Colorado Sees Increase In Cash-Only Primary Care — Two new medical offices in northern Colorado Springs are joining the ranks of others that charge patients fees in exchange for same-day appointments and longer visits with doctors —

Flying Horse Medical Center accepts coverage from five major health insurers though most patients don’t use it, while PeakMed Primary Care doesn’t accept any insurance coverage.

Former military physicians staff both practices. Dr. Aaron Fraser of Flying Horse Medical Center is the former medical director for family practice at the Air Force Academy, while Dr. Mark Tomasulo of PeakMed was a former Army flight surgeon who has worked in local emergency rooms and urgent care clinics.

Both physicians said they want their practices to offer a more personal type of medical care than they offered in the military health care system, where appointments often are scheduled weeks in advance for a doctor office visit that typically lasts 10 to 15 minutes.

Flying Horse Medical Center opened in a former wine shop and garden center; it’s staffed by Fraser, chief operating officer Ryen Hitzler, a nurse and up to 10 part-time nurses, billing clerks, laser technicians and an office manager. Patients pay a monthly fee starting at $50, but that fee doubles if they elect to use their health insurance coverage.

“Our target audience is about 5 percent of the population,” Hitzler said. “We are a good alternative for people who travel or don’t have a steady schedule and need to see their doctor within 24 hours.”

PeakMed will be staffed by two physicians, a nurse practitioner and a medical assistant. Patients will pay a monthly fee of $25 to $89, depending on their age; the fee covers office visits, urgent care that doesn’t require an emergency room visit, physical exams, minor medical procedures and other routine health care. By not accepting insurance coverage, PeakMed reduces its overhead expenses and allow it to charge fees that are fraction of what most concierge medicine practices charge, Tomasulo said.

Separately, PeakMed recommends patients pay for a high-deductible health insurance policy to cover major medical expenses such as emergency-room treatment, surgery and hospital stays.

“We are creating this from the ground up to change the perception and concept of primary (medical) care and show that you can have an affordable health care system and have concierge-level care 24 hours a day, seven days a week,” Tomasulo said. “The current health care system no longer fosters health care; instead it caters to acute and sick care rather than wellness and prevention. It’s hamster-wheel medicine when you have to see 30 patients a day and only spend 10 minutes with each one.”

PeakMed is one of a growing number of niche physician practices using the monthly membership model – similar to gym memberships – that started in 2007. The nation’s first concierge medical care practice opened in 1996.

The practices limit the number of patients per doctor to about 700 – a typical medical practice will have 2,500-3,000 patients per doctor.

“If I can spend an hour with a patient, I can really understand who they are, what they will accept and get back to being a teacher” about health, Tomasulo said. “We want to take a holistic approach to health care and take care of the person instead of just treating their diseases.”

Patients will be able to see their doctors not only in the office, but also by phone, text or video conference, get lab work done and they will be able to buy prescription medications through PeakMed at wholesale prices, Tomasulo said. PeakMed had signed about 300 patients through mid-July, he said. When they buy a high-deductible health insurance policy and combine it with a membership in a medical practice, patients will qualify as insured under the Affordable Care Act, or Obamacare.

Tomasulo has dreamed of changing the way primary medicine is practiced since he was in medical school more than a decade ago and spent the past year putting together PeakMed while working in urgent care clinics in Colorado Springs and emergency rooms in southeastern Colorado.

Before going to medical school, he was an aircraft mechanic for the Navy both in active duty and as a civilian. He received an Army scholarship to pay for his medical education and served as a flight surgeon until he completed his service in 2011.

Tomasulo said he hopes to expand PeakMed to include a south Colorado Springs location, as well as offices along the Front Range. He’s also talking with companies interested in opening his clinics in other states.