Kootenai County hears biannual PMR clinic report showing early savings and high patient satisfaction

The Kootenai County Board of Commissioners on June 24 heard a biannual report on the PMR employee health clinic covering July 1'Dec. 31, 2024, in which clinic operators said the site logged 1,990 patient visits, about 406 new patients and produced roughly $142,500 in net savings in the first five months and three weeks of operation.

The report, delivered by Natasha LaForce, regional operations manager for PMR clinic, said the clinic's objectives are to provide timely access to primary care for county employees and their dependents, improve early detection and chronic-disease management, and lower unit costs for visits, labs and medications compared with the county's health plan. "Everybody really loves Dr. Doxey. He is doing fantastic," LaForce said, summarizing patient feedback collected after visits.

LaForce told commissioners that, in the reporting period, about 406 distinct individuals used the clinic (roughly 33% of employees and about 16% of dependents, as reported), 282 patients received a complete physical, 645 prescriptions were dispensed on-site and more than 4,900 laboratory tests were performed. Some visits resulted in referrals to specialists including orthopedics, gastroenterology and dermatology; the clinic said it coordinates referrals and follows up on specialty care.

Clinic staff reported several early-detection outcomes, including an asymptomatic patient whose lab work led to an early cancer diagnosis and multiple cases of uncontrolled diabetes identified and brought into treatment. "If we can early diagnose a cancer perhaps in stage 1 versus stage 3 or 4," a PMR representative said, "that affects both quality of life and downstream health-plan costs." The speaker's remarks did not include patient names and were presented in compliance with HIPAA protections, the presenters said.

Scott Burkhart of Alliant asked whether the roughly $142,500 savings reported for the initial five-month period would annualize; PMR staff said the figure is not already annualized and could grow as utilization increases. "You could make that leap that the potential for it doubling could be twice that number after the following six months," a PMR representative said, while cautioning that utilization was still increasing.

Patient experience measures reported by PMR included immediate post-visit surveys that the presenters said averaged 96'97% positive on the questions shown, compared with an 85'86% benchmark the presenters cited for the open market. PMR said patients frequently cited longer visit time with the physician (some visits last 20 to 60 minutes) and same-day lab and medication availability as reasons for high satisfaction.

Presenters said the clinic works with Kootenai Health and Northwest Specialty to coordinate referrals and uses the employer benefit tools described as the Edison program and the EAP for behavioral health follow-up. PMR said it will place suggestion boxes in the clinic to collect additional written feedback and will forward survey and suggestion results to county staff and the commissioners.

Under the current contract, PMR will provide two semiannual reports; staff told commissioners monthly abbreviated reports could be provided if the county requests them. No vote or contract change was taken at the June 24 meeting.

Commissioners and PMR representatives said they will continue monitoring utilization and financials; county staff noted budget and program details will be discussed further at upcoming July meetings where the clinic and related Alliance numbers will be reviewed.