CostCare Direct & Medical Memberships

She doesn’t make house calls but many other facets of Lesley Von Eschen’s CostCare practice hearken back to old days of medicine—doctors who know you by name and diagnose what ails you, no muss and no fuss.

Lesley and Carol started CostCare in 2007 as a one-room clinic within Valley Drug in Stevensville, charging a flat fee of $45. In 2008, they moved the practice to Missoula, expanding to two urgent care clinics, plus a family practice clinic. Lesley and Carol raised their flat fee to $60 to accommodate the higher business costs of Missoula. 

Then came the Affordable Care Act. This blooming baby of a business was forced to accept insurance plans. Billing insurance meant more paperwork, more staff, and more expenses, driving up the cost of care. 

For two women who started their business after leaving emergency room-based care, the higher costs of doing business, increased red tape, and more hassle was an unwelcome change to their flat-fee model. 

Transparency. Clear fees, no hidden costs, no surprise bills. The CostCare model was born out of simplicity and a desire to take the financial worry out of paying for medical care. In 2018, CostCare started a direct primary care membership: pay one monthly fee for unlimited clinic visits and a variety of health care services. 

“We had to fight for it, legislatively,” Lesley explained. “But it is transparent, and that’s what we wanted all along.” 

Members of CostCare Direct can communicate with Dr. Carol Bridges via text, phone, and email. 

“As a member [of CostCare Direct], you’ve already paid the 70 bucks for us to take care of you; let us take care of you,” Lesley said. “If you have pinkeye at work, take a picture, text it to me, and I’ll call in a prescription for ointment. You don’t have to come in.”

Providing efficient and strategic solutions to members’ healthcare is possible due to CostCare partnering with Granite Pharmacy. They offer cash discounts for prescriptions and work with patients to find cost-effective immunizations.

The membership model of healthcare continues to grow. Lesley said over 1,500 clinics like CostCare exist across the U.S., with numbers increasing as health insurance premiums skyrocket. CostCare Direct members include people without insurance coverage and members with high deductible coverage, as well as local small businesses that offer the benefit to their employees. 

“Businesses can increase employee retention and decrease employees’ time away from work due to illness,” Lesley said. “They’ve saved thousands of dollars offering this to employees.”

Swimming against the tide is sure to cause waves, but Lesley and Carol are loyal to their transparency with patients and to their personal aspirations. 

“When we first brought this model to Missoula, it was so different. We were two women, brave enough to step out of a traditional emergency room setting and try something new,” Lesley said. “We love our team. If we didn’t have such an amazing team supporting us in all we do, we wouldn’t be where we are today.”

Lesley doesn’t waste time thinking about frustrations. She’s working to form a state-wide network of direct primary care providers so that if a member of CostCare Direct needs medical care in another part of Montana, they can visit another direct care provider, rather than make a costly visit to the ER. 

“This model thrives in a free market,” she said. And it’s her focus on the positives that keeps her head in the game and the wheels turning.

“My much larger goal is to fight for transparent, cost-effective healthcare,” Lesley said. “Everyone wins when patients know the cost of their care.”