Membership-based healthcare on the rise in Colorado: No insurance required

Posted at 9:52 PM, May 03, 2017
and last updated 2017-05-04 00:55:46-04
LONGMONT, Colo. -- Unlimited visits, 24/7 access, all for under $100 per month sounds like a gym membership. But that's actually the description of a healthcare plan. The type of plan that could soon become much more common in Colorado. 
"When you haven't met your deductible everything's basically full price," Christy Kennedy said. She's like many Americans, dealing with rising health insurance deductibles. 
"[That's] like $2,600 dollars a piece," Kenney said.
That's an insurance cost that she would've had to pay. That is, until she found Dr. Clint Flanagan and Nextera, a direct primary care practice which has offices in Longmont. 
"Patients, employers pay a fixed monthly fee and for that monthly fee they get to come to the doctor as much as they want," Dr. Flanagan said.
That's without any insurance company being billed. 
"It's less than a hundred dollars a month and you can come to the doctor 24/7," patient Connie Masson said. "It covers everything in the doctor's office." 
Things like sore throats, sinus infections and writing prescriptions are all included. So are more urgent care types of treatments for things like stitches, sprains or broken bones.
"You break your arm, you go to the doctor's office and not the ER," Masson said. 
Then, if you need to go to the hospital, the doctor will send you there.
Why is it cheaper? You're cutting out a lot of steps. A standard visit includes coding and billing the insurance company, the insurance filing the claim, determining how much they'll pay, and sending the remaining bill back to you. At a direct primary care doctor you pay your membership and that's it.
But it doesn't cover everything, and having some kind of backup insurance is preferred for "catastrophic" events like extended hospital stays or surgeries.
Nextera has several offices in Colorado and is expanding in several other states. There are a few dozen other direct primary care providers in the state as well. 
A newly minted law now fully defines 'direct primary care,' and takes it out from under the umbrella of insurance providers, which could mean more start popping up.
"This bill sends a message," Dr. Flanagan said. "If you want to open a direct primary care in the state of Colorado... this is a place you can do that."

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