By Kristin Sims-Kastelein
January 6, 2014 [PUGET SOUND, Wash.]— New business growth under the Health Insurance Marketplace and growth within existing business segments has led Qliance, a concierge primary care model for the masses, to care for 20,000 people in the Puget Sound area. In six and a half years, the privately held company has grown from one clinic to five and employs 14 primary care doctors. Its goal is to bring high quality, service intense primary care to Americans, while bringing down the total cost of health care.
“You can’t have it both ways,” said Dr. Erika Bliss, CEO of Qliance. “You can’t starve primary care and not pay it enough to do a great job, then say you didn’t do a great job, you had more expensive care downstream and penalize you.”
Qliance costs roughly two to three times as much as standard primary care. An individual pays anywhere from a $60 to $90 per month membership fee. What a patient gets in return is 24/7 access to a doctor, either in person, by phone or email; longer standard appointments: and night and weekend clinics.
By utilizing the technology most people carry in their pockets, Qliance is recreating the house call of the past to connect doctor and patient. Qliance wants to enable video appointments in the future. Preliminary data show estimated cost reductions between 15% and 40%.
“We are trying to prove that the direct primary care model can work for everybody and is adaptable for any population,” said Bliss.
Qliance now has contracts with multiple large employer groups, municipal and firefighter unions, and a Medicaid managed care organization.
The direct primary care model is part of a larger disruption of the status quo occurring in the U.S. health care system. The recent expansion in the employer market means Qliance now has direct access to claims data that was previously inaccessible.
“We are now in a position to get this claims data and integrate it into our platform, which bypasses the need for us to be integrated with the hospital system because we are getting all the claims data,” said Bliss. “We can now see what is going on with our patients.”
This will help Qliance and employer groups in getting the hard data needed to show whether the model is working or not.
The Affordable Care Act means more individuals have access to Qliance’s services. The company is listed in the Health Insurance Marketplace as a Coordinated Care Health Plan. Bliss says that a significant portion of Qliance’s individual patients have signed up for the plan and chosen the company as their primary care provider.
“The whole notion of Qliance as an individually based business model is being further pushed away,” said Bliss. “It doesn’t make financial sense to pay for it outside of a plan. People are going to decide to purchase a plan with a certain model of care and not pay the monthly fee.”
Will this change the level of care? Bliss says no.
“The key will be for us to demonstrate that we are a high-value proposition, and that we can dramatically and sustainably reduce health care costs,” she said.