A dispute between MU Health Care and Anthem Blue Cross Blue Shield has left more than 90,000 people out of their primary care provider’s network, and Dr. Adam Wheeler, CEO and pediatrician at Big Tree Medical in Columbia, said insurance plays a minimal role in some health care options.
“Primary care actually works really well as a membership model,” Wheeler said.
Big Tree Medical is a concierge medical clinic where people pay a membership fee to get care from doctors and pediatricians. No insurance is required for members.
“Our main plan is $80 a month, and then we’re able to provide all of our primary care, chronic disease management, mental health care management, medications, all at a pretty reasonable price,” Wheeler said.
He said that since the Anthem and MU Health Care agreement expired, there has been a surge in interest in the services his clinic offers through this business model.
“We’ve been getting a lot of calls in the last 24 to 48 hours from patients trying to find a new primary care provider,” Wheeler said.
Clinics that adopt this model are starting to gain traction in communities across the country, he said.
“There are about 2,000 so-called direct primary care clinics in the U.S.,” he said. “Most of them are small, with one or two doctors. But more and more people are realizing that their insurance doesn’t really help that much, especially when it comes to primary care.”
When a large provider in central Missouri failed to renew its contract with a major insurer, Wheeler said, it sparked community concerns — concerns that could cause people to rethink their outpatient care.
“People are interested in access to care,” he said. “They don’t necessarily care about what Anthem is doing or even what MU’s bottom line is. What they want to see is, ‘I have a stable way of delivering care.’ So the more unstable the traditional health care system is, the more people will seek alternative care.”
The National Institutes of Health still recommends that everyone get health insurance because people with insurance are more likely to seek care when they need it.
