Local physicians turn to new model to connect with patients

A growing number of physicians are branching out on their own to give more time to patients, reduce medical costs and eliminate insurance oversight. 

Direct Primary Care practices are growing in number in southcentral Pennsylvania and Lehigh Valley, offering patients a membership-based model that allows for longer office visits, reduced costs for testing, lab work, prescriptions, and better access to their doctor. 

The practices offer physicians more control over their business, allowing them to see fewer patients a day for longer, more in-depth visits, said four area physicians, all of whom previously worked for health care systems.  

Dr. Kimberly Corba, owner of Green Hills Direct Family Care in Allentown, who converted her practice to the Direct Primary Care model in 2016, said over her 26 years since residency, she has seen changes in the health care system that resulted in mandatory short visits where physicians could only address one issue. 

“I felt like I was losing control of the way I ran my business and cared for my patients,” Corba said. “Visits got shorter, I had to deal with third-party interference, and the administrative burden was overwhelming.” 

Dr. Danielle Miller, owner of LUZ Medicine in Ephrata, Lancaster County, agreed, saying, “I was in a practice that turned into a hospital model which changed the way we ran the practice.” 

She explained that under the former model, doctors in her practice would see upwards of 2,000 patients with visits lasting 15 minutes. Now, she said, she sees hundreds of patients and offers visits that run 25 to 45 minutes or longer. 

Miller, who opened LUZ Medicine in 2020, said she can address whatever issues a patient has, creating stronger relationships. 

Dr. Michael Carnathan, owner of Arrow Primary Care in Bethlehem, said it is the patient relationship that had him looking to change his practice.  

Carnathan, who also worked in a practice under a health care system, said, “Things got worse and worse with increased administration and decreased patient time. 

He started his practice in 2019 with no help and no patients.  

“It was just me,” he chuckled. “A few patients found me and within the first two months, I had 12 patients through networking. By the end of that year, I was seeing enough patients to break even.” 

“I saw that I was on the road to burnout,” said Dr. Patrick Rohal, owner of Covenant MD, with offices in Lancaster and York. “When the Affordable Care Act passed, people saw better ways to manage health care.” 

Rohal, who opened his Lancaster office in 2015, said he pitched his plan to small employers which helped grow his practice in the first year. He opened his York office as a clinic for a large employer there. Now, that clinic takes all patients, he said.  

The Direct Care model can work for employers who are self-insured or who are so small they can’t offer health insurance, the physicians said. Employers can pay the membership fees for their employees or offer them the option of joining on their own. 

All four explained that, while they know there is a place for hospital-run practices that take insurance, they chose to move to Direct Primary Care to spend more time with patients. And they said it keeps people out of urgent care facilities because patients have direct access to them. 

The model charges a membership fee, most tiered by the age of the patient, which includes everything the physician does in house.  No insurance is accepted. 

According to the Direct Primary Care Coalition, Direct Primary Care is defined as an innovative alternative payment model improving access to “high functioning” health care with a simple, flat, affordable membership fee.  

The group says on its website there is no fee-for-service payments and no third-party billing. 

“Patients have extraordinary access to a physician of their choice, often for as little as $70 per month, and physicians are accountable first and foremost to their patients,” the coalition said. 

“My overhead dropped 30% when I got rid of insurance,” Corba said. “And I run on a lean budget to keep prices down.”   

All four said the practice is not for just the uninsured. In fact, most patients have insurance. 

Rohal said 40% of his Lancaster patients have traditional insurance, 40% have shared plans and 20% are uninsured. In York, 70% are insured, 20% have shared plans and 10% are uninsured. 

Corba said most patients have high deductible plans that she encourages them to hold onto for catastrophic issues. She explained that when services are put through insurance, they generally cost more.  

“We are very transparent in our contract,” she said.  

Carnathan agreed, saying anything he does in house is covered in the membership fee, like urine, COVID and strep tests, electrocardiograms and other tests.  

All four said they draw blood in house and send it to a lab for testing at a reduced rate.  They also offer reduced rates for X-rays and other testing through agreements with outside facilities.  

And they offer reduced prescription rates. All four said they dispense most medications from their offices which they get wholesale and pass the savings onto their patients. 

“This is a patient-focused practice,” Carnathan said. “Most large practices have to get permission (from the insurance companies) to order tests. We don’t.” 

All four emphasized that their practices are focused on wellness.  

Corba said having the time to work with patients gives her time to discuss options for better health which saves money in the long run and makes for healthier outcomes. 

“We are part of the solution to the health care woes,” Carnathan said. “Everyone wins except insurance companies.” 

“I don’t know what the future of health care is,” said Miller. “It’s messy but right now this is a popular, good movement.”