Call CovenantMD in Lancaster, Pennsylvania, and there’s a good chance that a doctor may answer the phone. That’s because, like other direct primary care practices, CovenantMD is able to maintain a smaller staff since it doesn’t have insurance billing responsibilities, and has a smaller panel of patients. It’s one of the personal touches that Samaritan member Dr. Patrick Rohal, one of two physicians at CovenantMD, points to as an advantage of DPCs. Dr. Rohal started CovenantMD in Lancaster, Pennsylvania, in January 2016. Also on staff there are Dr. Susan Mellinger, nurse Hannah Barry, and Licensed Practical Nurse Lori Felizzi.
Dr. Rohal, who with his wife, Lynn, and three children have been members of Samaritan Ministries for two years, answered questions about his DPC practice for us.
How is your practice different from a typical one?
The biggest difference in our practice is that we do not bill health insurance. Instead, patients pay a monthly fee (from $15 to $85 per month, based on age). This fee covers unlimited visits to the doctor with no copays, same- and next-day availability, extended time with the doctor, discounts on lab tests and medications (dispensed from an in-house pharmacy), home and worksite visits at no additional charge, and 24/7 call coverage direct to the doctor’s cell phone. Our mission is to put a fresh focus on the primary care patient/doctor relationship, a focus that has waned in this era of large, busy practices.
What are the advantages to your practice that patients most appreciate?
They most appreciate the time they have with their physician. They seldom wait more than a few minutes in our waiting room, and they typically have 60 to 90 minutes with the physician for their first visit. Our patients also appreciate the streamlined access to their physician, in terms of the ability to call the doctor’s cell phone after hours, or text or email, all in a secure HIPAA-compliant manner.
What are some of the problems with regulation of health care that you are able to avoid by having a DPC?
The biggest problem that DPC is able to avoid in the current state of health care, I think, is in patient volume. With insurance reimbursements going ever downward, physicians are required to see an ever-higher volume of patients. In DPC, the monthly fee structure enables physicians to carry a much smaller patient panel (from 600-800 patients, compared with about 2500 in standard insurance-based practices). Lower volume helps to ensure quick access for patients, more time with the doctor, and the ability for the doctor to provide 24/7/365 call services for the patients he or she knows well.
Another problem in our health care system is the built-in incentives for price inflation. Our patients’ costs for lab tests are often 90 percent less than what they would otherwise pay if those prices were negotiated by a health insurance plan. We offer comprehensive annual fasting labwork for $17.50. A local radiology vendor offers x-rays for our patients at $45 cash at the time of service. Again, this is up to 90 percent less than what they would pay at insurance-negotiated prices.
Can you elaborate on your slogan, “Simplifying Primary Care”?
DPC simplifies primary care in that it removes third parties from being the primary payer for the most common, least expensive occurrences in health care. Our patients enjoy a very simple primary care cost structure, with very transparent pricing for lab tests, medications, and radiology. Because we do not bill health insurance, we do not need to employ a large office staff dedicated to all the nuances of insurance reimbursement. That means our patients interact with the one nurse and the one doctor that knows them. They get a live person when they call our office, and it’s either their nurse or their doctor, not a chain of command nor a recorded message. Yes, the doctor answers the phone!
Why did you join Samaritan Ministries?
I started my DPC enterprise in 2016. SM was an excellent way to have comprehensive health care for the unpredictable things, while keeping the monthly responsibility low enough to make it viable for a couple that was starting a business.
What has your experience been with having a need?
After over two years as members of Samaritan, we have not yet had a need! But I have frequent feedback from my patients. 40 percent of my patients are members of a sharing plan. I often hear that things are very streamlined at SMI when a need arises.
Find a direct primary care doctor near you through resources linked to on this page.