MaineHealth's Direct Primary Care Arm Opened a Second Clinic Monday. The Insurer Whose Plan Covered Those Memberships in Full Leaves the State January 1.

Industry News by DPC Insider — Market Desk
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Sources: Trellis Health expands member-based primary care to Brunswick · Purchase Membership — Trellis Health · Frequently Asked Questions — Trellis Health · Insurance — Trellis Health · Mending Health Notifies Maine Bureau of Insurance that it Will Cease Offering Health Insurance Plans · Mending Health to stop offering Mainers coverage next year · Insurance Commissioner Places Mending Health Under Supervision · Maine Revised Statutes Title 22, §1771: Direct health care service agreements · Maine Health Insurance — Mending

Trellis Health cut a ribbon in Brunswick on Monday, September 28. It is the second location for MaineHealth’s membership primary care subsidiary, which now lists two Maine addresses: 1945 Congress Street in Portland and 4 Stephen Drive in Brunswick.

Ninety-two days from today, one of the three ways a Mainer gets through that door stops being sold.

What MaineHealth actually opened

Trellis sells a membership instead of billing visits, and it publishes the price. Individual membership is $119 per member per month, or $109 if you pay for the year. Families of two or more pay $109 per member per month. The published table then lists primary care, physical therapy, behavioral health, medication management, health coaching and annual labs at $0.

The Brunswick staffing is the part a DPC physician will read twice. One site carries a primary care provider, a physical therapist, a behavioral health clinician, a clinical pharmacist, a nurse and a health coach, with same-day and next-day appointments and 24/7 phone coverage. Office hours run Monday through Friday, 8:00 AM to 4:30 PM, with after-hours calls routed to the care team.

“Opening in Brunswick means more Mainers can have an ongoing relationship with a care team that knows them, understands their goals and is there to support their health over time,” said Matt Rector, Trellis chief business officer, in the news release Mainebiz reported on.

The news release also claims early results showing roughly 30% fewer emergency department visits, inpatient admissions and specialist referrals among members, plus less imaging. The Mainebiz account of that release carries no sample size, no comparison group and no measurement window. Until those numbers appear somewhere, the figure tells you what the system believes about its own program and nothing about what an independent practice should expect.

Trellis points members to Elation Passport, the patient-facing product from Elation Health. The front door here is vendor software rather than something MaineHealth built, which is a small detail with a real implication: the operational stack is not the moat.

Who has been paying the membership fee

Three channels, per the practice’s own FAQ. You buy the membership retail. Your employer sponsors it. Or you hold a Mending Health plan, and the plan covers it.

That third channel is the one with a date on it.

Mending Health, formerly Taro Health, notified the Maine Bureau of Insurance that it will no longer offer health insurance in the state as of January 1, 2027. The Bureau posted the notice on June 8, and put the carrier’s membership at roughly 1,100. Those members keep their plans through the end of the existing plan year. The notice then splits them by segment: individuals and families who bought on CoverME.gov or direct from Mending can pick another carrier during open enrollment, while small employer groups are told to work with a broker or agent as renewal dates arrive. Reporting at centralmaine.com carried the exit the same day.

Maine was not the only exit. On August 26 the Oklahoma Insurance Department disclosed that Commissioner Glen Mulready had placed Mending Health Insurance in Oklahoma under department supervision in case 26-0712-SOL. The company consented. “Given the company’s current financial situation, we determined this action was needed to protect policyholders and ensure their claims are paid,” Mulready said in the release, which also states that Mending will leave the Marketplace for plan year 2027.

So the carrier whose plan, by Trellis’s own account, left the membership “fully covered” is winding down two state books at once, one of them under a regulator’s supervision over its finances.

Maine wrote the law that lets someone else pay the fee

Two subsections describe how an arrangement like the Trellis and Mending one can work.

Maine’s direct care law sits at 22 MRSA §1771, in a chapter the Legislature amended last year and retitled from direct primary care service agreements to direct health care service agreements.

Subsection 3 says the agreement runs between the provider and the patient “regardless of whether the periodic fee or other fees are paid by the individual, the individual’s representative or a 3rd party.” That is the clause that makes employer sponsorship clean. It names a 3rd party payer and never says who that can be.

Subsection 7 goes further. It says the statute does not stop a direct care provider from entering “an agreement with an insurer offering a policy specifically designed to supplement a direct health care service agreement.”

Maine’s statute permits third-party payment and insurer-supplementing policies alike, and neither provision names a carrier. Subsection 5 still requires the agreement to disclose that the fee cannot be reimbursed or applied to a deductible under a health insurance policy, and subsection 1 still bars the provider from billing third parties fee-for-service for anything the membership already covers. Both were in force when the Revisor’s Office last extracted the page in January, and neither one depends on Mending.

One definition in that statute lands differently when the seller is a hospital system. Subsection 1 defines a direct health care provider as “an individual who is a licensed allopathic physician or osteopathic physician or other advanced health care practitioner who is authorized to engage in independent medical practice in this State,” and says the term includes an individual provider or a group of providers. It does not mention corporations or hospital subsidiaries in either direction. Subsection 2 removes these agreements from Bureau of Insurance regulation, so no insurance filing settles the question.

The site says two different things about keeping your doctor

Trellis publishes two answers to whether a member gives up an existing primary care physician.

The FAQ says the practice takes over. “When you join Trellis, we take on the role of your primary care team,” it reads, and warns that the records request Trellis sends is something “many practices take as a sign that you’ve moved your primary care elsewhere.”

The page written for Mending subscribers says the opposite. “Trellis is an addition, not a replacement. You don’t have to leave your PCP to try us out.”

Both pages were live on October 1. If you are deciding what $119 a month buys, those describe two different products, and only one of them is a panel.

What To Watch

Open enrollment on CoverME.gov begins November 1. That is when Mending’s Maine members pick something else, and when the Trellis channel that cost them nothing goes away in practice rather than on paper.

Mending’s own Maine plan page still advertises $0 primary care and $0 mental health visits across its bronze, silver and gold tiers. When the Bureau announced Mending’s exit in June, it had proposed 2027 rate changes in hand from four carriers: Anthem Health, Community Health Options, Harvard Pilgrim Health Care and UnitedHealthcare. Whether any of them files a product that covers a direct care membership is the signal that matters, because subsection 3 still lets a 3rd party pay the fee.

The second signal is smaller and arrives sooner. Watch whether the Mending page on trellishealth.org comes down before January 1, and what replaces the sentence about leaving your PCP when it does.