The Hidalgo Special Commissioner's Court convened on July 29, 2025, to discuss various aspects of healthcare delivery in the region, focusing on the innovative model employed by Frontier, a direct primary care provider. The meeting highlighted the experiences of Dr. Maria Madrid, a physician with over 20 years of practice, who shared insights into the challenges of traditional healthcare models and the benefits of direct care.

Dr. Madrid explained that in a typical fee-for-service model, a physician might manage around 3,500 patients, often requiring them to see 25 patients daily to break even. This high volume can lead to rushed appointments and diminished patient care. In contrast, Frontier caps its physicians' patient panels at 800, allowing for more personalized care with longer appointment times, which Dr. Madrid emphasized as a significant improvement in patient experience.

Bev, the CEO of Frontier, reinforced the importance of meeting key performance indicators (KPIs) in their contracts, which include maintaining low wait times and ensuring quality care. She noted that if these standards are not met, the county has the option to exit the contract.

The discussion also touched on the staffing model at Frontier, which includes both medical doctors and physician assistants (PAs). Each clinic has a lead MD supported by PAs and nurse practitioners, addressing the shortage of primary care physicians. This collaborative approach ensures that patients can access a doctor when necessary, enhancing continuity of care.

A significant point raised was the financial implications of the direct care model. Frontier's approach allows employees to access care at no out-of-pocket cost, as the county pays for their membership. This model not only improves access to healthcare but also leads to substantial savings for the county. For instance, a negotiated cash price for a brain surgery resulted in a savings of $150,000 compared to traditional billing.

The meeting concluded with a focus on the efficiency of referrals and the importance of timely access to specialists. Frontier's team actively monitors referral times and works to ensure that patients receive necessary care without unnecessary delays.

Overall, the discussions underscored the potential of direct primary care to transform healthcare delivery in Hidalgo County, emphasizing improved patient experiences, cost savings, and enhanced access to medical services. The commission plans to continue evaluating the effectiveness of this model as it expands across the region.