|By Spitzer, Judith|
JANUARY 12, 2015 – Dr. Donald F. Condon, a Spokane-based primary care physician in practice for more than 35 years, plans to transition in January to a new business model offering Spokane patients primary health care for a flat annual fee, rather than billing insurance companies for care.
Direct primary care, also called concierge medicine and direct contract care, is a business model being offered as an alternative form of health care. Condon says it frees physicians from the complex reimbursement system so doctors can focus on treating patients.
Under Condon’s health care plan, patients will pay between $1,350 and $1,500 annually, which will provide an unlimited number of office visits, same-day visits, and no co-pays. Included in the plan are physicals, minor surgery procedures, sports physicals and about 90 percent of other outpatient health care needs, he says. Children under the age of 22 are covered free under his plan when a parent is a paying patient.
When Condon transitions to the new model, he won’t accept insurance coverage for care. Insurance dictates what care is covered and what isn’t, and he asserts the direct patient care model takes that issue out of the equation in most cases.
“There can be a more gratifying doctor-patient relationship because patients can get right in and see us for as long as needed to address concerns, and the annual fee keeps unexpected out-of-pocket costs in check while providing financial stability for our practices,” Condon says.
Direct primary care doesn’t eliminate the need for catastrophic care insurance, he says, but it can be a cost-effective way to supplement coverage of employers’ group plans or Medicare.
Condon’s office currently is located at 9631 N. Nevada in Spokane, but he will be moving in early January to a location on East Farwell Road. He currently employs seven people full time, including a physician’s assistant, two nurses, and an administrative staff. At the new location, he says he will be downsizing to two employees.
“This is how much we’re chasing and talking with insurance companies,” he says. “There will be no paperwork like that with this plan, so I won’t need as many employees.”
Under the new plan, Condon says, patients also will spend less on out-of-pocket expenses as well as lower-cost labs and ancillary services.
“I have negotiated lower prices for certain tests and one-third of the cost for lab values from what they charge when they go through insurance companies. People will be spending less, and what they do spend will be spent on their own care instead of the care for two other people,” he says.
Condon says his office will also offer health care coverage from an outside, independent insurance company with a catastrophic insurance plan that includes his annual membership plan.