Richland Township clinic takes the insurance out of health care

An Altoona physician’s unique approach to medical care has expanded into the Johnstown area.

Empower3 Center for Health opened Oct. 1 at 108 College Park Plaza in Richland Township. Inside these doors, terms like copay, deductible and coinsurance do not exist because they do not bill or accept traditional health insurance plans.

Instead, Empower3 Center for Health is a direct pay primary care clinic, where patients pay a monthly membership fee to receive services that include primary medical care from an in-house, board-certified family physician, routine medical procedures, a variety of generic prescription medications and visits with physicians in eight medical specialties through telemedicine.

Individuals and businesses alike can join, and there are no income guidelines or limitations for pre-existing conditions.

Basic and Prime membership levels are available.

Both options offer patients an extensive list of standard services, including primary medical care for people age 12 and over, sick visits, health and wellness checkups and exams, flu shots and standard vaccinations (except shingles), blood draws and routine lab work and generic prescription medications, as well as telemedicine specialty services from dermatology, cardiology, endocrinology, rheumatology, neurology, nephrology and pulmonary physicians.

The Prime membership adds more specialty services such as physical therapy, imaging (MRIs and CAT scans), cardiac testing, pulmonary and sleep studies, durable medical equipment, behavioral health services and an expanded list of covered generic prescription medications.

The center is working with local partners to provide the specialty services, such as Chan Soon-Shiong Medical Center at Windber for imaging, cardiac, pulmonary and physical therapy services; Penn Home Medical Supply for durable medical equipment; Nulton Diagnostics for behavioral health services and East Hills Pharmacy for prescription medication.

Dr. Zane Gates, who has degrees in both pharmacy and medicine from the University of Pittsburgh, developed the model while operating a free medical clinic in his hometown of Altoona.

The Empower3 direct pay primary care model makes an important distinction between paying for health care and paying for health insurance, Gates said.

“The actual formula of health insurance was never designed for 80 percent of the people who buy it to use it — and that’s what (is happening),” he said. “Eighty percent of the people that buy health insurance use it. It causes huge inflation.

“So what we do is, we take that 80 percent and drop it to 20 percent, which is more in line with insurance and then the rest of it, you’re just buying health care. The insurance coverage is stuff that’s not likely to happen — aka insurance.”

The Empower3 model actually brings members’ costs down, unlike the current system that continues to drive premiums for health insurance skyward, Gates said.

“I think it changes everything,” he said. “People like Amazon, like Netflix, what they figured out is you can develop a model where you can get economies of scale and you can actually buy the services themselves like Amazon did and bypass the big box (stores). It drops the price and makes it a lot cheaper, and it gives a better care model because our physicians and our providers don’t have to worry about the high processing of insurance.”

Gates opened his first Empower3 Center for Health clinic in Altoona about 2 1/2 years ago, and that office now has about 2,200 patients. A second clinic opened in January in Murrysville, and that office has about 150 patients. The Johnstown clinic currently has about 50 patients, Gates said, and they also have an arrangement with Senior Life to provide primary medical care to its members.

A fourth clinic is scheduled to open in Philadelphia next spring.

Val Mignogna, who is also part of the organization’s senior leadership, said that Empower3 Center for Health offers a health care option that is not found anywhere else in the country.

“We’ve put together this whole network of care in this very affordable and — critical in health care — transparent price,” he said. “You know exactly what you’re paying and you know exactly what you will get for that price. Again, nobody in the United States is doing this quite like us.

“Nobody’s put the breadth of what we’ve put together in one network, and fix the price. and the beautiful thing about it, unlike anything else in health care, we can get economies of scale and lower the price. Nobody else has come to the table with a solution that lowers the price.”

Tom Kurtz, president and chief executive officer at Chan Soon-Shiong Medical Center at Windber, said the medical center’s partnership with the center is a natural fit that benefits both parties.

“Honestly, this area has a shortage of primary care physicians and specifically primary care physicians that want to do business in Windber,” he said. “We get patients all the time wanting to come to the hospital, but they can’t get into a primary care doctor that actually sees patients at our place, so this is a natural for us. It expands our volume to a point where I’ve got capacity to add additional patients and it also gives us a great primary care physician right in the heart of Richland that will refer patients to Windber. So it’s a win-win for us.

“We’ve got a state-of-the-art MRI sitting there that we could add patients to it very easily by extending some hours and doing some things. The machine’s already paid for, so the more people we put through it, that’s why we can lower the cost to people like (Empower3 Center for Health), because I don’t have to add any costs.”

Dr. Stephanie Young from Ebensburg is the Johnstown clinic’s primary care physician. She has been a physician for 23 years, and she joined the center medical staff in September.

“I worked for 20 years in a traditional office, and it became a burden to try to get patients things that I thought they needed: MRIs, CAT scans, that type of thing,” she said. “And you’re hearing more (from patients) about paying very high premiums, they have very high deductibles, their copays are going up and they get less. and then when I want a test or a medicine, I can’t get it for them.”

Young, who worked with Gates in the past, was familiar with his efforts to create a different kind of health care model.

“I knew he was doing this and when he asked me to come aboard, I said absolutely,” she said. “I do believe (patients) get better care. They get time spent with them. They’re able to get the testing — whether it be labs, MRIs, CAT scans, whatever they need — without an insurance company being the middle man, making the decisions.”

The Johnstown office is open from 9 a.m. to 5 p.m. on Monday, Wednesday, Thursday and Friday, and from 10 a.m. to 7 p.m. on Tuesday.

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