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A 3-year-old medical practice that charges patients a monthly fee instead of copays or insurance deductible payments is expanding rapidly in both the Colorado Springs and Denver areas and is launching a new mobile medical service that allows its doctors to make house calls for homebound patients.

PeakMed has grown from a single location in 2014 near St. Francis Medical Center to three clinics in Colorado Springs and Englewood, and plans to open two more in the Springs and Littleton late this year and up to six more in the Denver area next year, said Dr. Mark Tomasulo, founder and chief medical officer of the practice.

Practices like PeakMed that charge membership fees, a model called direct medicine, are a fast-growing part of the health care industry, making up about 3 percent of the nation's family practice and internal medicine practices, Tomasulo said. Most don't accept insurance and recommend that patients pay for a high-deductible health plan to pay for hospitalization, emergency room visits and surgeries.

PeakMed charges monthly fees of $79 for adults under 65 years old and $125-283 for families, depending on the number of adults and children. The fees cover office visits, house calls, urgent care that doesn't require an emergency room visits, physical exams, minor medical procedures and other routine health care.

Patients pay extra for medication and lab tests the practice provides, but at fraction of the cost of retail pharmacies and stand-alone labs, Tomasulo said.

"From the beginning, this has always been about how to fix the (health care) industry and not about creating a viable company," Tomasulo said. "It is an exciting time to be in the health care space. There is a lot of room for innovation and to practice family medicine in a way that is conducive to having a relationship with the patient in a cost-effective, transparent model that provides better care at a lower cost. People crave health care, but they can't afford it so they don't see their doctor as often as they would like or need to."

PeakMed also plans to begin offering counseling, psychology, psychiatry, substance abuse treatment and other behavioral health services in November through an affiliated organization that he declined to identify.

PeakMed opened in mid-2014 with two doctors, a nurse practitioner and a medical assistant in a clinic near Powers Boulevard and Woodmen Road and opened locations in downtown Colorado Springs in early 2016 and in the Denver Tech Center in February. Additional locations are scheduled to open in November near the Polaris Pointe mall and in Littleton. By the end of next year, Tomasulo said PeakMed plans to have 10 locations, more than a dozen doctors and six additional physician assistants or nurse practitioners as well as doubling the size of its original clinic.

Besides new locations, PeakMed also is adding new services, including a recreational vehicle that provides medical services to several locations of a division of Discover Goodwill and two small cars that its doctors will use to make house calls for elderly or disabled patients who can't go to one of the practice's clinics, Tomasulo said.

The latest expansion into house calls started with PeakMed doctors going to patients' homes who couldn't make it to one of the practice's clinics, but is expanding with two miniCooper cars that doctors will use to make those visits.

Tomasulo said doctors will determine whether the patient's condition warrants a house call or whether a PeakMed staff member will use the vehicle to drive the patient to one of the practice's clinics for treatment. If the service takes off, it could become a separate operation.

"Our intent is not to go out to treat a sore throat because you don't feel like coming to the clinic. But we anticipate this growing and potentially creating a whole new line of business," Tomasulo said. "I started this because I was tired of the status quo and felt we could do health care in a better way that puts the doctor and patient back together like they were 30 years ago."

PeakMed also has group plans that provide care for about 100 employers in the Springs and Denver areas, and has a network of affiliated membership-based clinics in California and Texas, with plans to expand to South Carolina, for employees of large companies that have locations in Colorado and other states.


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