A 10-year-old medical clinic in Missoula is shifting its approach to health care, becoming among the first in the state to offer primary care for a low monthly fee that could save patients money for routine treatment and procedures.

Dr. Carol Bridges, who co-founded CostCare in 2007, said the clinic will step away from the health insurance model to offer “direct primary care” starting in January for $70 a month.

“Direct primary care is a movement, really, for primary care providers,” Bridges said Thursday. “It probably started in this country five or six years ago, and there are now 800 direct primary care practices in the country.”

CostCare, which runs two clinics in Missoula and one in Helena, was initially created to help address the inaccessibility and high cost of health care. In its early days, it offered a fee-for-service model in a walk-in setting.

But when the Affordable Care Act mandated health insurance coverage, CostCare changed its business model to bill health insurers for its patients. Bridges said the company is now looking to return to its roots and eliminate insurers from the mix.

“Primary care needs to come out of insurance because it's driving up the cost,” said Bridges. “For 80 percent of Americans, most of their medical needs can be handled by a primary care provider.”

Under the traditional health care model, patients must carry expensive insurance premiums that come with an added deductible when medical care is actually needed.

Under the primary care model, however, patients can drop their costly premium and opt instead for a $70 monthly fee through direct care, which covers most routine medical needs and wellness visits. Coupled with low-cost catastrophic insurance, the savings could add up for the typical patient.

“What we have found, and what nationally proves to be the case, is that a vast majority of doctor visits are for routine medical visits, like strep throat, a bladder infection or a diabetes visit,” Bridges said. “High health insurance premiums are crippling many of us, and most of the time patients are still paying for routine office visits on top of their health insurance. This model offers an alternative.”

For medical needs that require outside testing, such as lab work, the service is offered at additional savings. A mole biopsy that costs $370 for the procedure and $175 for the pathology fee – for a total of $545 – is reduced under the direct care model.

“The cost through direct primary care for the same procedure would be $20 for the procedure and $50 for the pathology fee,” Bridges said. “The total cost would be $70 – that's a difference of $475, just for one procedure.”

Bridges said the clinic's three providers will each assume a panel of 600 patients when the new model launches in January. Those patients can access their personal physician by text, email, phone or Facetime.

The CostCare clinic on Mullan Road will be the first to see the changes while the clinic in Helena will likely follow.

“It's a way for us to basically reinstate that close doctor-patient relationship with the use of technology,” said Bridges. “It's really exciting to see primary care taking the need and trying to protect its own specialty and really bring back that relationship between the patient and doctor.”

The Yellow Pine Naturopathic Clinic in Missoula also offers direct primary care.