Direct Primary Care Practice

We at Mountain Medical Arts moved here more than ten years ago to practice medicine in a style that honors you. Our specialty is longer visits: serving you, rather than the broken healthcare “system”.

Increasingly, insurance companies (including Medicare and Medicaid) are getting between us. As you have noticed, their definition of good care is based on how much we can type into a computer: your medications, your diagnoses, even your family members’ diagnoses are required documentation. All of this information is entered into centralized databases to “ensure quality” and “control cost.” Neither of those is happening, and yet, October 1st, new billing requirements will push even further into your privacy and take more time away from our visits. We want to take healthcare back from insurance! To do this, we will change to a Direct Primary Care practice.


Mountain Medical Arts – Direct Primary Care (DPC) Facts

Mountain Medical Arts Membership:

• $49 per month (comprehensive visit may be done after 6 months are paid)
• Children (up to 18) of an adult member will be $20 per month extra.
• A family maximum of $150/month
• Each in person office encounter will be a $20 fee (checkups)
• If we need to see you at home $125 (subject to schedule availability and distance from office)
• Dr. Rothe Osteopathic fees (with membership)$60 for each 40 minute session, $70 if coordinated with medical checkup
• Integrative Consult and Coordination of Care: $89/month X 6 months = $540

Nonmember active patient á la carte prices:

• To be active must have a yearly Wellness Checkup: no charge for common labs once a year $249
• Each office encounter (Single problem such as urinary or respiratory infection) $65
• Osteopathic evaluation $200 initial $150 follow up or $300 /$150 if other medical advice needed
• Integrative Medicine Consults $250 first visit and $100 per 30 minute follow up
• School sports, college or camp physical and completion of forms $50
• DOT/CDL $150 (doesn’t require being an “active” patient)

Benefits:

• Unhurried appointments – freed from excessive paperwork, we are less likely to run behind (emergencies do still happen) formerly spent on insurance requirements, time which can now be spent on you.
• Transparent and realistic billing pricing. Working with other DPC doctors gives us a collective buying power which will get you the very best prices for medications (80% less than Walmart in some cases), lab work, and other services. You will never get a surprise bill from us.

Online resources for more information about Direct Primary Care

www.libertydirect.org

www.aafp.org

www.dpcare.org

www.wikipedia.org

www.directprimarycarejournal.com


Summary of Direct Primary Care:

1. This is a membership in primary care, not insurance.

We cannot give you insurance advice, but do encourage you to have some form of insurance for emergency situations. When choosing the best plan for you, you may want to add up your copays, coinsurances, deductibles, prescriptions, labs and imaging costs over the last year and discuss with an insurance agent or your employer. We want you to make a decision about what is best (and affordable) for you. If you are concerned about costs, please consider that the cost of our plan is less than most cell-phone plans.

2. DPC is less expensive for most patients:

Medicare patients: save an average of 7% out of pocket over the cost of seeing a participating Medicare provider and paying their Medicare coinsurance (20% of bill total). People with supplemental policies to cover the coinsurance most often pay a premium much higher than our monthly cost.

Uninsured patients: DPC prices are much less than practices that bill insurance

Patients with high-deductible (catastrophic) PPO plans such as BCBS: about 82% less out of pocket expense, assuming the high-deductible is not reached (no catastrophe) – this is the case for most patients with these plans most years. HSA plan benefits will be discussed.

Patients with traditional low-deductible PPO coverage (such as BCBS) with copays for primary care visits: DPC was shown to be 12% less out of pocket than using insurance and seeing an in-network provider for the same services.

Medicaid: Apply for our reduced rates.

3. Insurance was created to cover things that happen rarely and are very expensive, not routine things.

For example: if car insurance paid for oil changes then the premiums would have to go up about 10 times the cost of the oil change per year to cover it due the administrative overhead.

Another example is flu shots. If you chose a plan that covers flu shots, they increase the premium $144 per year more even though the flu shot (preservative free) only costs $20. Wouldn’t it be better to just pay the $20?

4. This is the only primary care model approved under the ACA (ObamaCare) that may not trigger penalty

5. DPC is patient-centered with plenty of time and resources for care coordination.

6. Provides a safety net alternative for uninsured or underinsured.

7. Reinforces the patient/physician relationship. There are no conflicts of interest.