Employee healthcare costs are going up and Richard Green, CEO of DMOS Orthopaedic Centers isn’t insulated from the problem. His team is addressing the rise by adding healthcare benefits, vs removing them. He details his partnership with Hy-Vee Health Exemplar Care, how they’re utilizing the Direct Primary Care (DPC) model, and how it’s already saving them money.
As the CEO of healthcare company, Green understands the healthcare system better than most. He shares a mini case study on their decision to offer an unlimited DPC healthcare plan to his employees, and explains why adding this benefit reduced healthcare costs and increased access for employees. He breaks down the numbers and shares the hard data.
Green experiences healthcare from both sides of the spectrum: as a provider operating six locations and as an employer managing benefits for a growing workforce. Facing potential annual premium hikes between 15% and 25% under traditional fully insured plans, DMOS transitioned to Hy-Vee Health Exemplar Care’s Direct Primary Care (DPC) model to curb expenses.
“If we took what we would’ve gotten in a fully insured plan and been 15 to 25% increase, in a company like that, that’s a seven-figure number,” Green stated. By switching strategies, DMOS held its annual plan increase to just 3%, significantly beating the national 9% average reported by Aon studies.
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Testing and Scaling the Direct Primary Care Model
Before offering DPC to staff, Green, Board President Nick Honkamp, and plan architect Renee Pyle tested the membership personally. Green noted the stark contrast in care during an extended consultation with Dr. John Vanderveer, emphasizing that DPC limits panel sizes to 700–900 patients compared to 1,200 in traditional systems.
“Being able to sit down with your physician and spend time, form a relationship, have the access to get, go back and forth and communicate with them was really a powerful moment,” Green noted. Employee adoption rapidly expanded from 18% in the first year to 42% in year two as positive word-of-mouth spread.
ER Diversion and Long-Term Savings
A key driver of financial performance was 24/7 care access, which redirected employees away from emergency rooms. DMOS logged 212 after-hours visits between 7:00 PM and 7:00 AM last year. Avoiding hospital ER visits—which cost $5,000 to $6,000 on average—protected the plan’s underwriting profile.
“We save a ton of money with this after-hours care, plus at the same time you’re providing great access for people,” Green emphasized. DMOS also captured $400,000 in savings by managing its own pharmacy benefit manager (PBM), proving DPC’s value within a broader strategy.