half a day. And they tell you, well, you might want to just go to the urgent care because we can't see you for a week.
Switzer: Well, Spence, thank you so much for spending time with us today.
Taylor: Mike, thanks for having me on. It's a real pleasure. Thanks.
Switzer: Dr. Spence Taylor is with TPC Direct Care in Greenville, South Carolina. We will have a link to the company posted at our webpage so you can learn more at SouthCarolinaPublicRadio.org where you can hear this show again. And you can hear us again wherever you find podcasts. With the South Carolina Business Review, this is Mike Switzer.
The views expressed on the South Carolina Business Review do not necessarily reflect those of South Carolina Public Radio. South Carolina Business Review transcripts are intended to accurately represent the original audio version of the program; however, some discrepancies or inaccuracies may exist. The audio format serves as the official record of South Carolina Business Review’s programming.
