HELENA, Mont. – Insurance Commissioner Matt Rosendale today issued an advisory memorandum clarifying that direct primary care provider agreements are non-insurance health care options.
Rosendale’s action helps expand options for Montanans to have another, often more affordable, way to meet their health care needs.
“Montanans should have as many options on the table as possible to meet their health care needs as they see fit,” Rosendale said. “Direct primary care is yet another way for consumers to access routine, preventative, or preliminary health care.”
“These agreements between patients and their doctors are not insurance products, and will not be regulated by my office as insurance. While direct primary care provides a good alternative for many people seeking routine or basic health care treatment, it’s important for Montanans to have insurance coverage for major and unexpected health care costs,” Rosendale continued.
While there are already some direct primary care providers operating in Montana, Rosendale’s advisory memo removes uncertainties in Montana regulations, providing guidance to physicians who wish to establish and operate direct primary care practices.
Carol Bridges, MD, of CostCare Direct in Missoula, touted the patient benefits of direct primary care.
“In this ever changing healthcare environment and increasing deductibles, Direct Primary Care (DPC) is a monthly membership model that not only provides a cost-effective solution to the increasing cost of healthcare but at the same time renews the patient doctor relationship while using modern technology including telemedicine, FaceTime, email and text. Because providers are readily accessible, urgent care and ER visits are also minimized. The monthly fee covers all of the office visits and typically in-clinic testing. Procedures and other labs are priced at cost with savings typically 80-90%. This is not an insurance policy and does not strive to replace health insurance but rather to be coupled with a cost effective high deductible plan to cover catastrophic medical events,” she said.
The American Academy of Family Physicians supports the direct primary care model, writing that “Direct primary care rewards family physicians for caring for the whole person while reducing the overhead and negative incentives associated with fee-for-service, third-party-payer billing.”
As Montana’s insurance consumer advocate, Rosendale has fought for reforms to give Montanans more health care options and bring down costs. This latest advisory memo provides greater regulatory clarity to expand Montanans’ health care options.
The advisory memo can be found HERE
More information about direct primary care issues is available from the Direct Primary Care Coalition.