We Can’t Fix Everything That’s Broken in Healthcare, But We Can Change How We Practice Within It.
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We recognize that our announcement about transitioning to Rocky Mountain Direct Primary Care has left many of our patients feeling unsettled, frustrated, and even anxious about finding a new primary care provider. For that, we are truly sorry. The last thing we ever wanted was to create uncertainty for the patients and families who have trusted us with their care for so many years.
But before you feel you need to rush out or feel forced to find a new provider, we sincerely encourage you to explore your insurance options, take a closer look at your healthcare expenses, and really run the numbers. You may be surprised by what you find.
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The reality is that a large majority of our patients have high-deductible insurance plans, often with deductibles significantly higher than the cost of an entire year of RMDPC membership.
Under traditional insurance, each office visit may mean another copay, deductible charge, or coinsurance responsibility. Those expenses can add up quickly, particularly for patients who need regular follow-up care.
With Rocky Mountain Direct Primary Care, one predictable membership fee covers unlimited primary care visits and included in-office procedures—with no additional copays, deductibles, or coinsurance for those services. Eligible patients may also be able to use pre-tax Health Savings Account (HSA) funds to pay their membership fees, providing additional potential savings.
We're not suggesting RMDPC will save everyone money. Some patients have excellent insurance benefits with very little out-of-pocket expense. But for others, especially those with high deductibles or frequent primary care needs, RMDPC may actually cost less annually than what they're currently spending on primary care.
We encourage you to compare the full picture—your insurance premiums, actual out-of-pocket expenses, prescription benefits, and anticipated healthcare needs—not just the monthly membership fee.
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Imagine having the time to discuss all your concerns during one appointment instead of being told you need to schedule another visit because insurance billing rules limit what can be addressed.
Imagine coming in for your annual physical and being able to discuss that nagging knee pain or new concern without worrying about an additional office visit charge.
Imagine hurting your foot over the weekend and, when medically appropriate, having an X-ray ordered without first needing another office visit simply to satisfy an insurance company's documentation requirements.
Longer appointments. Fewer unnecessary barriers. More direct communication. More time to listen. Care focused on you—not on checking boxes. That's what Direct Primary Care allows us to work toward.
We can't fix everything that's broken in our healthcare system, but we can change how we practice within it.
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We want our patients to understand something very important: We're not making this change to provide less care or make more money. Neither assumption could be further from the truth. We care more about our patients than numbers, quotas and insurance company metrics.
To remain financially sustainable under the traditional reimbursement model, our providers must average 20+ patient visits per day. In an eight-hour day, that's just 24 minutes per patient to check in, see the provider, address concerns, document the visit, order tests, coordinate referrals, and complete the appointment.
And between those visits, our team is reviewing results, answering questions, refilling prescriptions, coordinating care, and spending countless hours navigating insurance authorizations and requirements. Meanwhile, insurance carriers continue to increase their documentation demands, quality measures and performance STARS, and administrative requirements while reimbursement to independent practices continues to decline.
We're being asked to do more and more with less time and fewer resources, while patients are paying more and more for their insurance coverage and taking on higher deductibles just to afford the premium! That simply isn't sustainable, and it isn't the kind of primary care we want to provide.
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We recognize that RMDPC doesn't work equally well with every insurance plan, particularly HMO plans that require a designated, in-network primary care provider for referrals and other services.
This is why we timed our announcement to coincide with the open enrollment period. We wanted patients to have time to compare their coverage options, review premium differences, and determine whether another insurance arrangement paired with RMDPC might better meet their needs.
It's also important to understand that we can still order labs (and draw them right here in our office), refer you to specialists, order imaging, prescribe medications, and coordinate your care just as we do today.
While we will no longer bill insurance for primary care visits or included in-office procedures, outside services can still be billed to your insurance and may be covered according to your plan's benefits and requirements.
Choice, EPO, PPO, Traditional Medicare, health savings plans generally offer more flexibility, while HMO plans often require orders and referrals from an in-network PCP. For some HMO patients, those requirements may make RMDPC membership incompatible with their coverage. We encourage you to explore all your options and specifically, your plans coverage requirements before assuming anything.
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We believe Direct Primary Care offers a more sustainable path forward—one that allows us to spend less time meeting insurance requirements and more time caring for the people who matter most: our patients.
We know this change is difficult, and we understand that not everyone will be able to make this transition with us. That is genuinely very difficult for our entire team and caused a lot of emotion.
Many of you have trusted us with your care for years, even decades. We've cared for your families, helped you navigate difficult diagnoses, and built relationships that mean far more to us than an appointment on a schedule. Those relationships are exactly why we're making this change. We don't want to lose what makes primary care personal.
Before making your decision, we encourage you to take the time to review your healthcare expenses, consider your insurance options, and learn more about what your membership includes. Visit www.rockymountainRMDPC.com for membership details, pricing, and frequently asked questions.
We aren't changing who we are or how much we care. We're changing the system we work within so we can care for you the way we believe you deserve. Whatever you decide, we are deeply grateful for the trust you've placed in us.
With sincere appreciation,
Dr. Darcy Scheeler and the Piñon Family Practice Team