Colorado: DPC Practice, Balance Health, now serving patients without taking insurance

By Greeley Tribune, Colo.

June 08, 2014 – After 13 years practicing medicine in Greeley, Dr. Frank Morgan wanted to come up with a way to spend more time on his patients and less time dealing with insurance paperwork.

That’s the idea behind his new direct primary care clinic, Balance Health, 1709 61st Ave., where he treats his patients without accepting insurance. Instead, patients pay a $99 monthly fee for access to primary care services, as well as access to the clinic’s gym and nutritional advice services.

“This really is somewhat of a dream to try to improve the situation for both me and my patients,” Morgan said, noting he’d been thinking about the move for five years.

Longtime patient Michele Reynolds said the new system works for her after years of traditional care.

“I liked (the clinic’s model) because it’s innovative and I think healthcare needs a change,” Reynolds said. “The other night I called him at 9 p.m. and I was in first thing in the next morning. That would never happen in the medical system.”

Morgan said with the traditional model in healthcare, hospitals have to hire employees dedicated to communicating with insurance providers and filling out the required paperwork. To cover those added costs, hospitals have to see a certain number of patients to make a profit. At Balance Health, Morgan said he’s able to keep his costs lower because if he doesn’t take insurance, he doesn’t need to hire employees to communicate with providers. Instead, he’s hired a wellness coach to offer nutritional advice and a gym coach to help his patients with the gym equipment.

“We have employees, but they exist to help and directly benefit our patients, rather than being support personnel to help us interface and work within the insurance system,” Morgan said.

He said without needing to squeeze in as many appointments during the day to cover the added costs of dealing with insurance providers, he said he is able to spend more time with doing what he loves — treating his patients.

“My focus in medicine has always been disease prevention through lifestyle modification, but I found it difficult previously while working within the system to have the time I needed to spend time with patients, to educate them and affect change.”

He said visits tend to last a half-hour to an hour, depending on the problem, and he sees his patients in his office rather than an exam room — he said patients enjoy the setting more. Patients also have access to Morgan’s cell phone, so they are able to call him after hours if they have an urgent need.

“Part of our service to patients is to be on call for them 24/7 and give them direct access to my cellphone number so that we kind of remove the barriers between patients and us, the provider. We think this can greatly reduce the cost of healthcare for individuals because what ends up costing people a great deal of money is when they can’t get a hold of their doctor and they have to go to Urgent Care.”

Balance Health offers any primary care services normally found in a doctor’s office, such as blood tests, casting of minor broken bones, electrocardiograms, lung-function tests, ultrasounds and prescription medication services.

However, Morgan said he insists all his patients have health insurance, not only because it’s a requirement of the Affordable Care Act, but also because if the patient needs to be referred to a hospital for a specialized service or surgery, they’ll need it to get the services at an affordable cost.

“With major hospitalizations — that’s where you encounter the need for health insurance,” Morgan said. “For example, some surgeries can cost tens of thousands of dollars and hospitalizations can cost hundreds of thousands of dollars. What we do in primary care is not all that expensive.”

The clinic serves about 340 patients, about half the total number Morgan said he plans to take. Morgan said he plans to cap the number of patients to continue to provide the quality of service he’d like.

Morgan said he isn’t alone in offering primary care services directly to patients, and the model is gaining traction across the country. One provision in the Affordable Care Act allows for direct primary care providers to compete in the healthcare exchange with traditional health insurance options if the patient is otherwise covered with a high-deductible plan.

“There’s a pretty big movement afoot to do it,” Morgan said. “This is really about letting the free market work.”

“This really is somewhat of a dream to try to improve the situation for both me and my patients.

— Frank Morgan, Balance Health clinic

Source: Greeley Tribune, Colorado —

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