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What is Direct Primary Care?

What is Direct Primary Care?

As of July 1st 2018, Cottonwood Family Medicine transitioned into a Direct Primary Care Model. Participating patients pay a monthly membership fee, in exchange, patients can schedule appointments that can last up to 30-60 minutes depending on your needs. Or we can address your medical questions over the phone, if you prefer. And you will have access to our office lab services at no additional fee. The only additional charges are for a few procedures that consume office supplies and these are listed on the website.

Why Choose Cottonwood Family Medicine?

Cottonwood Family Medicine has been open in Boise, ID since 2012 and Dr. Price-Miller has been practicing in Boise, ID for over 20 years. It takes time and effort to build relationships in the medical community. As a result, she is a known entity and she knows where to send her referrals in order to get her patients the best outcome. Dr. Price-Miller also has earned a reputation of spending an inordinate amount of time listening to her patients and getting to know their story. When your physician knows you as a person and not just a patient, then you can be confident that she will take care of you and your family.

How can Cottonwood Family Medicine Save my Health Care Dollars?

A very common example, is to help a Medicare Patient understand how to manage their prescription costs with their Medicare Part D. With some thought we can sometimes find an equivalent drug that has a cash price less then the co-pay. Recently we had a couple that spent close to $4000 annually between their monthly premiums, co-pays and end of year no coverage. Through our help, we reduced their cost by more than the cost of their annual membership. One of the ways was simply to have them demand to pay the cash price on a drug at $4 versus paying the $17 co-pay plus reducing their annual coverage with the remainder of the cost. Next year we will help even more by recommending the appropriate Part D coverage for their specific medical needs. This is just one example of how we help.

Does Direct Primary Care Replace My Current Insurance?

Cottonwood Family Medicine will no longer be charging insurance companies for any of our services, but we recommend that all of our patients continue to stay insured in order to cover your costs for a surgery, hospitalization or a referral to a medical specialist. Therefore, all Medicare patients should continue their part A, B and D coverage. Of note, to Medicare patients, the "Medicare Advantage Option" might disqualify you from joining our practice because it can limit which doctors you can see. If you do not qualify for Medicare or Medicaid, you might consider an insurance plan with a very high deductible that would cover large expenses from a major surgery, hospitalization or referral to a specialist. The cost of an annual membership will be less than your deductible. Or you could also choose to have an even less expensive limited coverage policy, known as a "wrap around policy". You will need to make sure that you qualify for this type of coverage. People with known existing diseases are usually disqualified by the insurance companies.

What's Covered with Direct Primary Care?

Your DPC membership covers all of your clinic visits plus a dozen different labs or minor procedures. You will also have direct access to Dr Price-Miller after hours and can call her directly with any questions or concerns.

How Do Prescriptions work with Direct Primary Care?

Filling your prescriptions is the exact same as it is with any primary care practice. We can send the prescription electronically, verbally, via fax or through hand written prescription pad. Rarely, a pharmacist will confuse the DPC provider as a physician who no longer participates with Medicare as a physician that can no longer write prescriptions for their patients. This is not true and sometimes will require that the physician educate the pharmacist. Again, this is a rare event and can be overcome with a phone call.

What About Outpatient Services like lab tests, Imaging and other tests?

Ordering lab tests or X-rays etc. is no different than any other primary care practice. The lab or imaging center will ask you for your insurance information and they will charge your insurance. However, we are able to sometimes negotiate better pricing for our patients if you desire to pay cash instead of using your insurance. Paying cash can often times cost you less than if you were to use your insurance where the cost to your deductible alone will be more.

What if I need to be hospitalized for some reason?

If you are hospitalized, you will be treated by the hospital physicians. Dr. Price-Miller will follow your hospital course, and after you are discharged, she will resume your care in the clinic setting.

Why did Cottonwood decide to make this change?

The simple answer is time spent with patients. Primary Care has the ability to make a really big difference in addressing health care problems, but it takes time to know your patients and time to help them understand what they really need to do. As a Primary Care Doctor you can either see lots of patients and react to a limited number of complaints or you can see a small number of patients and listen to their whole story. It shouldn't be surprising that you are better able to help people when you have time to listen. The traditional fee for service or employed physician model does not financially allow you to spend lots of time with patients. The Direct Primary Model does.

What is Cottonwood Laser Care?

Because Dr. Price-Miller chooses to spend time with her patients, the clinic invested in a Quanta Laser to help cover the overhead of running a clinic. The Quanta Laser is a high end non-ablative laser that can be used to remove age spots, unwanted skin pigment, tattoos or hair reduction. Cottonwood Laser Care continues to offer treatments to non-members, but is offered to DPC members for a 50% reduction in cost. We have not done a very good job advertising and unfortunately, it's one of the better kept secrets in Boise, ID.

What do I need to do to Register for Direct Primary Care?

If you are interested in joining Cottonwood Family Medicine, then we would like you to schedule a visit to the clinic where you can interview Dr. Price-Miller and together you can decide if this is a good relationship for everyone. If the decision is to join, then Jeannette our receptionist can help you register at the clinic or you can do it yourself online at your convenience. It is necessary that you register in order to become a member. Your clinical chart is created from the registration process and all of your health care needs are coordinated from the chart.