As part of its doctorate program, Duke University’s School of Nursing is coaching its students on how to make effective health policy “asks” to state and federal lawmakers.

Presentations were held on campus last week, and one of my colleagues and I had the pleasure of providing these students feedback on their policy pitches. Topics ranged from granting nurse practitioners the authority to prescribe medications without physician oversight to expanding Medicaid benefits for Doula Care. It was particularly satisfying to hear one student advocate for the abolishment of North Carolina’s Certificate of Need Laws – rules in which health care providers must ask their competitors permission to update major medical equipment or expand certain services.

One “ask” that stuck out to me was made by a nurse practitioner who voiced concern about his home state’s proposal to cut Medicare’s chronic care management (CCM) fee – an extra payment made to primary care providers who coordinate care for patients suffering from multiple illnesses. Given that one in four Americans has more than one chronic condition, the financial impact could be a big deal for providers in the state.

To prevent such Medicare cuts from taking effect, the legislature could certainly respond to upset primary care providers by raising revenue in other ways to offset state budget reductions. But I couldn’t help but think of the direct primary care (DPC) model as an ideal market solution for nurse practitioners to use to their advantage. Under DPC, primary care providers would no longer have to concern themselves with unexpected Medicare payment reductions because they no longer contract with third-party payers. They also wouldn’t have to comply with Medicare’s cumbersome “quality reporting” metrics and “meaningful use” requirements that don’t improve clinic workflow nor enhance patient care. Patients would have  peace of mind knowing that without the bureaucratic hassles associated with health insurance at the primary care level, they have better access and more TIME with their providers – all for an average $75 monthly fee. Taxpayers would also benefit. So Would Medicare.

Read more here for more details on how the DPC model helps chronically ill patients and providers alike.