Gov. Greg Gianforte and the 2021 Montana Legislature dramatically expanded healthcare access by using a novel approach in today’s political landscape: cutting through red tape and empowering the free market.
Just over a year ago, Gianforte signed SB 101, the most expansive authorization of Direct Patient Care (DPC) in the country, sending a message to healthcare entrepreneurs everywhere who embrace free market principles and price transparency that Montana is open for business.
DPC, if you’re not familiar already, is an innovative health care model where patients bypass insurance to pay doctors directly with cash, often in the form of a low cost membership similar to a gym membership. By eliminating the middlemen and bureaucracy involved in billing insurance, DPC providers save patients money and focus on their health.
Montana’s 2021 reforms gave maximum freedom to entrepreneurs of all sorts — doctors, nurses, specialists — to innovate with the DPC model and grow the market for affordable healthcare options. Today, free market healthcare is flourishing in Montana.
My organization, the Frontier Institute, recently created the Free Market Healthcare Hub to map where patients can find DPC. We have verified at least 16 providers now operate primarily with the DPC model in Montana, double the count from just a year ago when SB 101 was signed into law.
SB 101 gave DPC entrepreneurs certainty they wouldn’t be targeted with red tape from overzealous regulators, and it’s led to a booming market. DPC can now be found everywhere from Eureka to Billings, providing an estimated 5,000 Montana patients with affordable, high quality healthcare.
Healthcare providers embracing the DPC model in innovative ways include physicians, nurse practitioners, naturopaths and pharmacists. Dr. Hayley Miller of Mountain States Diabetes in Missoula is making specialized diabetes care the focus of her direct care practice. Bigfork Nurse Practitioner Katie Borges is taking her DPC practice mobile. Kalispell dermatologist Dr. Kathleen Brown and her husband Jack are even outfitting vans to bring DPC to rural parts of Montana with underserved populations that don’t have ready access to specialty care.
The average membership fee for unlimited access to comprehensive primary care at a Montana DPC clinic is just $77/month, which helps put the cost of accessing care in reach of patients who are uninsured or struggling with high deductibles.
A price comparison shows the incredible cost savings in DPC. My local hospital in Helena, St. Peter’s, charges $103.66 for a standard lipid panel. Pacific Source, a common insurance plan for Montana’s individual market, pays the hospital $98.48 for the service. Dr. Morgan Coleman, owner of Big Mountain DPC in Whitefish says a lipid panel costs her patients “$7.50, no more, no less.”
In addition to making healthcare more affordable, removing insurance bureaucracy also has another benefit: radically transparent prices. Without the documentation, coding and billing of insurance, direct care practices in Montana are regularly providing the real cost of services upfront on their website — not just estimates.
Take for example Bear Grass Drug, a DPC pharmacy in Columbia Falls that posts no-nonsense prices for the drugs they provide on their website. Bear Grass says they charge only $21.10 for the cholesterol drug Ezetimibe, while the retail price for the drug at Walmart is listed at $234. Depending on your insurance situation, that price difference could save you a bundle.
Montanans should be proud that our leaders in Helena had the wherewithal to cut red tape, enabling our state to benefit from one of the freest healthcare economies in the country.
This column was originally published in Lee Newspapers