Crossroads Direct Payer Clinic offers an alternative to insurance | For subscribers only

Crossroads family doctor Claire Zengerle is looking to bypass insurance companies and work directly with her patients with her new direct-payer care clinic.

Her clinic, Zengerle Medical Clinic, 2721 Farm-to-Market Road in DeWitt County, is scheduled to open Aug. 1.

Direct payer care has been a growing model of care over the past several years and has accelerated in the pandemic environment. After being disillusioned with the insurance model of health care, Zengerle hopes the direct payer model will lead to success for her clinic and better care for her patients.

Zengerle has practiced medicine at Crossroads since 1995, and during that time she grew increasingly tired of the insurance model of care, which made it increasingly difficult to work with patients, she said. After medical mandates were put in place during the pandemic that she disagreed with philosophically in terms of how she made recommendations to her patients, she felt it was time to take a different path and start her own clinic.

“I’m at the point in my career where it’s time to do something different because it’s just not working well the way it’s going,” Zengerle said. “Covid has really changed the landscape quite a bit for different businesses, so it’s time for people to try something different.”

Direct payer care, unlike the fee-for-service insurance model, is a subscription-based model where patients pay to access a doctor.

In 2020, direct payer care membership increased 21%, while paid adult primary care visits decreased 10%, according to Hint Health’s 2022 Direct Primary Care Trends Report. In Texas, membership in direct care services increased 18% over the same time period, the second largest increase by state in the nation, while paid outpatient visits decreased 25%.

The model is also endorsed by the American Academy of Family Physicians with a recommendation to still maintain insurance in the event of an emergency.

With his clinic, Zengerle hopes more people will be proactive with their health instead of waiting until the last minute, recalling how people avoided getting treatment during the lockdown due to fear of cost and illness from COVID-19.

“I know for a fact that people didn’t go to the doctor, so they didn’t get a cancer screening test,” she said. “I knew a guy who sat at home and had a stroke and never went to hospital before it was too late, just horror stories. We have to get people to not put off their care.”

An additional feature of the clinic for patients is a HIPAA-compliant app that patients can report injuries or other conditions to Zengerle, and she can advise a course of action for appointments or other decisions, she said.

Zengerle learned about the model through Roger Moczygemba, CEO and founder of Direct Med Clinic San Antonio, which has been in operation for the past four years.

It’s hard for patients to wrap their heads around the model at first, but once they do, they’re more proactive in their health, and that generally leads to better patient outcomes, Moczygemba said.

Direct Med Clinic San Antonio has seen steady growth over the past four years, with the pandemic being notable, and he expects Zengerle to see similar, if not more, success in a rural community because there is a much larger region to serve, he said .

Although she created the clinic to serve her DeWitt County community, Zengerle is confident she can handle the increase in patients from the other Crossroads as her clinic grows, she said.

Kyle Cotton was born and raised in San Antonio and graduated from San Antonio College and the University of Texas at Arlington. Cotton covers economic development, healthcare, finance, government, technology, oil and gas and higher education.

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