PORTLAND, Maine — More medical providers in Maine are pursuing an alternative model for treating patients.
Direct primary care allows patients to pay a monthly fee directly to their doctor for services instead of billing their insurance company. Doctors say the option gives them more time to spend with their patients, which leads to better health outcomes.
Dr. Jennifer Beall loves being at patients' bedside, but she was close to burning out for good.
"I had about 1,600 patients when I left, and they wanted to double that," Beall said. "I was already drinking through a firehose."
She was also overwhelmed by a mountain of paperwork, leaving her little time to spend with her patients.
Less than a year ago, she left an extensive medical practice in Greater Portland and started Casco Bay Direct Primary Care with another primary care physician, Dr. Leigh Ann Higgins.
"They want time in the office with their physician," Higgins explained. "Or they want to know if they have a problem, you can call them back or they can text you. It's all about having a relationship with your patient."
It's all part of the direct primary care model. Patients typically pay a monthly fee that covers office visits, clinical and laboratory services, and consultative services. Providers say patients often get wholesale pricing on medications and blood tests without insurance companies acting as a go-between. Fees can run anywhere from $50 to $125 per month.
Kevin Brusie said having access to his primary care doctor gives him and his wife peace of mind. He recently had what he thought was an urgent medical problem on a weekend, but after consulting with his doctor, he didn't have to go to urgent care.
"It was a Sunday morning. I could hear her kids in the background on the phone," Kevin said with a laugh. "She gave me the proper guidance. It saved me from the worry and stress about what I would do and the expense of going to the emergency room."
Kevin and his wife's direct primary care doctor fee is part of their monthly premium with Taro Health. Mainers who enroll with the insurance carrier can access traditional primary care providers and choose from nearly 40 direct primary care doctors who partner exclusively with Taro for in-network coverage.
Taro Health entered the state's health insurance marketplace in Cumberland County two years ago. The company has since expanded coverage to York, Lincoln, and Sagadahoc counties. Jeff Yuan, Taro Health's co-founder, said there is growing evidence that the model is helping make health care in Maine more affordable.
"We see in the data and the claims that there are fewer hospital admissions and fewer urgent care visits than a typical insurer goes through," Yuan said.
Beal and Higgins, who are part of the Taro Health Network, believe that not following the status quo health care is driving an increase in patients and keeping doctors by the bedside longer.
"People ready to give up are now, saying, 'I'm not going to give up and retire early and stay in another 10 to 15 years,'" Higgins said.
However, direct primary care doesn't include specific needs like hospitalization and more advanced testing. Most patients still need a separate insurance plan that covers those things.
Individuals and families can find Taro Health's plans on Maine's CoverMe.gov. Open enrollment begins Nov. 1.