This allows workers to address evolving health concerns rapidly in order that the condition can be treated more quickly and the number of sick days or days of decreased productivity from illness might be reduced. Many DPC practices provide phone or email access to providers so that employees or patients may not even need to leave their workplace to seek medical advice. Another emerging model is partnering with Healthshare plans where fees are sometimes reduced when participating in both a DPC practice and Healthshare plan. Coverage is more complete and affordable though still lacking for certain services depending on both the DPC practice and Healthshare plan. Criticisms Opponents of direct primary care models assert that direct primary care is unethical, primarily benefitting providers and not patients. Proponents of direct primary care models believe that insurance companies as middlemen are unethical, primarily benefitting insurance companies and taking time away from providers. The US Patient Protection and Affordable Care Act requires that DPC practices offering such services must include in their plans a secondary qualifying health plan (QHP) that covers other hospital services that the DPC provider may not offer if they choose to offer their DPC arrangement in the healthcare marketplace. Therefore, in cases where the DPC provider has chosen to participate in the healthcare marketplace, the patient would be required to carry and pay for an additional insurance coverage plan for catastrophic and hospital services in addition to the DPC arrangement for primary health care access if he/she purchases this plan from the healthcare marketplace. It is argued that DPC plans can be more expensive in the long term, since by design none of the payments made to the DPC provider practice are counted towards insurance deductibles because the provider neither accepts insurance nor participates in the submission and management of the insurance claims process, potentially resulting in a higher out-of-pocket catastrophic or hospital services cost to the patient because deductibles would not necessarily have been reached when these services are provided. See also Consumer-driven health care Concierge medicine References Primary care United States federal health legislation Healthcare reform legislation in the United States Medicare and Medicaid (United States)