Mountain Medical Arts —Direct Primary Care (DPC)
Mountain Medical Arts Membership Pricing Schedule:
- $50 per month. $150 maximum per single household family.This keeps our doors open so we are always available to you, but does not per say cover any services other than simple phone or patient portal questions, prior authorizations done outside of visit hours etc.
- $25 per month disabled adults or financial hardship (financial hardship spots are currently full)
- $325 Seasonal Memberships are 6 consecutive months from the time you pay, you must have another doctor who manages you at your other location the other six months. Must be renewed at the one year date to maintain membership privileges.
- Children (up to 18 or in college up to 26) of an adult member will be $20 per month extra.
- With membership we pay for your annual blood work if your insurance does not include that coverage. We have deeply discounted contract laboratory prices for other specialty labs.
- You may cancel your membership at any time, but if you wish to return to the practice, assuming we have room to accept you back, you have to pay the difference to catch your membership back up. We have found that people were using us just for urgent complicated matters or when they were unhappy care other places, and our model depends on most patients being healthy and not needing regular complicated management. In essence this is a cost sharing model where everyone is covering sick patients knowing that if you need us we are here for you 24/7 365 days a year. This fee does also cover our administrative costs to create your chart, gathering and reviewing records to coordinate care.
- $25 anytime you come in to see us (comprehensive yearly visits, an acute illness or simple follow up, or disease management at the same time as yearly visit)
- To see you at home $125 (subject to schedule availability and distance from office)
- Dr. Rothe Osteopathic fees (with membership) $75 for each 25 minute session, $140 for 50 minutes, $200 for 100 minutes
- Jonathan Polgar PA-c Cranio-sacral, Reiki, IM hands on treatments $60-$80
- Integrative Consult, Coordination of Care for direct admit to hospital or specialist $50 25min, $100 50 min and DOT/CDL physicals, includes written instructions and online paperwork for you and other necessary professionals
- Internet, patient portal or phone visit $25 simple, $50 complicated with coordination of care and printed education information.
Nonmember but Active Patient prices:
- To be active must have a comprehensive yearly visit $300
- DOT/CDL physicals $150
- Dr Rothe Osteopathy 25 minutes $200 50 minutes $300
- $600 Dr Rothe Integrative Medicine Initial Visit includes review of all records, clinical exam and review in person or via internet, and printed plan with patient portal questions and answers on all recommendations made that visit (additional charges for new problems)
- Unhurried appointments – freed from excessive paperwork, we are less likely to run behind and have more time to spend with you (emergencies do still happen)
- Transparent and realistic billing pricing for visits, labs, pathology and medicines. You will never get a surprise bill from us.
Online resources for more information about Direct Primary Care
Summary of Direct Primary Care:
- 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. You can ask us about Liberty cost sharing which pays for part of your DPC membership and is an alternative to insurance for many people. 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.
- 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.
- Most patients are coming in many times a year, which we want to encourage as needed, but consider this: when someone comes in monthly at $20 for the visit + $50 for the month = $70/hour-long visit, even in our low overhead model, the hourly cost to be open (staff, mortgage, computers, phones, internet, supplies, etc.) exceeds that amount. Most Direct Care practices charge a higher monthly fee than we do. Many also charge more as people age, the assumption being that as people age, they require more medical care; but that isn’t true here – some of our oldest patients are also our most healthy!
- 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?
- This is the only primary care model approved under the ACA (ObamaCare) that may not trigger penalty
- Laboratory prices in cash versus billing, which may end up being much higher
- 33% of independent practices are expected to be DPC.
- DPC is patient-centered with plenty of time and resources for care coordination.
- Provides a safety net alternative for uninsured or underinsured.
- Reinforces the patient/physician relationship. There are no conflicts of interest.
Mountain Medical Arts Staff
Mountain Medical Arts uses the best evidence-based, allopathic, osteopathic and integrative medical approaches to deliver comprehensive health care for patients of all ages from birth through life and into the dying process.
Our practice has an in-house lab and can coordinate state-of-the-art skin, urine, salivary and blood testing including allergy/immunology, autoimmune, neuroendocrine, nutritional and toxicity panels for accurate diagnoses and treatment of myraid diseases and assessing wellness.