As 2017 comes to a close and open enrollment is upon us, many are considering their health care options for the new year. Thanks to the legal approval it received from Montana insurance commissioner Matt Rosendale this week, a monthly fee-based health care model that does away with insurance billing is now a viable option. CostCare, a Missoula-based medical walk-in clinic, will be switching over to direct primary care on the first day of 2018.
For a monthly fee of $70 for adults and $25 for children under eighteen, patients who chose CostCare will be able to access routine medical care and a personal physician with no charge for office visits. Lab work and additional routine procedures will be available at minimal to no charge as well.
“We’re looking to re-establish the patient-doctor relationship,” said Dr. Carol Bridges, co-founder of CostCare. “We’re doing away with insurance. So, we’re going to do everything to keep people healthy and we’re going to do everything we can to keep people off medications. We’re finally getting out of that ‘do more, bill more’ concept that is bankrupting our health care system.”
Members will still need to have a high-deductible, low monthly cost insurance option for catastrophic medical emergencies, at least for the time being, and Bridges said the family practice clinic will be capped at 600 adults. Children will not be included in the limit.
“What we have found, and what nationally proves to be the case, is a vast majority of doctor visits are for routine medical issues such as strep throat, bladder infections or diabetes visits,” Bridges said. “High health insurance premiums are crippling many of us, and most of the time patients are still paying for routine office visits, lab work, etc., on top of their health insurance. This model offers an alternative.”
Of the patients who would most benefit from CostCare’s new model, she said, “These people are going to have full-time access to me through cellphones and email and other technology. For example, I have a patient that was out of the country and she was so glad she could talk by email with me every day. She had constant access. So many patients have issues that can be done over the phone. And the only way I’m going to get paid without forcing them to come to the office, and maybe leave work, is by taking the insurance company out of the equation.”
On Monday, Rosendale announced, “Montanans should have as many options on the table as possible to meet their health care needs as they see fit. Direct primary care is yet another option for consumers to access routine, preventative, or preliminary health care. These agreements between patients and their doctors are not insurance products, and will not be regulated by my office as insurance. He added, “While direct primary care provides a good alternative for many people seeking routine or basic health care treatment, it’s important for Montanans to have insurance coverage for major and unexpected health care costs.”
Bridges applauded Monday’s memorandum. “In this ever-changing health care environment and increasing deductibles, Direct Primary Care (DPC) is a monthly membership model that not only provides a cost-effective solution to the increasing cost of health care but at the same time renews the patient-doctor relationship while using modern technology including telemedicine, FaceTime, email, and text. Because providers are readily accessible, urgent care and ER visits are also minimized. The monthly fee covers all of the office visits and typically in-clinic testing. Procedures and other labs are priced at cost with savings typically 80 to 90 percent.”