Kootenai County now has its own clinic for county employees with unlimited visits and no co-pay

Kootenai County employees now have a health clinic all to themselves with no co-pays on visits or prescriptions.

The clinic is paid for by the county and operated by a private company contracted by it. Kootenai County leadership argues the innovative model will provide cost savings for their employees and taxpayers by cutting out the need for health insurance.

“If your kids wake up with a sore throat, you have two choices right now – go to the expensive doctor at urgent care or send them off to school. And that is a choice a parent no longer has to weigh if you work for Kootenai County,” Kootenai County commissioner Bill Brooks said.

The new clinic provides county health plan members primary care, episodic and acute care, preventive care, select prescriptions and select lab services for free at the point of service. It is unaffiliated with the Kootenai Health system.

County Director of HR Sydney Plouth said conversations about a government-funded clinic arose following employees’ difficulty in finding primary care for the mundane health issues of life.

“We have a productive staff and an engaged workforce. And anything that would improve access to care for our staff was critical to us. And it just was to me – it was so important,” Plouth said. “Hearing from our staff that they couldn’t get in to doctors, couldn’t get primary care for their family – that was the tipping point for us to do something different.”

That something different was a three-year contract with Premiere Medical Resources to set up a clinic where Kootenai County employees would be its sole patients. By contracting with PMR Health, employers pay a monthly lump sum to the clinic, and all employees gain access to unlimited appointments with no co-pays. This arrangement makes primary care easier and cheaper for employees – who only have to pay for their employer-provided health plan that comes out of their paycheck.

PMR sets up these specialized clinics for private employers and governments. Kootenai County has 753 employees on its health plan, and approximately 2,000 individuals are eligible for care at the Kootenai Member Health & Wellness Clinic. The county is only the third entity in Idaho to set up a PMR clinic and the first county government in the state to adopt this model.

“We provide clinics to companies for their employees and any of the spouses or dependents on the health care plan to have access to health care at a low cost,” PMR Health CEO Craig Marcroft said. “With us, employers can offer their employees better access to health care and better medical outcomes by giving them a clinic that is specifically designed for them and them alone.”

The county government also argues the new clinic will save taxpayers up to a $1 million a year in the long run. Because PMR bills the county in one lump sum, it can provide medications and health care at a reduced rate compared to what the county would need to pay ad-hoc at another provider. The model also eschews providers having to bill through insurance, which cuts out another middleman.

According to a PMR presentation to the county last year, the clinic cost nearly $130,000 in its initial setup. As part of the contract, Kootenai County pays PMR $99,702.52 a month plus an undetermined monthly cost for labs and prescription services. Annual increases in the amount paid to PMR are capped at 4.75%.

County Commissioner Leslie Duncan believes this model will be adopted by more companies and governments in the coming years.

“Our health care system is broken, and it really needs some attention. And I honestly think clinics like these are going to force traditional health care to wake up and do something different,” she said.

The highly conservative members of the Kootenai County commission said their new clinic was not akin to government-run health care provided by many nations outside of the United States. The county does not provide health care itself, and county employees still have the option to use their insurance at any other health care provider.

“That is why this is a very beautiful model. The county does not have any say in our employees’ health care. There is nobody in between the doctor and the patient. Not the county, not insurance. That’s very important to me, because I highly value medical freedom,” Duncan said.

County Commissioner Bruce Mattare said the clinic is not “government-provided health care” but a fiscally responsible “cost-savings measure.”

The PMR clinic employs three full-time employees – two medical assistants and a physician. Because the clinic’s patient base is so much smaller than the typical health care provider’s, appointments can be longer and more in-depth. Initial appointments last for 90 minutes, followed by 60 minutes the next week to go over lab results.

All appointments last longer than 15 minutes, PMR clinic physician Robert Doxey said.

“The clinic can accommodate between 13 and 20 patients a day. Health plan members can also get same-day appointments, compared to a three- to four-week wait at another clinic,” he said.

Duncan was one of the clinic’s first patients earlier this summer and just used it this week in a same-day appointment for an acute issue.