New Primary Care Model Delivers 20 Percent Lower Overall Healthcare Costs, Increases Patient Satisfaction and Delivers Better Care

Jan 15, 2015, 08:03 ET from Qliance

SEATTLE, Jan. 15, 2015 /PRNewswire/ -- A review of two years' worth of healthcare claims data on thousands of patients reveals, contrary to the prevailing view, that unlimited primary care drives down overall costs while improving patient outcomes and experience.

The analysis by Qliance Medical Management Inc. – hailed by Time magazine as "one of the most intriguing experiments in the medical industry"reveals that the increasingly popular "direct primary care" model, with its emphasis on unrestricted access to primary care, makes healthcare 20 percent less expensive than traditional health insurance yet leaves patients feeling more satisfied with their care.

The success of the monthly-fee primary care model challenges the notion that simply making traditional health insurance available to all is the best way to heal the nation's troubled healthcare system, according to Qliance President and Chief Executive Officer Erika Bliss, MD.

"At a time when our country is struggling to make healthcare less costly, our results confirm that primary care, when made more personalized and accessible to patients, can lower specialty and hospital costs, and keep people healthier and more productive," said Bliss, a practicing primary care physician. "We have an opportunity to rebuild our healthcare system to ensure we're delivering the right kind of care in the right place at the right time.  But we can't do that without investing in primary care that puts the patient and the doctor-patient relationship first."   

Qliance Savings Data – 2013-14


Incidents Per 1,000 Qliance patients

Incidents Per 1,000  Non-Qliance patients

Difference (Qliance vs. Other)

Savings per   patient per year

ER Visits

81

94

-14%

($5)

Inpatient (days)

100

250

-60%

$417

Specialist Visits

7,497

8,674

-14%

$436

Advanced Radiology

310

434

-29%

$82

Primary Care Visits

3,109

1,965

+58%

($251)

Savings Per Patient

---

---

---

$679

Total Savings per 1000 (after Qliance fees)




$679,000

% Saved Per Patient




19.6%

Data Sources:  All claims data (except prescription claims) from carriers for selected large employers; Qliance EMR data; Employer eligibility data.


Claims Attribution: All claims incurred by Qliance patients prior to first Qliance visit were excluded; All employees with any interaction with Qliance included as our patients, even if the employee used another primary care provider (which is possible in some of the plan designs among clients); All claims incurred after any interaction with Qliance included, regardless of employee's intent to use Qliance as their primary care provider; All non-primary care provider visits included under "specialist" category (such as physical therapy, acupuncture, etc.)


Population: Eligible members in employer-sponsored health plan; Employees only, to remove confounding factors from differences in dependent benefits structures and participation variances among clients. 

Methods
Qliance examined insurance claims data from 2013 and 2014 for approximately 4,000 Qliance patients covered by employer benefit plans, and compared the cost of their care to that of non-Qliance patients who worked for the same employers. The results (see table) revealed a savings of $679,000 per 1,000 Qliance patients on total claims –19.6 percent less than the total claims for non-Qliance patients during the same period. The savings were driven by a marked reduction in expensive emergency room visits, inpatient care, specialist visits, and advanced radiology, which more than made up for the higher investment in primary care for Qliance patients.

Rather than coming at the expense of patient satisfaction, the cost savings were accompanied by a strong uptick in the overall patient experience. A 2014 assessment of Qliance's patients' experience, conducted using the national CAHPS survey, placed Qliance above the 95th percentile in overall patient satisfaction, well above the 90th percentile nationally.

The Clinic
Qliance is a national leader in the burgeoning direct primary care movement, whose adherents provide unrestricted access to primary care through longer appointments, extended hours, and phone and electronic communications with providers so patients can take care of health needs promptly and avoid downstream care and costs.

Qliance clinics are designed to address approximately 90 percent of the issues for which patients seek a doctor's care, including all routine primary and preventive care. This includes women's health services, pediatric care, urgent care, wellness education, ongoing chronic disease management, select onsite procedures and diagnostics, as well as coordination of outside specialist and hospital care by a Qliance provider.

The company has rapidly evolved from a startup with star investors Jeff Bezos and Michael Dell to a true growth company. Since 2011, when Bliss became CEO, Qliance has grown its patient base from 3,500 to 35,000 members, and opened up several new locations in the Seattle area. After signing up travel company Expedia in 2013, Qliance in 2014 added several significant Puget Sound employer groups including Comcast and the Seattle Firefighters' union.

Qliance also added 15,000 new Medicaid patients to its rolls in 2014, opened two new Puget Sound clinics, and became the first "direct primary care" provider in the country to join traditional health plans on the Affordable Care Act's health insurance exchange.  Revenue for the 32-provider private company grew 300 percent in 2014, according to Bliss. 

About Qliance 
Qliance is a leading Direct Primary Care services organization pioneering a transformative business model with a patient-first approach to healthcare.  Qliance has uncompromising focus on personalized, high-quality care, providing convenient access to doctors, nurses, and medical teams who deliver comprehensive primary care services to patients giving them unparalleled attention and care.  Patients have unrestricted access to appointments in the clinic, by phone and electronically, extended office and weekend hours, and 24/7 physician coverage.  By spending more time with patients, Qliance helps them avoid unnecessary specialist and hospital care, thereby reducing overall healthcare costs and focusing on the patient, rather than the paperwork. Having an advocate within the healthcare system, Qliance patients report increased satisfaction with their care and benefits.  For more information, visit www.Qliance.com.

 

SOURCE Qliance



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