Low-cost models

Low-cost models

Success stories | Clinics like Schweitzer envisions for state employees in Helena already operating elsewhere in Montana

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Gov. Brian Schweitzer wants to create low-cost health clinics that will treat covered employees for cheap, save money and still provide great care.

Like for $10 a visit, as they do at the CostCare Clinic in Missoula?

Or maybe for free, like at the MiCare clinics in Billings and Laurel?

As owners of these clinics will tell you, they’re already doing what the governor is proposing — and it’s working.

“This is really common sense-meets-

innovation,” says Jarrod Weenum, MiCare business operations manager for EBMS, a Billings-based manager of health care benefits. “We make sure there are no gaps in care, we’re doing wellness and prevention and we’re building a healthier, more productive workforce.”

The Schweitzer administration is asking for bids to operate a low-cost clinic in Helena that will cater strictly to state employees, with a minimal co-pay for patients. It hopes to award the contract and get the clinic opened by December.

The idea, says the governor, is to create a center that offers easy access to primary care and prevents its patients from getting more severely ill, thus saving on overall, long-term costs. And, it aims to keep the cost for patients low, in part by having salaried staff who don’t get paid more if they order more procedures.

The same philosophy is behind the CostCare and MiCare clinics.

Carol Bridges, a physician and co-owner of the CostCare clinics, worked at a hospital-owned urgent care clinic in Missoula before opening the clinics.

“We saw so many people coming in and using the emergency room and urgent care as their primary care,” she says. “They were walking in for strep throat and getting charged $350. …

“We just started to ask questions: What do things really cost? We started doing some research and were amazed at how much things didn’t cost.”

Bridges, another physician and a physician’s assistant decided in 2007 to open CostCare, first as a walk-in clinic. It now has two other offices, including a primary-care center where patients can see the same doctor and get chronic-disease management and other services.

CostCare now has arrangements with several local employers, including the city of Missoula and the Missoula public schools. Workers at these businesses, which have self-insured health plans, pay only $10 to visit CostCare, and the health plan pays any extra costs through their plan administrator, Allegiance Benefit Plan Management of Missoula.

CostCare also has staff visit the businesses for wellness programs that include lab screenings and blood tests, and medical staff follows up on-site, meeting individually with workers to discuss any potential health problems.

Anyone who isn’t employed by these businesses can walk in to CostCare and pay $50 for a visit. Additional services will cost more, but the average charge for a patient last year was $68, Bridges says.

“If you compare us to an emergency room, it’s a 900 percent savings,” she says.

CostCare has two physicians, two physician assistants and two nurse practitioners on staff, as well as support staff. Its health records are all electronic, and its billing costs are minimal, Bridges says.

CostCare is considering whether to bid on the state contract, and already had been contemplating whether to open a new clinic in Helena.

EBMS’ MiCare clinics operate on a similar model, but serve only the workers of four employers, and are at a worksite in each city.

The Billings clinic, opened in 2006, serves employees of EBMS and steel manufacturer TrueNorth Steel; the Laurel Clinic, opened three years ago, serves employees of the Laurel School District and Wood’s Powr-Grip.

All of the companies have self-insured health plans managed by EBMS; together, the two clinics serve about 650 employees and their dependents.

EBMS also operates similar work-site clinics in Colorado and Idaho and is opening up another one in Bellingham, Wash.

The clinics, which are staffed with a medical director, two nurse practitioners and a nurse, see patients at no charge. Routine lab tests and generic prescription drugs for many conditions also are free of charge, Weenum says: “It’s almost like purchasing health care at a wholesale rate.”

Patients can make appointments on-line, appointments are 20 minutes long, and there’s usually no wait, he says.

Each employee also is required to have an annual health-risk assessment, which enables the clinic to track its patients’ health and recommend ways to improve it. Like CostCare, the EBMS clinics have electronic health records and next to no billings costs.

Weenum says EBMS will be bidding on the state contract.

“We think our model is exactly what they need, and I think it would provide a lot of savings and value for them,” he says.



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