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Q&A Part 3: A New Customer Centric Delivery Model

Despite the progress made in recent years, the healthcare sector still faces many challenges that need to be addressed if we are to improve the quality of care and outcomes for all. In this important three-part series, Tom Spencer, Co-Founder and CEO of HealtheMed shares his vision of the future of healthcare, based on 30 years of physician management, managed care contracting and health care technology innovation.




1. How can new health delivery models solve the greatest healthcare challenges?

Minnesota approved Clinic@Home because they could see that tens of thousands of Medicaid special needs participants were not receiving an annual wellness visit, also known as an annual checkup. Many of them wait till they get very sick and use emergency rooms at county and community hospitals as their primary care clinic. That’s not just wasteful, it will actually break the system. The state pays for Clinic@Home because it facilitates a regular doctor-patient relationship which is central to patient well-being and patient education.

2. How does the Clinic@Home model promote the doctor-patient relationship?

The Clinic@Home system facilitates a doctor’s house call and ensures the doctor is paid for making that visit four times a year to help their patients – we call them our clients -manage their health. Our clients get consistent access to primary care from their doctor and the education that comes with the visits to help them better manage their care. The education is a critical component that we’ve brought back to the relationship. For example, if people know why they’re taking a drug based on a conversation with their doctor, they are more likely to take it consistently and as prescribed. In fact, we’ve seen a 30% increase over baseline in medication adherence because of the way we engage with our clients.

3. How do you ensure clients use the system of care?

Every day we engage with our clients. The hub of our clients technology in the home is a connected, smart TV that they use 99% of the time for watching television. We use this platform to remind them when to take their meds and when there is an appointment with a doctor or advanced practitioner on the schedule. We’ve found that these reminders result in a 20% reduction in missed doctor appointments.

Furthermore, we put a nurse in the home to help with every doctor visit. The nurse knows the client, the client health history, and the social determinants which impact the effectiveness of the treatment and care that is prescribed for that client. Our nurse consultants act as advisor and educator, not only for the client, but also members of the client care team.

We can see that our clients are using it and they love it, which is why we have a 96% renewal rate.

4. Do you leverage client data to improve outcomes?

With our system, we know a lot more about our clients than anybody else does at this point. Care managers characteristically do not have regular insight into the home. We know, in real time, their vitals, medication adherence and utilization for example. And we regularly collect a full set of social determinants of health data that would affect what’s prescribed in terms of therapy and treatment.

Because we make this data readily available, the entire care team can be better informed and can do a better job in working with clients. That is a big deal because it’s really the first time that the health system has had real-time, actionable data about this population.

5. Why would an organization partner with HealtheMed?

Organizations that share our vision of better, more cost-effective healthcare delivery are ideal partners. Payers will value member education because they can see the increase in response, better outcomes and lower costs, as well as the data that they have never before been able to collect on this population. As one health plan put it, “When HealtheMed is in the home, it’s care coordination and case management on steroids,” because we have the relationship with the client, and that makes all the difference in terms of how effective all the plans and treatments that are ordered are ultimately going to be.

Other organizations that see the client relationship we’ve developed and how we are promoting behavioral change with an underserved population will want to be involved. We really want to work with forward thinking companies that want to change the way healthcare is delivered forever.


Did you miss Part 1 of our Q&A series?  Click here.

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