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MICHIGAN: ‘For a flat, out-of-pocket fee of $30 per month, patients have access to diagnoses, disease management, preventive care and limited procedures performed at its clinic at 138 W. M-59, Suite 950, in Howell, MI.’

By Mike Lammi Daily Press & Argus

himss concierge medicine survey 2013 DPCDec. 28, 2013 – A Livingston County medical clinic is hoping to change the way patients view — and pay for — primary care.

BlueSky Health recently launched its direct primary care model known as BlueSky Direct, which essentially eliminates the insurance middleman. For a flat, out-of-pocket fee of $30 per month, patients have access to diagnoses, disease management, preventive care and limited procedures performed at its clinic at 138 W. M-59, Suite 950, in Howell.

“It’s taking ownership of your health care,” said Tom Valenti, chief operating officer at BlueSky.

BlueSky Direct is not an insurance plan, and patients still need health insurance to cover medical care beyond primary care. The cost of BlueSky Direct cannot be applied to a patient’s insurance deductible, but switching to BlueSky Direct combined with a high-deductible health insurance plan can save a patient 10 percent to 40 percent on health-care costs per year, according to its website.

Because the law is vague, BlueSky asks that patients contact their insurance plan’s administrator to see if their HRA, HSA or FSA will pay for BlueSky Direct fees.

While it can make primary care more customer-friendly and less expensive, BlueSky Direct also eliminates many of the headaches associated with doctor visits, Valenti said.

The current system isn’t working, he said, partly because it is largely controlled by two bodies: the federal government and insurers.

blue sky dpc“They’ve created a system that has two major roadblocks to providing good care,” Valenti said. “The amount of paperwork and coding required adds about 40 percent overhead to a primary care practice. The second barrier is providers can only get paid if they see patients face to face. So now you have primary care providers seeing 25-40 patients a day, seven minutes apiece, and it takes two weeks to get an appointment. It’s a terrible patient experience.

“We’re saying, get rid of those two roadblocks, pay us directly, and now we can provide better value of care,” he added.

Working the phones

BlueSky Direct allows Dr. Craig Ross and the clinic’s nurse practitioners to forgo some face-to-face visits by handling patients’ health issues 24/7 over the phone or even via email, webcam or text messages.

“If someone has a sore throat, they can take a picture of their sore throat, send us a text, and we can potentially treat it just that way,” Valenti said. “But if they do need to come in and see us, we can generally see them same day or next day.”

While BlueSky Direct currently is being sold to and used by individuals, Valenti said the goal is to collaborate with employers, unions, municipalities and insurers — and save everyone money in the long run.

Preventive care and disease management, he said, are key components to a quality primary care product.

“When you buy coffee, you want it to be hot and you want it to taste good. We’re saying to any employer or individual or any payer to hold us to two criteria: Have we kept you out of the emergency room, and have we kept you out of the hospital? If we’ve done those two things, then we’ve done our job,” Valenti said.

BlueSky Health opened its Howell clinic in April 2012. It’s other clinic in Houghton was founded in 2006 by Dr. Jeff Huotari, the company’s CEO.

The Howell clinic is the launch pad for its direct primary care model, which Valenti said isn’t being provided anywhere else in Michigan on a grand scale.

“It makes a lot of sense to us; it’s just a matter of getting the word out,” Valenti said.

To enroll in BlueSky Direct, patients pay a six-month minimum upfront but can cancel at any time after that.

For more information about BlueSky Direct, call 517-545-2400 or 888-288-0201, or go to http:// www.blueskyhealth.org/ bluesky-direct.

Source: http://www.livingstondaily.com/article/20131229/NEWS01/312290012/Howell-clinic-rolls-out-new-model-primary-care

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