As part of the implementation of the Affordable Care Act, health care organizations have extended their patient coverage umbrellas.
A trio of Medford naturopaths who think they have a more efficient approach launched their own primary care business last year, and they believe others will follow as the health care industry seeks to contain costs.
McClane Duncan, Blake Myers and Sarah Sue Myers opened Siskiyou Vital Medicine in the fall of 2014. A year later, they adopted a subscription-based, direct primary care model that charges monthly dues. There is no insurance billing or Medicare or Medicaid coverage.
"We're going to take care of 95 percent of person's medical needs," Blake Myers said.
The health care debate leading to the ACA centered on expanding access to medical insurance. Doctors at Siskiyou Vital Medicine see access to primary medical care as the real need and adopted a subscription-based approach not tied to insurance, offering patients unrestricted access beginning at $70 a month. A children's plan costs $50 monthly. Coupled with a low-premium, high-deductible catastrophic insurance plan, Duncan suggests patients will have greater access to medical attention at far less cost.
"We believe this model will become the standard within the next 10 years, because its reduces costs and red tape," Duncan said. "When it costs $180 for an office visit, it becomes a financial barrier. We've unlocked accessibility."
Siskiyou Vital Medicine is one of 22 "retainer" practices certified by the state since 2011. At present, Duncan, Meyers and Meyers say they are the only naturopaths operating a direct-care practice. Monthly fees cover office visits, wholesale pricing on labs, discounts on supplements and medications, and procedures. The practice provides on-call physicians, same-week appointments and contact via email, Skype and Twitter. The practice doesn't handle emergency room trauma calls or obstetrics. It does provide lab testing and can put in imaging orders. Its patients run from 5 months old to senior citizens.
"The number of primary care physicians has been on the decline for a number of years," said Blake Myers. "At the same time, more people have become interested in natural approaches to their health."
The present staff could handle 1,800 members, 600 per doctor — a far better ratio than coordinated care organizations, where typical primary care physicians deal with four times or more as many patients, they said.
"Those insurance models typically take seven staff to support that position," Duncan said. "Our model needs one or two support staff, drastically reducing overhead and cost of care."
Even with wider availability of health insurance, Duncan believes it has been effectively used.
"In our model we can spend an hour to 90 minutes with a patient," he said. "In an insurance model you spend 10 to 15 minutes with a patient and then send them along to a specialist. We do that less often."
Sarah Sue Myers said about a quarter of her office's patients are referred to specialists.
The three naturopaths are graduates of Bastyr University in Kenmore, Wash., northeast of Seattle. Duncan thought the Rogue Valley was a promising location to start a practice. He didn't need long to convince the Myers to move to Southern Oregon.
"Ashland was pretty saturated with natural health practitioners," Duncan said. "But we felt Medford had been neglected and had a population desiring natural care."
For more on the practice, go to www.siskiyouvitalmedicine.com
Reach reporter Greg Stiles at 541-776-4463 or firstname.lastname@example.org. Follow him on Twitter at www.twitter.com/GregMTBusiness, on Facebook at www.facebook.com/greg.stiles.31, and read his blog at www.mailtribune.com/EconomicEdge.