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City staff say Frontier direct-primary-care users have fewer admissions and readmits
Summary
Presenters told the McAllen City Commission that about two-thirds of eligible employees use the Frontier direct primary care program and that users show lower inpatient admissions and readmissions, which staff say helps reduce claim costs.
City staff highlighted the municipal direct primary care arrangement as a material factor in the plan’s claims experience. "Please note that the ... purple that would be our experience had we not implemented Frontier Direct Care as our primary care program," Jolie Perez said while describing a 10-year spend trend comparison. Perez said the Frontier program concentrates care for sicker members and that, despite higher per-member costs among those members, Frontier users have "significantly below" inpatient admission and readmit rates compared with non-users.
Staff said engagement is incomplete but meaningful: "We have, on average, 66 to 67% of our members are utilizing Frontier at any given time," Perez said, and outreach and plan design incentives are being used to increase engagement. A consultant on the panel said better integration between a TPA (UMR) and direct-primary-care models would improve data-driven management and give staff more options to steer care in ways that reduce future claims.
