Kootenai County hears biannual report showing early patient use and preliminary savings at PMR employee clinic

Kootenai County Commissioners on June 24 heard a biannual report on the county's PMR member health and wellness clinic covering July 1, 2024, through Dec. 31, 2024, in which PMR staff said the clinic recorded 1,990 visits and preliminary net savings of about $142,500 during the clinic's early months.

The report, presented by Natasha LaForce, regional operations manager for PMR, and PMR team members, said 406 unique patients used the clinic in the reporting period, representing about 33% of employees and 16% of dependents on the county plan. PMR officials described high patient satisfaction scores and early clinical findings, including diabetes management and an early cancer diagnosis identified through routine lab work.

County commissioners asked about the potential to annualize savings and about reporting cadence. PMR staff said the existing contract requires two semiannual reports but that abbreviated monthly reports were available if the county requested them. A commissioner indicated a preference to continue with the two semiannual reports; PMR staff said they would confirm delivery timing for the next report.

PMR officials described the clinic's stated objectives as improving access to primary care for county employees (reducing typical appointment wait times of eight to 10 weeks to same-day or next-day visits), enabling earlier detection of medical conditions, managing chronic disease, and reducing out-of-pocket costs for patients. LaForce said there is no out-of-pocket cost for primary care visits or medications dispensed at the clinic.

Operational and utilization figures presented by PMR included: 1,990 scheduled office visits; 406 patients served; 282 complete physicals performed; about 645 medication dispensings; and more than 4,900 labs processed during visits. PMR reported net savings of roughly $142,500 "net of fees" after approximately five months and three weeks of operation; that figure reflects PMR's comparison of its unit costs for visits, labs and medications against the costs those same services would have generated through the county's health plan.

Scott Burkhart of Alliant, present during the briefing, asked whether the savings could be annualized; PMR staff said utilization is growing and that savings could increase as more services are routed through the clinic. PMR staff also said the Kootenai clinic's utilization is slightly higher than many of their other employer clinics and that the program is tracking close to early projections.

Presenters highlighted patient experience measures. LaForce said patient survey scores are in the mid- to high-90s percentiles on aggregated questions about availability, scheduling and staff professionalism, compared with an 85 to 86% benchmark she cited for the open market. LaForce also said patients value the longer appointment times; new-patient appointments often last up to 90 minutes and allow a full blood panel and extended clinician time.

Clinical staff reported several early clinical interventions, including an early cancer diagnosis identified through lab work on an asymptomatic patient, multiple uncontrolled diabetes cases now in treatment, and increased access to behavioral health care through use of employee assistance program benefits and medication management pending specialist appointments.

Commissioners discussed operational feedback from employees, including anecdotal reports about difficulty reaching clinic staff. PMR said it will place a paper suggestion box in the clinic and continue electronic patient surveys; staff said they will compile that feedback and provide it to PMR marketing and the county. PMR also indicated it will work with the county to confirm timing for the next semiannual report.

No formal motions or votes were recorded on the item during the meeting. The presenters thanked commissioners and said they looked forward to continued reporting and to the next conversation about clinic performance.