Michigan Schools Embrace Direct Primary Care to Tackle Rising Health Costs
In a bid to curb escalating health care expenses, three Michigan school districts have adopted a novel approach by establishing a clinic that charges nothing for medical services. Located on Corunna Public Schools’ main campus, the Corunna Plum Health clinic offers its services at no cost to its patients.
The clinic, housed in repurposed high school classrooms, saw 13 patients recently without requiring copays or deductibles. Physician assistant Shelley Littleton attended to various health issues, from skin rashes to anxiety, and dispensed nearly $550 worth of medications—all complimentary.
Corunna Public Schools Superintendent John Fattal expressed satisfaction with the clinic’s model, stating, “What I love about it more than anything else is the ability to be seen and have a lengthy conversation.” This initiative, he notes, exemplifies “health care the way it’s supposed to be.”
The clinic is part of a consortium involving Corunna and two nearby districts—Lansing and Van Buren—that collaborate with Plum Health, a Detroit-based direct primary care provider. This arrangement circumvents traditional insurance, opting for direct transactions between employer and provider.
For the past two years, Corunna has paid $90 monthly per employee for access to a clinic open twice weekly. This fee covers deeply discounted medications, eliminating any out-of-pocket expenses for prescriptions.
The districts hope that easy and free access to primary care will reduce expensive emergency room visits, which can exceed $1,000 per visit, and urgent care, often costing hundreds.
Currently, about 110 district staff members have insurance through the Michigan Education Special Services Association, covering emergencies and hospitalizations. Fattal ponders how many ER visits could be avoided if parents had morning access to their physician.
Direct Primary Care: A Growing Trend
Direct primary care operates independently of insurance, making it an appealing option as traditional insurance becomes less accessible. Over 131,000 Michigan residents recently lost insurance obtained through the federal marketplace, and more than 80,000 have been removed from Medicaid since January, per state data.
The financial pressure on Michigan businesses and employees with job-related health coverage is mounting. According to a Chicago-based Aon report, health care costs are projected to rise by 9.5% next year, largely due to high drug prices and increased medical service usage.
Advocates for direct primary care highlight its ability to avoid these cost spikes and the administrative complexities of traditional insurance. Dr. Philip Eskew, a direct primary care physician, emphasizes the focus on patient care over billing requirements. “You get to spend time with the patient,” he noted.
At Plum Health’s Detroit and Royal Oak locations, a $95 monthly fee provides patients with continuous access to family medicine services, often with same-day appointments. In contrast, networked doctors may not have availability for over a week.
Direct primary care allows physicians to manage fewer patients—around 400 compared to the national average of 2,500—promoting comprehensive and personalized care, as per a 2024 survey by the American Academy of Family Physicians.
Fattal views the clinic as a tool for attracting and retaining staff, particularly in light of Michigan’s educator shortage. The convenience and cost-effectiveness of the clinic appeal to employees like Erika Eiseler, who appreciates skipping the $40 copay per doctor visit under her family’s insurance policy.
Challenges and Opportunities
While some argue that direct primary care could expand access in underserved areas, there are concerns about its impact on the overall health care system. The American Academy of Family Physicians and American Medical Association support this model, but acknowledge that each doctor in direct primary care may reduce the availability of primary care providers for other patients.
Plum Health founder Dr. Paul Thomas believes that by improving work-life balance, more doctors may opt for primary care specialties, potentially changing the health care landscape to be more cost-effective and patient-centered over time.
For now, the model benefits those with insurance who avoid additional ER and urgent care charges, while offering uninsured individuals a new avenue for medical care.
