Primary Health Care for $49 Per Month – Insurance Not Accepted

Dr. Garrison Bliss has found a way to decrease the role of insurance companies in day-to-day medical care that leaves both doctors and patients with more money.

As a co-founder of the Qliance Medical Group (, Bliss operates three clinics in theSeattle, Washington area that treat both insured and uninsured patients who pay a monthly fee of between $49 and $89, depending on their age.

“The primary difference is that we don’t take money from insurance companies,” said Bliss, who opened his first clinic in 2007 and claims the business model decreases wait times and reduces the costs of treating patients. “The amount of money per patient that we make is actually higher than it would be if we ran an insurance practice.”

Under insurance-based healthcare, physicians see 2,500 to 3,000 patients annually, each for only 10 minutes, Bliss said. At Qliance doctors see 800 patients and spend at least 30 minutes with each and as long as one hour. “We promise to see you on day that you’re sick, or the next day,” said Bliss, adding Qliance neither pre-screens nor cares about pre-existing conditions. “Patients want to have access, they want to be the boss, they want to be appreciated and taken care of and physicians want time to do good work.”

Qliance clinics are open seven days a week and 12 hours a day on weekdays. Patients are also given cell phone and email access to doctors. The monthly fee covers first-time prescription fills, stitches, casts and X-rays, all of which are taken care of at the clinic. “We don’t make money on ancillaries,” Bliss said, adding that 50 percent of the money spent in primary care gets “burned up” in insurance company transaction costs, which instead could go to doctors.

Insurance companies are still needed, he said, but only for “catastrophic events” such as big operations or month-long hospital stays — not for basic primary care. “We have 62 percent fewer emergency room visits in our patient populations compared to others in our region here,” said Bliss, noting Qliance has to date processed more than 4,000 patients of all ages and incomes. “We have about 50 percent less use of specialists, 50 percent less use of advanced imaging 25 percent fewer hospital days.”


Qliance is classified as a direct primary care medical home (DPCMH), which currently operate in more than a third of U.S. states and treated more than 50,000 Americans in 2010, according to the Direct Primary Care Coalition. “We’re ready now to start looking at a national roll-out. Our objective is to be in 50 states within the next five years,” Bliss said, adding that Qliance plans to open at least four more clinics in the Puget Sound region this year.

The moves will require Bliss to raise another funding round for “substantially more money.” The company has had three previous rounds, generating a total of $13.5 million.

Second Avenue Partners, an early funder of, has been Qliance’s main angel investor. Amazon founder Jeff Bezos, Dell Inc founder Michael Dell and comedian Drew Carey have also invested. Revenue for 2010 was about 60 percent higher than the year before, Bliss said, due to very significant patient growth and growth over the next year is expected to be at least 100 percent. Earlier last year, the company laid off nine employees because of what Bliss described as “overprojecting slightly” how fast Qliance would scale. If the expansion goes as planned, Bliss said the company will likely double its 53 employees over the next year.

The biggest challenge for Qliance is what Bliss calls the “dysfunctional marketplace,” adding that many financial organizations make their money “doing the wrong thing for healthcare.” “This is a big barrier for us but one we have really come a long way toward getting around,” Bliss said, adding the Obama Health Care Act, most of which comes into effect in 2014, contains a paragraph that involves direct practices, which “opens up a playing field in the United States for us to really compete.”