New Health Care Option for the Uninsured, Small Businesses & Individuals: ‘Direct Primary Care’ Comes to Peoria

By Clare Howard

A small office on North University Street is turning out empirical evidence that one of America’s most intractable problems may be resolvable with a new economic model that removes health insurance from primary care.

The projected results of removing insurance: patients save money, they spend more time with their primary care physician, health outcomes improve and physician satisfaction soars.

Last month, Dr. Michael Jongerius became the first physician in Peoria and one of the few in Illinois outside Chicago to introduce this new economic model, Direct Primary Care (DPC).

This is not his first alternative medical model. With over 20 years in family practice and work in medical administration at Methodist Medical Center, Jongerius started Junction Medical on North University about five years ago based on the “patient-centered medical home” concept with patients receiving often same-day appointments. He coordinates all the treatments his patients receive from specialists. He’s the clearinghouse, making sure prescriptions don’t conflict or compound, his patients get timely appointments with specialists and test results get reported quickly. He maintains electronic records, tracks how his patients fare under his care and measures outcomes, quantifying overall declines in high blood pressure and cholesterol and measuring improvements in diabetes and asthma.

Jongerius is continuing this “medical home” practice with its current patients, and he is expanding his practice by offering DPC to new patients who subscribe for a $50 monthly fee.

He has targeted three demographic groups for DPC: the uninsured, individuals on high deductible plans and small businesses that want to improve the overall health of their workers while keeping costs in check.

“I’ve studied alternative models of health care for decades. With Direct Primary Care, we can really drive down the cost curve,” Jongerius said. “The foundation of all good health care is the physician-patient relationship. Primary health care is important. To improve quality, we need access to primary care.”

The Direct Primary Care Coalition, an association advocating for the concept, contends that using health insurance for primary care is like expecting auto insurance to pay for oil changes. The coalition estimates that eliminating insurance coverage reduces primary care by 40 percent. Other estimates put the cost reductions even higher.

Jongerius calls the current system of health care in this country “dysfunctional.” That is especially evident when patients can’t afford access to primary care and end up seeking treatment in emergency rooms. Uninsured patients as well as those who can’t afford their deductible and copays often postpone annual physicals and treatment until health problems become serious.

“Both patients and physicians are disgruntled with the current system. The only people who don’t complain are those in the health insurance industry,” Jongerius said.

The Affordable Care Act provides for DPC practices to be listed on state insurance exchanges and that will help patients shop for the best plan. But Jongerius cautions that DPC is not insurance. He still recommends patients enrolling in DPC also enroll in a high deductible catastrophic plan to cover hospitalizations, serious illness and accidents.

The DPC model improves patient satisfaction and frees physicians from the grind of spending just minutes with each patient rotating through their offices. It may even help with the decline of medical students going into primary care. Medical students are seeing DPC physicians have high rates of job satisfaction, good earning potential, good hours and more opportunities to work with patients rather than just treating illness.

People enrolled in Jongerius’ DPC plan receive unlimited office visits, proactive help in controlling and preventing disease, annual wellness checkups, E-mail and phone consultations, home visits and some routine laboratory work. When a specialist is required, Jongerius coordinates with other area providers.

Illinois State Sen. Dave Koehler, D-Peoria, has worked on health insurance issues for decades and said, “This is a very interesting model with a lot of possibilities. A lot of families and individuals can’t afford the high cost of insurance. This is health care focused on maintaining and improving health versus just treating sickness. This is part of the whole move toward outcome based medicine.”

Koehler said there may be legitimate concerns with this model, but they can be resolved and should not become roadblocks.

“Let’s look for ways to make this work, not look for roadblocks,” he said. “This is the free market in health care. This is innovation.”

Jongerius calculates cost savings for patients can be thousands of dollars a year. At $50 a month, DPC is $600 a year. A high deductible health insurance plan may cost $250 a month or $3,000 a year. That combination compares with typical health insurance costs of $5,000 to $10,000 annually.

Jongerius is calling his practice a hybrid model because he’s continuing to work with patients on conventional medical insurance plans and Medicare while adding this DPC model for others who need or prefer an alternative.

DPC has been offered in the Seattle area since 2007 by Qliance. The company points to its track record to prove good, comprehensive primary care keeps people healthy, saves them money and cuts costs. It helps restore health insurance to its intended goal of covering serious problems.

In an interview published in Holistic Primary Care, Dr. Garrison Bliss, the medical director of Qliance, said the DPC model has met with huge bipartisan support: “Republicans love it because it’s a ‘free market’ solution and it doesn’t involve raising taxes. Democrats love it because it can provide great care to people who currently have nothing, and we don’t charge an arm and a leg.”

For more information on Jongerius and his practice, go to www.junctionmedical.com or call his office at 309-740-4232.

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