A Castine nonprofit tasked with providing health care to area residents is trying to establish a direct primary care center after Northern Light Health unexpectedly announced it would move its practice out of town.
The Castine Community Hospital Corporation, which owns the health center building and had leased it to Northern Light for years, last year started a study to see if it could establish a free, independent direct primary care practice. That exploration was in response to the system facing financial problems, location closures, insurance disputes and other operating challenges.
“We don’t want to be caught flat-footed if something bad happens, God forbid,” board chair Bobby Vagt said in October.
Last week, Northern Light announced it would move operations to Blue Hill, half an hour away, by the end of next month. The Castine practice will be combined with the Northern Light Primary Care practice at Sussman Health Center on the campus of its Blue Hill hospital, health system officials said.
In response, the Castine board has decided to speed up the process of opening a direct primary care center, according to Vagt.
Independent direct primary care providers typically see patients for a flat monthly fee and don’t take most insurance. The model has been growing rapidly in Maine recently, often run by former Northern Light employees who say the direct approach lets them spend more time with patients and give them more personalized care.
At the same time, eastern and northern Maine is facing a shortage of primary care providers that’s expected to get worse in the coming years.
The Castine group may not be able to have a center up and running by Feb. 27, but now aims to announce the operating structure, timeline and staffing before the end of February. For now, the board is working to determine what the organization would look like structurally and legally.
Northern Light said last week that its current Castine clinic faces similar challenges to other small health centers in Maine, including staffing challenges, smaller patient panels, high operating costs and “inconsistent access.”
“We carefully considered all of our options before making this decision but ultimately found that combining the practices is necessary to best support long term access to high quality, coordinated primary care for all of our patients,” John Ronan, FACHE, president of Northern Light Blue Hill and Maine Coast Hospitals, said when the move was announced.
The Castine group wasn’t necessarily shocked after the system’s closures and announcements in recent years, Vagt said, but the timing was a surprise.
The clinic serves an older population, with almost half of its roughly 1,150 patients on Medicare. Patients who have called since the Northern Light announcement say they’ve been surprised by the sudden change and concerned about how they’ll get to Blue Hill.
The initial feasibility study was also exploring the possibility of creating a community health plan, which is a form of group-based insurance typically anchored to an employer, in partnership with Maine Maritime Academy. That remains an option, but isn’t a focus area for the board now, Vagt said.
