ReforMedicine began as a direct-pay, no insurance, pay-as-you-go practice. Since 2013, Usher’s “ReforM” model has evolved to be, primarily, an employer-paid, membership-based program. This ReforMDirect approach allows self-insured employers to provide free or very low-cost primary care to their employees and families while better controlling the cost of their health plans. Usher says that health insurance is very often the second-largest line item in an employer’s budget.

“With ReforMDirect, we become the patient’s regular doctor. When a patient needs something, we get them in the same day or next day,” he notes. “That ability to access their provider when they need them is what builds trust, and curbs cost by avoiding unnecessary trips to urgent care or emergency rooms.”

Dr. Usher describes membership-based primary care as working like a cellphone contract: “All the talk, text, and data you need for one low monthly fee.” Patients can be seen by providers, send texts, message through a web portal, or call as often as they need to and there is no additional cost to the patient or employer. Most additional costs, such as lab tests and vaccines, are passed through with no mark-up to the employer. “Often the lab savings alone, which can reach 95% or more, will be enough to cover the cost of the whole primary care membership!” Dr. Usher says.

“We work directly for over 30 local employers. With plan beneficiaries ranging in number from 10 to over 1,500, our mission is to be a partner to employers as part of their health plans. We are totally independent and want to work toward better care for employers’ valuable people, while helping to save employers 20, 30, or even 40% on their health care spending. Patients love the care, and employers appreciate the cost-sensitive approach ReforMDirect takes as an integrated part of their health plan.”

Dr. Usher says 80-90% of what people need from medical care they can get from a family physician. “If they can get in. It may take weeks to get an appointment with a primary care doctor, and after getting burned by large, surprise bills, they end up not going, or delay going until they’re really sick and wind up in the ER.”

Medical weight loss is included in ReforMDirect at no extra cost to employers. Obesity is such a fundamental aspect of chronic illness that treating weight first is “ultimate” primary care. Usher, a Diplomate of the American Board of Obesity Medicine for over 10 years and treating obesity for nearly 20, says that more than 230 illnesses, including 13 common cancers, heart disease, and diabetes, find their roots in or are worsened by obesity.

“I can put you on a bunch of meds for these chronic diseases, or you can change the ‘what’ you’re eating — not the ‘how much’ you are eating,” he proposes to patients. “I’m not telling you to starve yourself. I want you to eat until you’re full and happy and satisfied, but you’ve got to eat the right stuff.” While patients do lose weight rapidly on the plan, they feel better even faster.

By addressing obesity effectively, patients can improve chronic conditions such as diabetes, high blood pressure, and more. Patients in the weight loss program lose an average of 14% of their body weight within the first six months, Dr. Usher says. “This is faster on average than the published rates of some really expensive, newer weight loss drugs,” he claims. “Some of our patients use those drugs, but most do extremely well on inexpensive, safe, and effective meds that have been around for nearly 70 years. Some need no meds at all!”

Confirming the effectiveness of the “ReforM” (as Usher refers to it) approach, ReforMedicine has grown from one physician into a team of 12 providers, including physicians, nurse practitioners, and physicians’ assistants. Diane Peterson, the Chief Operating Officer for ReforMedicine, who has been working with Dr. Usher since 2013, enthusiastically reports, “We are happy to grow more and expand our footprint to wherever there are enough patients that it makes sense.” Ms. Peterson also heads up the Partner Care team at ReforMDirect, working to ensure patients and employers are getting as much value from ReforMDirect as possible.

Ms. Peterson is happy to connect with employers who are interested in making changes to their health plans. “Interested employers may email or call us, come through our website, or have their insurance advisors reach out. Any employer may inquire. We can start anytime. We are not insurance, so we are not beholden to a ‘plan year,’ ” Peterson notes. “Employers can start getting their people more than merely insurance; they can get them actual medical care, at any time of year!” she states with a smile.

Dr. Usher received his M.D. from the University of Iowa in 1993, and first came to Eau Claire in 1999 to work for Mayo Clinic Health System for over 12 years. In 2011, he founded ReforMedicine in Menomonie. ReforMedicine locations now include Eau Claire’s south side at 3004 Golf Road, as well as clinics in Lake Hallie, Menomonie, and Hudson, plus an on-site clinic in Chippewa Falls for Chippewa Falls school district employees and their families.

ReforMedicine continues to see patients for both primary care and medical weight loss on a pay-as-you- go basis. Their cash prices are posted transparently on the walls of the clinic and online at reformedicine.com.

To learn more about the ReforMedicine approach, check out the podcast Dr. Usher Weighs In at Eau Claire Hometown Media, Spotify, or wherever you get your podcasts.