By Michael Tetreault, Editor in Chief
At The Direct Primary Care Journal, we believe that by studying the country’s top entrepreneurs, other physician business owners can gain insight into what makes a private-pay medical practice so successful. Not everyone we’ve interviewed is a physician — nor should they be. Insight comes from all sources and people but we believe there is something we can learn from everyone out there. Some of the entrepreneurs who are included on the list were able to turn a failing company around, while others grew a new startup from a mere idea.
By coming up with innovative ideas and successfully navigating the murky waters of Direct Primary Care business ownership, the CEOs we are going to feature over the next few months top our Editor’s List of the “best of the best.” They are listed in no specific order and please note, whether they’re weathering controversy or acquiring new patients, these CEOs are changing the way we live, work, and operate. They take big risks, successfully predict future trends, and drive their companies to the top of their class.
Meet Blaine Lindsey, JD, CEO of Get Healthy
As CEO of GetHealthy, Inc. Blaine is responsible for driving the company’s growth and establishing a culture of innovation in a rapidly-expanding healthcare company. A seasoned healthcare executive and attorney, Mr. Lindsey previously served as President of Capra Health, a healthcare reimbursement, regulatory and commercialization consulting firm.
DPC Journal Editor: What advice would you give the physician considering a career change and moving into DPC? Why/why not? What makes a great DPC doctor in your mind?
Blaine: GetHealthy creates value for Direct Primary Care practices through employer recruiting and partnering services and patient engagement software. Right now, it takes a special kind of physician. A beacon. An entrepreneur. A trailblazer. This is just an enormous idea. The idea that you can reach in and rip primary care from the jaws of the existing healthcare system and essentially make primary care a consumer good is wild. But it is being done. Going forward, I think that all a DPC physician will need to be is a practical business person. DPC provides less headaches, higher reimbursement and, most importantly, better outcomes.
DPC Journal Editor: What does the future of DPC pricing look like from your vantage point?
Blaine: Right now, I think the agreed upon pricing for DPC is below $100 per member per month with most coming in around $59-89. What I predict is that we are going to see two major DPC pricing models emerge. The first is going to be a lower-tier pricing that will be directed toward individual consumers and tailored to the economic realities of the community that the DPC practice is involved in.
The second, and what we are seeing more and more of, is what GetHealthy‘s customers have zeroed in on — targeting employers to partner with for DPC services.
When you look at the numbers, if a DPC contract can save an employer 20-30% in a year, that could equal a few hundred thousand dollars per year for a mid-sized employer. This leaves a lot of room for aggressive pricing because self-insured employers are often desperate just to bend the cost curve. When a DPC practice delivers the kind of savings that they are capable of there will be champagne and crying and hugs in the company HR department.
The trick will then be not raising the price so high as to lose credibility for the DPC model as a whole.
DPC Journal Editor: What does the future of DPC and employer/small/mid-sized business relationships look like from the GetHealthy perspective?
Blaine: Currently, GetHealthy is getting incredible results for our customers with small employers. Small employers have nearly been priced out of the insurance market. The first client we ever recruited for our first customer practice was a 40-person technology company. Their insurance bill was going to be $330,000 for the employees and their families. In order to not go bankrupt they had dropped all health coverage. They had employees quit and were getting killed by competitors recruiting talent. We found them, pitched DPC, and now they are providing the best healthcare their employees have ever had for 10% of the price.
For mid-sized employers that are fully-insured, I am dissatisfied with the wrap-around plans that exist and ethically have a hard time advising our customers to attack this market at the moment. While there are some solid examples of exchange-based products in a few states, our customers in “red” states with no state exchange are finding stiff resistance from existing insurers. I am worried about the gap between the DPC product and the deductible. I hope this improves in 2015 and beyond.
Last, we [GetHealthy] love DPC with large self-funded employers — but the sales cycle can be long and the existing relationships can be very strong. A long term strategy and DPC bench strength will be the keys to securing these accounts.
As an industry, we are all just waiting for that first big public announcement by a huge company to come out proving DPCs cost savings, then it will be bedlam.
DPC Journal Editor: We can’t ignore hospitals. They are part of every local communities healthcare ecosystem, both big box hospitals and smaller community hospitals. How can hospitals and DPC work together?
Blaine: Not only can they work together, but the progressive hospitals are already sniffing around. On the DPC provider-side GetHealthy‘s fastest-growing customers are multi-specialty groups who are starting DPC primary care centers. Many of these groups are already building hospitals or have plans to. It is a great way to establish yourself in a crowded market.
However, we have also heard from old-line hospitals. Recently, a hospital saw us in an interview somewhere and the Chancellor of one of the largest university medical systems in the Southeast called to say, “We have been trying to do DPC for two years, where have you been?”
The simple fact is that DPC works and as word gets out DPC and membership medicine will become part of the fabric of the healthcare system, no matter how disruptive it seems at the moment.
DPC Journal Editor: DPC doctors are typically staffed with 2-4 employees. We hear from DPC clinics each week that they’re hesitant and reluctant to adopt new technology and introduce it to their patients, for a variety of reasons you already know. However, it is abundantly clear that over the past decade since the rise of Concierge Medicine and MDVIP’s positive outcomes (and now as of late, DPC practice, Qliance published patient outcome data) that the efficacy and value of these membership medicine practices is what is proving to skeptics how well these practices care for and treat patients. How can we get more DPC clinics to use advanced technology and track patient outcomes?
Blaine: Here is what I see in technology in primary care at the moment. There are tons and tons of new companies and tools out there that make getting treatment easier for the patient. Random telemedicine doctors, drugstore and big box clinics, random info portals in EHRs, even simple good old Google searches.
But, what is missing from all of that technology is the core of all human health: the physician-patient relationship. We have an amazing customer who says that sometimes his most important job is being Persuader-in-Chief because he works so hard to convince his patients to change harmful behaviors. That is what our technology firm [GetHealthy] was founded to do: become a technology tool that helps physicians increase the health of their patient panel without hassle, pain, or wasted time by supporting and enhancing the physician-patient relationship.
DPC Journal Editor: Share a thought about why you believe your business have been so successful in this sector of healthcare. Tell us what you hope the future of medicine, technology and the doctor-patient relationship will be in the next decade or two.
Blaine: GetHealthy is primarily a technology company that provides the quintessential “non-covered” service — a wellness and treatment plan that DPC providers use to engage their patients. As we continue to rapidly expand in Membership Medicine and DPC, the outcomes that our software produces, tracks and reports has become essential to landing and maintaining employer relationships.
Now that we have data and experience, we have had great success recruiting those employers for our customer practices. We use technology to bridge the gap between a physician who cares about outcomes and an employer who cares about money.
What I love about DPC and Membership Medicine (which includes: Concierge Medicine) and why we are betting on it becoming a major part of the future landscape of medicine is that the model addresses the major problems of today. In the model:
- Primary Care and Family Physicians can be compensated at a level that recognizes the value that they provide;
- The patient receives the best healthcare they have ever had in their lives; and
- Technology is used in a way that enhances the physician-patient relationship instead of in a way that detracts from it.
DPC Journal Editor: Thank you, Blaine.
Blaine: Thanks for the opportunity to participate. I had a great time.
GetHealthy is an evidence-based health and wellness platform that develops customized solutions and services for:
- Direct Primary Care
- Concierge Medicine
- Accountable Care Organizations
- Insurance Providers
GetHealthy drives engagement by delivering meaningful, peer-reviewed optimal health services through comprehensive, creative, and personalized interventions.
In the news … Health and wellness platform developer GetHealthy is up to 8 full and part time employees and is bringing on two more FTEs in January. Furthermore, GetHealthy announces a major new partnership with ALLnHEALTH to provide software and employer partnership services to help build the premier Direct Primary Care practice in the Southeast. ~The New Orleans BioInnovation Center, December 19, 2014.
To Learn More About GetHealthy, Inc., visit: http://www.gethealthy.com