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By Mike Terry, Deseret News

Editor's note: This is the fifth in a five-part series.

Where many Americans see nothing but a mass of confusion when it comes to health-care reform, at least one local doctor has decided to revamp how primary care is provided.

His approach to basic medical care is one of several innovations being tried by Utahns looking to reduce costs while providing alternatives to the traditional way of doing things.

Dr. Rachot Vacharothone is so confident that his plan will succeed, he's invited President Barack Obama not only to take note, but to visit one of his six new Wasatch Front clinics to see how it's done.

As president and CEO of After Hours Medical, Vacharothone sees the future of private medical care being made over as employers shift an increasing burden for their workers' costs back at them. So he's offering a choice that he believes makes sense for a growing number of Utahns.

For $49 per month and $5 per visit, those who enroll in his urgent care membership program will receive evaluation and treatment of acute, minor illnesses like fever, cough, sore throat, ear infection, bronchitis, pneumonia, chest and abdominal pain, kidney, bladder and skin infections.

Evaluation of acute injuries like lacerations, sprains, fractures and back pain are included, as are rapid strep testing, X-ray, splinting, casting and some IV treatment. Well-baby and well-child care, annual health screenings, and treatment of simple chronic conditions like hypertension, diabetes, asthma, allergy and depression also are treated.

Because those conditions are relatively simple and inexpensive to deal with, Vacharothone said he can lower the cost of care for those who don't have insurance and can't afford $150 to see their doctor for an ear infection. By lowering the cost, he figures his patients will stay healthier, because they won't put off needed care until it becomes critical — and very expensive.

He formulated the idea while working for local urgent care facilities where patients were often irritated after waiting hours to see a doctor for simple medical care. And last year, he began noticing that many patients who came in were seriously ill because they let simple ailments get out of control.

Determined to cut the waiting time and the cost, he set up his own urgent care facility and experimented earlier this year with charging a $60 flat fee for service. "When I did that, many of the patients who had lost their insurance were happy," he said.

After a couple of months, he began working on a plan to provide urgent care services long term because he's come to believe if you keep it affordable, and focus on patient and staff needs, "the money just flows."

The company began advertising in September, and as of Oct. 1, After Hours had enrolled nearly 400 members. For information, see www.afterhoursmedical.com.

Vacharothone said those who will be drawn to the clinics include the uninsured, those with high insurance deductibles, those who are uninsurable because of pre-existing conditions, and employers looking to help offer basic care that isn't wrapped into an insurance plan.

While 65 percent of Utahns in a recent Deseret News poll rated the overall quality of health care in Utah as either "best quality" (22 percent) or something above a "neutral" rating (43 percent), it's clear that cost is a concern for thousands in the Beehive State.

e-mail: carrie@desnews.com