C3LX: Dr. Bessmer, we really appreciate your time speaking with us today and sharing your insights. To open up, we wanted to understand your thoughts on how the COVID-19 crisis is impacting primary care in general, and specifically, Direct Primary Care.
Dr. Bessmer: It’s having a tremendous impact on the economy overall, and one of the industries it’s having a large impact on is primary care. If you look at visits in primary care, and you eliminate virtual and texting and all of that, I would guess that visits are down 50%, and that’s a large revenue hit in a very short period of time. I would say that the majority of visits that have gone down are annual well visits, like how healthy am I and what can I do to be healthier, as well as even sick visits, because patients are not as likely to come in for a visit today. I think it’s had an enormous economic hit on primary care.
C3LX: And, in the Direct Primary Care space, what has been the impact to Strada, both financially and how have you changed practice?
Dr. Bessmer: I can speak for Strada in general, and I’m sure that it’s probably true for most of Direct Primary Care. We are perfectly positioned for this. The beauty of membership medicine and Direct Primary Care is you are paying a monthly fee, or an annual fee and you get 24/7 access to your provider already. So, we’re already all geared up for this! There was nobody better positioned to deal with this in the primary care world than Direct Primary Care, because this is already what we do day in and day out. It doesn’t have near as much of a hit on our revenue, and I’m sure in some Direct Primary Care companies, there have been hits in the revenue cycles, but for Strada Healthcare, that’s not the case. We have not lost much volume at all, and instead are actually picking up volume because of our ability to deal with this in a number of different directions.
C3LX: Wow, that’s great to hear!
Dr. Bessmer: Yeah, and I’d say even on top of that I think one of the things that we’ve been able to do, at least with Strada healthcare is go to businesses with different proposals because of our ability to do telemedicine and easy visits with patients, and understanding of how to triage and do all of those things. As an example, we’ve taken a company of 1,400 employees and we became a 24/7 call service for all COVID-related issues. The business just pays us a per-employee-per-month fee, and then we deal with all the COVID questions from the employees. It’s really had a tremendous impact for that employer; they think it’s the best money they’ve ever spent! The beauty of that also is that now all of a sudden, all those employees are exposed to how Direct Primary Care can help healthcare in a microcosm.
C3LX: What an innovative adaptation! We think that’s fantastic. Along those same lines, we read everywhere about the rapidly growing proliferation of telemedicine because that’s our reality right now as it went from a convenience to an absolute must-have. However, much of telemedicine is still very transactional, or it’s a patient connecting to an unknown physician that likely won’t know their medical history and chronic conditions. How would you say Strada is utilizing telehealth/digital health differently and in a more robust way?
Dr. Bessmer: Telehealth is a part of our daily interactions with patients. It’s not just something that we’re doing because of COVID, we’re doing it because we feel it’s the best way to manage patients, period. COVID just brings that out. And what do I mean by that? Well, today healthcare is run by in-person medicine. A doctor cannot bill a patient unless both of them are in the same room together! And, that just is not the way we should be functioning. It’s not good for the insurance companies, it’s not good for healthcare, it’s not good for the doctors, and it’s not good for the patients. We have great data and great whitepapers on what we can do if we come into a company and we introduce Direct Primary Care, and how we can take the cost of care down, how we can improve almost every healthcare metric we follow, and yet increase patient satisfaction and employer satisfaction.
From that standpoint, telehealth becomes a critical part of how we deliver care. It’s what allows us to care for these patients outside of just the traditional office setting. We actually have far more touches with our patients than traditional medicine would. That allows us to reach out proactively, it allows patients to reach out earlier and sooner, and that’s what allows us to save that money of less urgent care visits, less ER visits, less hospitalizations, etc.
C3LX: You make a great point there related to those touchpoints and early-on being more proactive. Describe for us a little bit about how you are in the position to not only deal with the acute, COVID patients, but also monitor and support your patients remotely, in this case, virtually?
Dr. Bessmer: Yeah, that’s a great question. In all honesty, I don’t think COVID has changed it that much. Maybe a little bit, from the standpoint of we wouldn’t have as many in-person visits, but one of the things that Direct Primary Care does is our providers directly reach out to the patients proactively. It’s absolutely one of the things that we try to push our providers to do. I am constantly encouraging our providers to use Spruce innovations (our communication platform) just to say, “how are you doing? Is there anything I can help with?” and once again, you think about some of those chronic disease patients, that’s exactly what they need! Patients are so geared in our old healthcare system, that they’ll say “well I’m not really sick enough that I want to reach out to my doctor yet,” but as we start to open those lines of communication for them, it makes it easier for them to reach back to us, not just because I reached out but because that line of communication is open.
C3LX: That makes a lot of sense! Pivoting a little bit, we did want to talk to you about the 2015 Harvard Business Review article that demonstrated the importance of strong patient-provider relationships in improving health outcomes. What are some of the examples of the power of these relationships that you personally see with your Strada patients?
Dr. Bessmer: One of the beauties of this in the Direct Primary Care realm is the model allows patients to communicate earlier on in the process. And, as we know in almost any disease process, we want to make the best difference for their health. In other practices, so often patients feel guilty for taking the time, they don’t think they’re sick enough to come in and take the doctor’s time, or you and I both know, the biggest barrier is the cost. If you take away that cost barrier, patients are much more likely to reach out earlier. Patients are much more likely to develop that robust relationship with their primary care provider. And there is great data out there to say that is the most critical thing you can do for your health is develop a robust relationship with your primary care doctor. And what they’re talking about in that article is just that. I know this isn’t the only way to fix healthcare, but I guarantee it’s helping!
C3LX: Dr. Bessmer, this has been very insightful! Final question: how do you think healthcare is going to change because of COVID-19? Do you feel like it will push people more into the Direct Primary Care space for all the reasons you mentioned?
Dr. Bessmer: Well I think if you are a privately-owned family practice group, you’re probably struggling financially. I think they’ll need to reflect on, what do we need to protect ourselves, and I will tell you Direct Primary Care is a great answer for that. I’m a firm believer that if Direct Primary Care is going to be successful, we’ve got to help primary care physicians convert. The way to do this is start with employers and have them convert slowly and allow them to take Medicare and Medicaid and Direct Primary Care in their same practice…more of a hybrid model. I’m hopeful that medical students now will be inspired and reflecting on how they can improve and make a change to our healthcare system today. I’m hoping they see that we have to have a more engaged primary care work force and that primary care is our true value in healthcare.