As a direct primary care provider, Frontier Direct Care started in 2018, serving just a handful of individual families. Eventually, it grew to working with larger, self-funded employers.
The company provides unlimited primary care services virtually and in-person at $60 per member per month for employers or $60 to $100 per month for individual consumers. However, there was a barrier for some potential employer clients: they didn’t always know where to place Frontier on top of their current health insurance plan, said Dr. Peter Lazzopina, founder and chief medical officer of Harlingen, Texas-based Frontier.
“For the employer, they’re thinking, ‘Well, how do I fit this in? I’m already spending all this money on my traditional self-funded insurance plan with a third party,” … They’re thinking, “This is going to increase my healthcare spend,” Lazzopina said.
That’s why Frontier decided to work with New York City-based Flume Health, a digital health plan administration platform, to launch its own self-funded health plan. Flume considers itself a more tech-forward option than traditional third-party administrators like Sedgwick or UMR. Through this health plan — expected to become available October 1 — members will have access to Frontier’s primary care services, as well as hospital visits, prescription drugs and other needs.
“We’re basically able to go to an employer group now and say, ‘Hey, we have this package that will fit your entire healthcare needs,” Lazzopina said. “You’ve got your primary care with Frontier and then we’ve got all of the catastrophic coverage built around that for employer groups.”
With the new health plan, Flume is providing its full set of services through its Flume OS platform, which includes provider contract management, payments and claim processing, said Richard Fu, Flume chief growth officer. By working with Flume, Frontier will be able to grow its business long-term, he added.
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
“We’re enabling a pretty robust primary care model where they can actually start to be closer to the funds flow, so aligning incentives that help make them more relevant and also solvent in the long run,” Fu said.
In working with Flume, Lazzopina said he hopes to solve a major barrier for people in healthcare: affordability.
“We think that by working with employers, who provide 80% of the healthcare coverage for our population, we’re going to be able to dramatically decrease the healthcare spend,” Lazzopina declared.
Other direct primary care companies include Forward Health and EverMed, which operate in different areas of the U.S. Frontier is the largest direct primary care provider in southern Texas, according to a news release.
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