Health care

PETERBOROUGH — The cost of health insurance can be debilitating.

That’s certainly true in New Hampshire, where residents spent nearly $2,000 more annually than the national average on insurance in 2014, according to the latest data available from the Henry J. Kaiser Family Foundation.

Siobhan Benham of Peterborough, who spent years as a nurse practitioner in the clinical setting, recognized the need for primary care that is not only cost-effective, but brought back the meaningful patient-provider relationship.

“I was burned out,” she said. “It felt that when I went to work, I was no longer working for the patient in front of me, but I was working for the insurance companies. I just really felt the system was lacking.”

In her search for alternative care options, Benham came across the Direct Primary Care model. Around since the 1990s, the model has patients pay a monthly fee directly to their provider for services, taking insurance out of the equation.

In September of 2017, Benham took the plunge and opened her own Direct Primary Care practice, Hearthside Family Health, with locations in Peterborough and Bedford. The patient level has grown continuously since then, according to Benham, who said she’ll be adding a physician to her Peterborough office in December.

Benham is the full-time nurse practitioner in Peterborough, while Tracey Bottazzi, also a full-time nurse practitioner, is stationed in Bedford.

This is the fourth Direct Primary Care practice in New Hampshire, with one in Concord and two in Portsmouth, according to Benham.

“I have had families tell me they have saved $30,000 by stepping out of the insurance world,” she said. “I’ve also had people say they feel like they’re paying for a friend and that they look forward to visits when they used to feel fear.”

The monthly price is dependent on age: Children and young adults from birth to 26 are $25 (with a parent), adults ages 27 to 59 are $50, and adults 60 and over are $75.

The two offices offer annual physicals, acute disease management, chronic disease management, vaccinations and injury visits. Laboratory services are also offered at discounted prices, according to Hearthside’s website.

Benham noted that of the more than 200 patients she has, many still carry a cheaper form of insurance in case they need surgeries or care from the emergency room.

This patient load is the maximum she allots herself to see on a monthly basis, nearly nine times lower than in her last job.

“When I worked [in] hospitals, it was expected your patient panel was about 1,800,” she said.

With that many patients, she had only 10 minutes per visit. Now, she can give them a full hour, which she said results in fewer referrals to other providers down the road.

“We’re able to know all of their problems and have less referrals to specialists because there is a whole scope of care that primary care providers can do, but just don’t have time to,” she explained.

In addition to in-depth consultations, Benham said she is always available for a phone call if patients have a question.

She noted that a majority of her patients are self-employed and of middle income, and didn’t have insurance because of its cost.

“As people are becoming more frustrated with bureaucracy, more people are looking at this model,” she said.

And though she isn’t bringing home the same salary as when she worked in hospitals, she said she would never go back.

“I love my job,” she said. “Every day I come in, and there’s never a dread ... It feels much more rewarding.”

Hearthside Family Health’s Peterborough office, at 109 Grove St., Unit C, can be reached at 312-1600. For the Bedford office, at 116 South Rivier Road, Unit D-2, call 305-9964. More information can be found at

Olivia Belanger can be reached at 352-1234, extension 1439, or Follow her on Twitter @OBelangerKS.