Medical memberships may cover basic health needs

FORT COLLINS – Even with health-care reform, the cost of health insurance just seems to keep going up.

According to a December report from the Colorado Department of Regulatory Agencies, the average increase for individual health insurance premiums by the 10 largest carriers in Colorado in 2010 was 12.9 percent. And rate increases are expected to continue in 2011.

But there’s a health-care provider in Fort Collins that’s offering a new program to help people without insurance and employers who can’t afford comprehensive insurance coverage packages for their employees to get access to basic care at a reasonable price.

GeneralCare Medical Clinic, at 620 S. Lemay Ave., is offering medical memberships that provide access to basic care for a monthly membership fee of $50 and a charge of just $30 per visit. Members must commit to a one-year membership at $600 but don’t have to pay the entire amount upfront.

“It’s not health insurance, it’s health care,´ said Jeff Winkler, one of two physician assistants employed by GeneralCare, which also has a clinic in Windsor. “For most of the reasons you’d end up in a doctor’s office, that’s what we do.”

Those reasons include treatment for colds, minor injuries, wound sutures, bladder infections and physicals. GeneralCare also can do in-house X rays and in-house lab work. But Winkler said that list is not all-inclusive.

“There’s no way to foresee everything, but we try to be accommodating and meet the needs of our members,” he said. “We don’t provide hospital care or emergency room care. It’s essentially in-house medical services.”

Renee Lesser, GeneralCare’s director of business development, said the 30-year-old clinic started the program in January and has had an “exceptional” response so far. “People have told me this is the best thing that’s been presented in a very long time,” she said.

Lesser noted that the medical membership program does not screen out people with existing conditions and there’s no limit on the number of visits. She said while the program is aimed at individuals who are without insurance or underinsured, it’s also targeted toward employers who want to provide health-care coverage to their employees but can’t afford the ever-rising costs of insurance.

“It’s great for employers because they know exactly how much they have to pay each month, so it’s cost-effective for them,” she said.

There’s no minimum number of employees required for an employer to sign up and the company can pay for all or a portion of the employee’s medical membership. “It’s an amazing benefit for them to retain and attract employees,” she said.

Winkler said one of the reasons the business model works is that it cuts out the middle man. “There is no insurance person between the health-care provider and the member,” he said.

Winkler cautions that the medical memberships don’t cover major, serious illnesses or injuries that require hospitalization, and he advises members who can afford it to also have a catastrophic coverage policy to cover that kind of care.

“But (the membership) provides most of the care most people need most of the time,” he said.

Winkler said the model is based on one first used in Springfield, Mo., in 2007. That clinic now has 1,100 members, most of whom came through employer memberships.

GeneralCare was founded in 1980 as an occupational medicine facility, and employs three physicians and a six-person nursing staff as well as PAs. Its medical membership program is believed to be the first in Northern Colorado, but probably not for long, Lesser said. “I don’t doubt that others will follow,” she said.

Winkler said GeneralCare’s established history is an important aspect of the service.

“We are local people providing local services who have been here a long time,” he said. “We really understand the health-care landscape of Northern Colorado.”

Winkler said he believes the medical membership program will provide a much-needed service when health-care costs are increasingly burdensome to families and businesses.

“It’s not just important to a business but to our community,” he said. “Somebody had to step up to do this.”

Steve Porter covers health care for the Northern Colorado Business Report. He can be reached at 970-232-3147 or at sporter@ncbr.com.

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