A great new model of health care

MEDICAL CARE is going through traumatic changes in this country. You might not be aware, but primary care family physicians are disappearing rapidly – either by being gobbled up into large care groups, or going out of business.

The net effect of this is that quality of primary care is going down and options are disappearing.

This became painfully clear to me when I talked to Aaron Peterson this week, business administrator for Heritage Family Medicine.  They are part of a rapidly growing movement to change the way primary care is handled.

I’m excited about this trend, because I see this happening with the doctors that my family and friends use.

“Primary Care” refers to your family physician, the first person you typically go to for ordinary care.  Not the emergency room, not the specialists for the unusual ailments you might have, but the ordinary stuff.  The flu.  Keeping your blood pressure, cholesterol, and weight healthy.

The person who should know the most about your overall health.

But medical decisions these days are severely limited by the insurance carriers. This leads you to a situation where your typical doctor visit is ten minutes or less, and the time the physician actually spends looking at you and talking with you is, well, minimal.

Behind the scenes it’s quite scary. Typically the doctor will spend more time filling out insurance paperwork than they did with you, and a physician’s practice will spend over half of its revenue meeting insurance company requirements.

It’s a dreadful waste, which puts quality of care at the bottom.

A new emerging model pioneered by Heritage Family Medicine and others across the country is radically simpler and puts quality of care at the top. They call it Direct Primary Care. How does it work?

For a straightforward monthly fee, you get full primary care at no additional cost.  Everything they can do, they will do, and it’s included in your membership.  In return, HFM doesn’t have to deal with insurance companies, thus removing a whole set of requirements and restrictions.  And they pass the considerable savings on to their patients.

Doctors love it because they can actually return to doing what they love, helping their patients stay healthy and happy.  Members love it, because they actually have a deep relationship with their physicians, and ultimately are healthier.

Dr Marilu Orozco-Peterson

I had a chance to meet the two physicians with HFM. They’re warm and friendly and just the kind of people you might like to have on your side.  But this article is really more about the new business model that they have.

They’ve actually been providing family medical care in Fort Collins since 2002, but just recently they have adopted this new model.

As of October 1st, they’re doing this exclusively.

As you’d imagine, this means that they’re focused primarily on building their membership base so that they can support a full-time practice.

Dr. V. Raja Chandrasekaran

They’ve carefully crunched the numbers, and are confident that they’ll have a sustainable business which improves the lives of their members.  Which means they’re happy, as well.

Others around the country have shown that this model works well, but takes time to explain. People are accustomed to paying their insurance companies every month, but paying the physicians directly is unusual.

What I found out is that it may not be an additional cost, though. You still need an insurance policy – not only because the government now requires it, but because you need a high-deductible plan to cover those high-cost exceptional items.

If you are able to switch from a low-deductible to high-deductible insurance plan, you can then apply some of the saving to Direct Primary Care and actually lower your monthly costs. In this case you can save money and get better care. Which actually keeps you healthy.

This is an amazing innovation, brought on by both patients and doctors who are disturbed by the direction of health care in the U.S.  It takes courage and vision.

I’m so excited to see this happening!  Right here in our community, and across the nation.