New Insurance Plan Transforms Urgent Care Clinics Into Primary Care Facilities

Arizona-based Nextcare announced a new partnership this week that will allow its 13 Dallas-area urgent care clinics to begin providing primary care to employees at small and medium sized businesses that buy into a first-of-its kind insurance program.

It’s a pairing with North Carolina company Physician Care Direct, which will begin selling self insured group health plans to small and medium sized employers in North Texas. Nextcare’s urgent care clinics, known here as PrimaCare, will provide primary care services to those who opt in. The program, called the Employer Health Ownership Plan, allows the business owner to purchase the primary care services and later add coverage for specialists and hospitalizations based on need, providing more incentive for the employee to be healthier.

“You’ve got about 30 to 40 percent of your healthcare dollar at a fixed cost,” says Dr. William Lawson, CEO of Physician Care Direct. “It includes administering a plan, buying re-insurance, and providing for basic access to primary care. What that means is 60 to 70 percent of your healthcare spending is at a variable cost.”

In other words, it pays for employees to take advantage of primary care appointments. And this pairing empowers urgent care clinics, often more accessible than large-scale healthcare facilities, to expand its services to primary care, Lawson says. Typically, urgent care clinics treat acute injuries or conditions that require immediate attention but are not severe enough for an ER visit.

It’s the first time an urgent care company has combined its services in an insurance plan directly for employers, said John Julian, CEO of NextCare Holdings, Inc.

“This is a great place for them to launch off into a neighborhood medical center that could really handle issues for the long term,” Lawson says.

All the 13 PrimaCare centers will operate as medical homes, meaning anyone with the insurance plan can visit any location and the on-staff physicians can access their medical records. There are locations in Cedar Hill, Colleyville, Dallas, Frisco, Lewisville, Mesquite, McKinney, Plano, and Richardson.

The program will launch in early August. Lawson said they’ve reached out to Dallas Society of Human Resource Managers and have begun making relationships with health insurance brokers to spread the word.

“We are committed to increasing access to high-quality patient-centered primary care for Dallas-area employees,” Julian said. “Small- and medium-sized businesses everywhere are struggling to maintain decent health insurance benefits for their employees. We believe that this initiative can help companies save money while demonstrating to their employees that their health is a top priority.”

Posted in Insurance/Benefits, News.