At Strada Health Care patients pay a monthly membership fee to their doctor, usually under $100 a person, rather than paying copays. Patients then receive all their primary care needs without having to file insurance claims, meet deductibles or pay copays. Patients also typically get longer appointments and increased access to their healthcare providers with unlimited visits and contact by phone, text, or email. Dr. Joel Bessmer started Strada soon after the Nebraska Legislature unanimously adopted a law in 2016 opening the door for direct primary care practices. Currently three providers — a doctor and two physician assistants — practice at Strada’s main office south of 90th Street and West Dodge Road and in an office in Council Bluffs. Strada also has five other locations, where clinicians enroll and see Strada members alongside their traditional insurance-using patients in a hybrid practice. Two new locations — one in South Omaha, another in Kearney — signed on to offer that arrangement Friday, adding to existing affiliates in west Omaha, Bellevue and Papillion. The American Academy of Family Physicians supports the direct primary care model and even provides a toolkit on its website to help doctors convert their practices. The Nebraska Medical Association views it as another alternative for health care delivery, said Dale Mahlman, the group’s executive vice president. Nationally, the number of direct primary care practices has grown from a few in the early 2000s to more than 700 today, according to the Direct Primary Care Coalition. Twenty-three states, including Nebraska, have direct primary care laws on their books. The Nebraska law sets basic standards for the agreements and makes clear they are not insurance plans and therefore aren’t subject to state insurance regulations.