How To "Sell" DPC In The World Of "I Have Good Insurance" with Lauren Tancredi

In this episode of My DPC Story, host Dr. Maryal Concepcion talks with Lauren Tancredi, a successful DPC entrepreneur, about the benefits and challenges of the direct primary care (DPC) model. The discussion addresses common concerns from potential patients about insurance coverage and the advantages of building a direct relationship with a primary care provider. Lauren shares valuable strategies for converting skeptical patients, emphasizing the importance of personalized care and transparent pricing. The episode also covers practical tips for DPC practices to educate and nurture prospective patients effectively, ultimately highlighting the transformative potential of DPC in improving patient satisfaction and healthcare outcomes. 

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Transcript

Maryal Concepcion, MD: 1:02

Primary care is an innovative, alternative path to insurance driven health care. Typically, a patient pays their doctor a low monthly membership and in return, builds a lasting relationship with their doctor and has their doctor available at their fingertips. Welcome to the My DPC Story podcast, where each week, You will hear the ever so relatable stories shared by physicians who have chosen to practice medicine in their individual communities through the direct primary care model. I'm your host, Marielle Conception, family physician, DPC owner, and former fee for service doctor. I hope you enjoy today's episode and come away feeling inspired about the future of patient care, direct primary care. Thank you so much for tuning in today. My DPC story listeners. I am super excited to get this podcast out there on the airwaves because Lauren Tancredi, who is joining me today, who is an amazing DPC entrepreneur. She is fantastic. Most of you already know her but she and I are going to talk about this time of year. A lot of people are looking at their benefits. A lot of people are looking at their benefits for so many reasons. And a lot of people are looking for other options, including DPC. So Lauren, welcome back to the podcast.

Lauren Tancredi: 2:19

Thanks for having me, Mariel. Super excited to be here, especially as it's January and everybody's like, Oh my gosh, I'm back in my resolutions and health goals and like actually putting this forward in front of mine. So the perfect time of year to have this conversation.

Maryal Concepcion, MD: 2:33

And I'm sure the listeners have already heard out there, you know, patients saying, Oh, I, I tried to do my whatever that I wanted to for preventative health, but it's not covered by my insurance. And so that might be a reason why people are already ringing your phone. So let's get started. By talking about when it comes to patients who are out there and they are not yet members of our DPC practices, a lot of those patients have insurance. So Lauren, when you've talked with other people, individual doctors, as well as practices as a whole, what are some of the things, the stories that you've heard in terms of can't join DPC because I have insurance, whether that be under Medicare or whether that be under traditional insurance.

Lauren Tancredi: 3:17

Yeah, well, I think, you know, there's a bigger kind of construct to this whole conversation, which is, if they're not seeing value, they're going to keep leaning into their insurance because they don't know any better, right? And I think that when Obamacare kind of came forward, as somebody who's been working in the private pay Medicine space since 2007, like it opened up a whole nother conversation for us because now all of a sudden people had to be their own advocates of their health, right? And how they get to navigate that. However, in direct care or direct pay in general, this objection of Will my insurance cover it? Right. Or I don't want to do it. Or those are the, you know, the military folks who have Tricare. And it's like, I serve my country so that they could take care of this kind of stuff for me. It's like, it's hard for our hearts not to go out to those people and say, yeah, I totally get it. And I was just teaching a class of sales class last week to a group of folks that were starting. And they were saying like, I constantly get this. Like I have insurances, insurance cover it and I told them like, Well, be spicy. You know, like, what do you have to lose at the end of the day? Like, be spicy and ask them, like, you just told me access is a problem. You just told me that you can't get into a provider that's listed in your insurance network for three to four months. Ask them, how's insurance working for you? Really? Because at the end of the day, there's a reason that that person is on the other end of your phone seeking you out, right? Seeking you out. And so if you don't uncover those pain points, yeah, insurance is going to be the default response. Um,

Maryal Concepcion, MD: 4:45

Here it makes me think about, you know, my own journey in DPC and living in an area that's very much leaning towards Medicare by age qualifications, not by disability qualifications. And I when I hear you say that, and I absolutely agree, you know, calling those calling those myths out about like, oh, insurance is so good because and then when a person actually thinks about it, they can't use it. It also, I think, comes with this, like, taking the patients that we are talking to our potential patients a back because I find that they are then faced with like, I didn't even know that in this conversation I was going to be thinking about is my own insurance serving me properly, and then having another layer about how do I get to understanding value. So I think that that's something that I noticed in my patients, it was like, when we started talking about, we don't take insurance in our practice for our services, the conversation would stop there because in my, in my very early days with meet and greets, the conversation would stop there. Now I have. You know, transition to how I talk about where insurance plays a role in our practice. But I'd love to hear your, your take on that because I have seen that where patients just completely stop listening after they hear, but we don't take insurance at DPC.

Lauren Tancredi: 6:05

Yeah, I think a lot of times kind of to your point, I don't really ever say no, we don't take insurance, right? I don't ever tell them no, even though the answer is no, especially in direct care, right? And so, when somebody's like, do you take my insurance? I usually like, would suggest, right? That it's like, you know, We actually do things a little bit differently here. And before I go into that answer, let me kind of like match the pain to the value, right? Then once you have that conversation, then we can come back around and actually address the insurance question, which I like to respond to. Like all of our patients have insurance and the way that we work with your insurance is different. And then we can explain like, Hey, you still use your tests, your insurance for testing and specialty doctors and like, The things that you might need to use. And you know, for those of you who followed me, you probably heard this story a hundred times, but like I had insurance, right? I have a high deductible. I went to the OB GYN and they're like, here's your 1, 300 lab bill. And I turned around and took it to my DPC doc. And it was a hundred and eighty bucks or something like that. So that savings alone paid for my direct care membership for a year, just that one, that one thing. And so the more we can build like and have these case studies and understand, you know, what is the attachment to insurance, what kind of insurance and how can we navigate it? Like. The easier it is for people to to see the value in what you're offering. So it's not like, you know, kind of what you're saying, like multi layered and I have to go into the deep dive. It's like, if you gather enough information, you guys are your doctors, right, your clinicians, and you're constantly gathering information to put together a story. That's all we're doing in the sales process too. And insurance just has to be, is one of those markers we're looking at.

Maryal Concepcion, MD: 7:46

Yes, I totally agree. And I found that that type of approach was completely transformational for the like, you know, vacant looks or the like, I'm not even listening, you know, looks on the zoom calls when I was doing my meet and greets early on. And I will say that this is where being strategic about how you even set up a meet and greet can be helpful. So like at our practice, we have specifically like, what are you looking for in healthcare? And that's a very open ended question that we've gotten amazing responses to. We also have a question that is, you know how did you find us? And one of the options is former patient of Dr. C and Dr. Philo. The other one is like Google, social media, et cetera. But I, I think that also. You know, Figuring out by doing is so important and I think that this is where, especially if you're a micro practice doctor or if you're a doctor who is planning on having staff, I think this is where it's important to, you know, think about doing and knowing what the system, what the workflow is, what types of conversations you have before you train someone is really important.

Lauren Tancredi: 8:53

Yeah, totally. I mean, it's definitely my recommendation. And one of the things I say is like, there's no failure. It's just feedback, right? And so I think you probably even heard me say Mario, like early on when you're doing these things, and people are saying, you know, 50 percent of people are going to say no to you big deal, like get the nose out of the way to get the yeses. And when we hear the no, you get to ask, like, Can you tell me why you're no, because it will teach you on where the conversation may have a gap. Transcribed Right. So that you can actually educate further or correct. Maybe a misunderstanding that happened in a conversation because ultimately DPC is like, you know, icing on the cake in terms of healthcare. And even this morning in my networking meeting, I was telling like people about what I did and like three entrepreneurs came up to me. They're like, we need to change our health plan and talk to you about what this thing is that you're doing. And, you know, like, And so people just, they don't know until they know and it's our job to be really great educators of, of what that means. And that doesn't mean necessarily like you have to be an expert in the hundreds of thousands of plans that are out there that people are caring for insurance.

Maryal Concepcion, MD: 9:55

Totally. And I think that even just knowing basic facts about how DPC and direct care is different than Medicare and traditional insurance, you know, any like it we are in such a state of health care that our patients most of the time, from my experience, patients of all ages, all insurance coverage backgrounds are like, I didn't even know basic facts like that. They don't cover da da da. I mean, I had a patient who had gold platinum And they still couldn't get their 3D mammogram covered. The only one that was covered was a 2D mammogram. And this patient had to pay 400. And this patient, patient does have Medicare and a supplementary. So when, when you talk about education, I would love your take on story. Like sometimes people have testimonials from their patients on their websites. Sometimes people use those testimonials and social media. What's your take on educating through story? story, either if it's a story that you've experienced as the, as the physician at the clinic or from your patients or from people that you've heard about within the community.

Lauren Tancredi: 10:59

Yeah, I mean, people can relate to stories. Storytelling is so great because a lot of folks are visual. So all of a sudden they get to one relate to what's happening in some ways, or even imagine it happening. And so I think you're spot on. It's like, you know emulate until you innovate is what I like to say a lot of times. And so sometimes we have to borrow the stories like you can borrow my story, right? My story of saving me a thousand dollars on my, on my bill and paying for the costs. There's tons of providers out there that have been sharing these stories with, you know, the general public in our conferences and our You know, in our meetings and that type of thing. And so, you know, borrow stuff that shows the value add until you actually create your own. And also too, what it does is it helps you like really show your person that you're talking to your prospective patient that you're listening when you could actually map that up. And I, and I've talked about this too, a lot in the business training, like those of you who don't have businesses that want to work with them, it's like, Give them an example of like, imagine if you were driving to work, imagine somebody called out and you're like, Oh man, I'm going to have to like cover today. Right. And you can give them your doctor's phone number and say, call, let's get you, get you healthy and get you back in. Like you get to like create these things for people to imagine what's possible with direct primary care, whether it's the insurance side or the actual care side of things.

Maryal Concepcion, MD: 12:21

Totally. And I also think that one of the hidden benefits of, you know, doing this process of everything that you've talked about, you know, having the conversations, figuring out, like, what is the reason that, you know, direct care still doesn't seem like it's an option for you, whatever it might be. I think it's I think a hidden layer of benefit that I found in doing these conversations was it also pushed me to answer my own questions as to we can do it more transparent or possibly cheaper. How much does a CBC cost? How much does a, you know, a mammogram, a 3D mammogram cost in my area? So I think it, it, it, you know, it, it challenges the, the, the business owner and all of us to say, like, Now I actually know now I actually need to go find this information. And then once I have it, I'm able to do things like if you can publish it on your website or publish it on social media, going along with these stories to show not only like here is here is the the story, but also how we solved it as a DPC practice.

Lauren Tancredi: 13:25

Yeah, absolutely. I know, like, one of the presentations that I'd help create early on for a group. That was converting some of their docs into direct primary care is like, let's take the avatar and show them like, here's what, what he paid in his insurance plan, right? That was supposed to cover the things and he still came out of pocket and here's what he would have paid for with direct care and cash. And the savings is significant, right? Even, even the people that have the insurance, we can still save them a significant amount of money. I think of Dr. Bushman and Reliant DPC. It's like, he was telling me stories about how he got somebody their meds, and the savings in their meds alone was like 3, 000 a year. Crazy. Crazy amount of dollars.

Maryal Concepcion, MD: 14:07

And, you know, just jumping on the story bandwagon, like, it's not even, sometimes it's not even calculable how important having a direct care option is, like, for example my patient was having heart palpitations and the cardiologist's office, and this is, you know, a couple months ago, we'll see you in March. And I'm like, you absolutely can do that option. The other option is you can go to the front of the line and I can order a zeo patch for you and get it to your door for hundreds of dollars and that can happen within a week because it just. It means me ordering it online and then you, and then them shipping it to you and then you wearing it. And then I can send that information to your cardiologist to make them say, Oh, I actually have to take this more seriously and get you in sooner. And so, that potentially life saving intervention, it, how, what, what do you put, you know, to, what do you put as cost on that or price to that? I mean, you

Lauren Tancredi: 15:04

don't at the end of the day, it's your life, right? And so it's like, not only are you helping improve the quality of life, but the coordination of care is pretty priceless, especially given our, our current climate and as you were alluding to like the long wait times. And so it's, you know, it's about the care that you're giving to people directly, but also like how you're able to coordinate with the community and colleagues to be able to. Go and reach these multi specialty groups to be able to facilitate what your patients need and potentially already have cash pricing for them if they need that.

Maryal Concepcion, MD: 15:34

Tell me about how you talk with people, practices, physician owners, about when a person has that meet and greet and they're like, okay, I, the patient comes away with like, wow, I didn't realize insurance was actually not helping me because of that conversation. I'm thinking about it now. And then they come back, they come back a year later, a month later, who knows? But how do you talk to. Talk to physicians and practices about how to consider that lead. Would that lead be considered a warm lead? And how would you nurture that lead?

Lauren Tancredi: 16:08

Yeah, totally. So, you know, the thing about primary care for those of you that are like in direct primary care and not necessarily the specialty side of things is most of the time, people won't need you till they need you. Right. They're not like, Oh, let me make sure I've got my family doc in my back pocket. It's going to be like, Oh crap, I have flu symptoms and now I need somebody. And it's like urgent care or die. Right. It's like, so they may not be a yes right now to your point, Mario. And so then it's like, how do we nurture and educate and keep them warm? Whether that's, and really for you as a provider and, or a practice, it's like. Who do we have and what can we share so that we can continue to show like our expert secrets, right? I'll take like Russell Branson's approach, like who we are and like the value we bring, you know, I think of Dr. Boucher and he's giving out tips all the time on you know, how to get your kids to sleep and whatever it is, right? What is it that makes you excited to share with people? And if it's not you, if it's somebody on your team, that's totally cool too. But there's got to be some kind of like keeping you top of mind in between. So that way, when The kid gets sick in the middle of the night and they're like, Oh gosh, let me go back to that video. And then tomorrow I'm going to call this doctor because they've been giving me so much value that I can't help but go to the person that's been supporting me even though I'm not enrolled. Right. And so My thing is, and when I first started working in, you know, cash pay businesses or direct pay businesses, you know, I worked for a hormone replacement clinic and that was like a 30 to 50, 000 a year program. It took me six months sometimes to get people enrolled into a program like that. But I take notes and this is again, like it's just like when people come into your meet and greet or calling into your practice, You get to treat it like a consultation in some ways where you're allowing them to talk, be heard and seen. And that way you can find like the thread of things, right? So if somebody tells me X, Y, and Z, when I see an article or when I write a newsletter or whatever it is about that thing topic, I'm going to be like, Hey, this made me think about our conversation, Mariel, here you go. I thought it would be useful. Right. And so we're like building this relationship because sometimes it takes a little bit of time before people are like, yeah. ready and willing to enroll and invest money in themselves, especially if there's not like an urgent need right there. And that's, that's the challenge with direct, primary care is like, unless you're really niching down to, you know, thyroid or hormones or something, like people don't, won't need you necessarily until they need you. And then from a practice perspective, it's like allowing for the time and space for when these people to call in to actually feel heard and seen. And so many of you probably have a front desk person who's scheduling appointments and doing the consults and. You know, I've shared this hundreds of times, but at hint summit three, two or three years ago, now we called over a hundred practice to secret shop them. And I did this just the other day for a client I'm consulting with. And again, yeah, didn't even ask for my name. And he just told me all about how it works like all of a sudden I got an IUD thrown into the package for 80 bucks a month. I'm like, there's no way that that's real. Right. And so. You know, making sure that your team is educated about what it is, maybe even having the experience of it, potentially shopping other practices so they can see how it's done. But really it's just about like listening and matching those pain points to, to solutions. And if you don't have somebody who's able to like take back and have time to do that, put them into a meeting. Great. Because the last thing you want to do, and so many of us like we're generating leads, we're looking for new business, and then they're coming into a bucket with a hole in it. And it's just going up right out the other side. And that's so frustrating as a business owner.

Maryal Concepcion, MD: 20:27

So let's do a little role play because I think this would be a great way to just sum all this stuff up I'm going to play the role of the very well insurance endowed patient and I'm going to be calling into your DPC. Does that sound like a plan? Sounds great. Let's do it. Awesome. Ring, ring. Hi, thanks for calling my DPC story. This is

Lauren Tancredi: 20:49

Lauren. How can I help you?

20:51

Hey there I am just calling because I'm not really sure what this My DPC Story thing is. I my neighbor told me that you guys see people of all insurances and so I'm just wondering, you know, can you tell me about what's, what is My DPC Story? Sure.

Lauren Tancredi: 21:11

Before we get started, we do things a little bit differently here. So I'm going to ask you for your name and, and contact information just in case I need to follow up with you or send you any additional information after your call.

Maryal Concepcion, MD: 21:22

Yeah, absolutely. So my name is Susan. And my last name is I'm just going to try to think of something that could be misspelled. I. Johnson.

Lauren Tancredi: 21:35

We, so Susan, and it's Johnson J O H N S O N. It's actually J O H N S T O N. Oh, perfect. Thanks so much. I wanted to make sure that we got that right the first time. And then you've also given me your email and your phone number that I've written down and repeated back to you because I'm just going to make a side note. This is so important, you guys. So, so important. All right, Susan. So. And we would love to be able to thank your neighbor for having you call in. Can you, would you mind sharing their name with us so that we can say thanks?

Maryal Concepcion, MD: 22:09

Oh yeah, absolutely. Regina, Regina George.

Lauren Tancredi: 22:13

Awesome. So Regina has probably told you a little bit about our practice enough to make you pick up the phone and call us today. Tell me a little bit about what you're looking for in terms of, or when it comes to primary care.

Maryal Concepcion, MD: 22:25

Yeah. So I have a primary care nurse practitioner right now, but I can't. get in to see them. Unfortunately, every time I've called the last six months, if I've had a cold, cause it's cold and flu season I've had to just go to the urgent care or emergency room. And I didn't realize that it was actually going to be really expensive every time I went there. And I wish I could get in to see, you know, my primary so that I could save my, my pocketbook going to the ER and urgent care.

Lauren Tancredi: 22:56

Yeah, so it sounds like you really are looking for a primary care home that can help you when you have like urgent needs outside of like maybe regular maintenance stuff. Would you say you're pretty healthy overall? Thankfully, yeah. Oh, give thanks. We, we love those kinds of patients. And so you know, Susan, some of the things that we do differently here, I'd love to tell you about if you've got maybe a couple extra minutes, so I can share the experience of my DPC story with you. Yeah, sure. Okay. Awesome. So Regina probably told you we take all our, we work with patients that have all kinds of insurances here. However, we do do things a little bit differently. And now I'm going to start to like explain, and this is more for the listeners than it is for you, Susan, right now, but explain about how I'm matching her pain points to the, to what we DPC story. Right. So what I'm hearing is that takes a little while for you to get into your nurse practitioner that you would love to be able to see her pick up the phone and call her or even receive a call back when you have like these urgent needs, maybe outside of clinic hours or after hours to save from that large hospital or ER bill or urgent care bill that you're receiving. And the beautiful thing is that my DPC story is our doctor works with a small set of patients. Like there's only X amount of patients in our practice. Let's just call it. for 500 patients, which means that you've got great access to your provider and care team. So typically, if you're not feeling well, And you're having like those cold and flu symptoms. Like you told me, Susan, we can get you in the same day or next day. And now the most exciting part about that is most of the time, 80 percent of primary care needs can get done by virtual visits. So if you're really feeling under the weather, we can see you on a zoom or over a phone call. And if it's medically appropriate, get you the care that you need. Does that sound like it would

Maryal Concepcion, MD: 24:49

be beneficial to

Lauren Tancredi: 24:50

you?

Maryal Concepcion, MD: 24:52

Yeah, definitely. Like this, this phone call is definitely helping in terms of me understanding what, what the practice is about. I'm just wondering in terms of my insurance, I have said book a plan that I get through my employer. Is it. Are you guys a covered provider?

Lauren Tancredi: 25:11

Like I mentioned before, we have patients that have all kinds of insurance and you're absolutely going to want that in case you need care outside of the four walls of our office. The beautiful thing is what I've heard from you say is like you're getting unpredictable bills from your ER visit and your urgent care. We do it things for one flat fee. You pay every single month and you get unlimited access to the practice. And that fee is X amount of dollars a month. Now, unfortunately, that doesn't get covered by your insurance because we're doing things a little bit differently here. And what I heard you say was your insurance is making you wait a really long time to get in to see your nurse practitioner and then driving you to urgent care, which wouldn't happen in our practice. Are you starting to see a little bit of how the value of your investment could actually give you a little bit more support without those surprising bills at the end of the day?

Maryal Concepcion, MD: 26:01

Yeah, I, you know, I think about it when you say that, you know, 12 months of the monthly membership is actually Less than one visit that I had to the emergency room. So that's a really, I'm glad you pointed that out.

Lauren Tancredi: 26:17

Yeah, absolutely. And a lot of times we don't understand what the surprise bill on the back end is going to be with insurance. So another great benefit, and now I'd go into X, Y, and Z if I've got on site dispensing or labs, or, you know, like I can get you an x ray for 10 bucks if you needed it, where oftentimes it would cost you X, Y, and Z through your insurance if I needed to go down that route. But this is where we can actually take the time to educate a patient around. What the difference is with direct care versus using a plan like an insurance plan if we needed to.

Maryal Concepcion, MD: 26:47

And Total kid born in the 80s gonna pull this one on you, Lauren, but you know, like I'm going back to the, if you want to do this, if you want to go into the dragon's dungeon, turn to page 82, if you want to go to the park, whatever, turn to page 83. I'm going to now switch that in terms of you asking me, like, does that help you understand the value? Well, you know, I, I think so, but I just, I'm really interested in what my insurance covers today.

Lauren Tancredi: 27:13

Yeah, and I totally get that. This isn't for everybody. However, what I'm hearing you say is your insurance isn't working on your behalf right now because when you're sick, you're having to go wait in a room with sick people. And when you need your nurse practitioner, you're having to wait three or four weeks. So when you're ready, Susan, to be able to have access to the care that you deserve with the same day next day or whatever. Text your physician when you're not feeling well after hours, then I would ask you to reconsider my DPC story. But for now, if that sounds like that's the path you want to take, I'm totally, like, that's totally fine. We realize this isn't for everybody.

Maryal Concepcion, MD: 27:48

That was awesome. And I, you know, thank you for also playing along with my choose your own adventure role playing in the end there. But I, I think that. You know, this is, this is such an important time. Like you said, it's the, it's the first, portion of the year people are really invested in, being advocates for their own health care more so than ever before. And I think that we as direct primary care and direct care physicians can absolutely fill that that, that void. desire to find a relationship in a healthcare journey that people are really wanting and don't really know exists and don't necessarily know the value of. So if this conversation has sparked your, interest in looking into your own workflow, or if it's prompted more questions, join Lauren and I, we're going to do a live zoom event to just basically do a workshop what's your scenario that you've gone through? What is your pain point in terms of talking with patients who are interested, not interested saying they have insurance, et cetera. And you'll find that event registration on the, the events page at mydpcstory. com. And for those of you who are able to make it to our live event we're going to send you a free download, which is customizable, it's a Canva template for your practice, where you can put your own information in, and you can have it as a handout specifically for those patients who have insurance and are, you know, wanting to know the value proposition of your practice.

Lauren Tancredi: 29:14

Yeah, and that would be a great resource to send Suzanne after she told you no, and she's not for you because I guarantee you the first time she had that experience you reiterated to her, you're going to be the one that she calls. So it's okay. It's okay to let some people go because sometimes they got to go back out in the world and remember what it's like before they come back to something that might be new and unfamiliar with them.

Maryal Concepcion, MD: 29:35

Thank you so much, Lauren. I am so excited for our live event to continue the conversation even more. And I hope this is so helpful for you guys, the listeners. Thanks Muriel for having

Lauren Tancredi: 29:45

me and you all for putting up the hard work and the fight to be able to like not only care for people but also go through this educational process. I know it's not always easy and I trust that by having these types of conversations, you'll only continue to expand your practice and your impact.

Maryal Concepcion, MD: 30:04

Thank you for joining us for another episode of My DPC Story, highlighting the physician experience in the world of direct primary care. I hope you found today's conversation insightful and inspiring. If you want to dive deeper into the direct primary care movement, consider joining our My DPC Story Patreon community. Here you'll have access to exclusive content, including more interview topics and much more. Don't forget to subscribe to My DPC Story on your podcast feed and follow us on social media as well. If you're able, I'd greatly appreciate if you could leave us a review. It helps others to find the podcast. Until next time, stay informed, stay healthy, and keep advocating for DPC. Read more about DPC news on the daily at dpcnews. com. Until next week, this is Mariel Concepcion.