Out of the Box 

  Out of the Box: Aldridges

Jed and Diane Aldridge

Flat-Fee Care with an 'All-You-Can-Eat' Approach

By Rebecca Jones
Photograph provided by Jed Aldridge

Jed Aldridge knew it was time to find a new doctor when 10 minutes into his routine physical, his physician looked at his watch, said their time was up and suggested Aldridge make another appointment if he had further questions.

"I was just a number to him," says Aldridge, 62, a retired firefighter living in Kent, Wash., a suburb of Seattle. "I was just a revenue-generating device. He and his staff weren't concerned about my health and wellness."

Today, Aldridge and his wife, Diane, enjoy relaxed 30- to 60-minute visits with their primary care doctors as often as they wish. They can get appointments within 24 hours. And their clinic – and its adjacent pharmacy – is open seven days a week. For this coverage, they pay about $150 a month.

The Aldridges are among the roughly 3,500 members of Qliance Medical Group, founded in 2007. It operates a chain of insurance-free, direct-primary-care clinics in the Seattle area under an innovative business model that proponents say could revolutionize the way health care is delivered in the United States.

Qliance membership doesn't replace health insurance, says Norman Wu, president and CEO of Qliance Medical Management Inc. Instead, insurance is reserved for big-ticket health bills.

"You don't use your auto insurance to cover oil changes and new batteries," Wu says. "But in health care, insurance has become synonymous with all health care. It's used as a payment system for even the most routine things. Our idea is [to] have different business models for different aspects of health care."

Joining Qliance is similar to joining a health club or going to an all-you-can-eat buffet. A flat fee allows unlimited access to the plan's primary care providers and covers routine, low-cost, predictable care such as simple sick visits or routine physicals – the kinds of care people need to stay healthy. Insurance covers "the big, expensive stuff," Wu says.

Qliance isn't alone in offering flat-fee care in the United States, but its price is much more reasonable than many "boutique" or "concierge" care plans. Still, Wu says about 1 percent of members leave each month, and two-thirds of those cite financial reasons.

Monthly dues depend on age. The basic plan ranges from $44 a month for a child to $84 a month for a person more than 65 years old. The deluxe plan, in which doctors will come to your bedside and coordinate your care should you be hospitalized, ranges from $59 to $134 per month. No one is denied membership because of existing medical conditions.

Visits to specialists aren't covered, and people still need to buy catastrophic coverage, Wu says. But the cost of a high-deductible policy, combined with Qliance's monthly fees, means customers still generally save between 15 percent and 50 percent over traditional insurance plans, he says.

"But the greater financial impact is downstream," Wu says, "because if you can get people unlimited access to the best primary care, you have a much better shot at keeping them healthy, reducing the need for specialists and hospitals. And that's where the big health care costs come from."

Aldridge, who suffers from arthritis, likes the easy access. "When we have things go wrong, waiting six to eight weeks to see a doctor is unacceptable. For us, this is worth the expense," he says.