Health and Safety

One Medical’s New Care Model

September 25, 2016 
By John Quinn

New York, NY – A new chain of health-care offices contends that it can get patients appointments within 24 hours, have them seeing a doctor within a minute after they show up, and save union health plans that use it 6% to 9% a year.

The group, One Medical, was founded in 2007 in San Francisco by Dr. Tom X. Lee. Dr. Lee, who has both M.D. and MBA degrees, was “frustrated by how inefficient the primary-care experience was,” says vice president for sales Phil Barbaro, speaking in its Columbus Circle office, overlooking Central Park. One Medical now has more than 50 offices in seven metropolitan areas, including nine in Manhattan and Brooklyn. It plans to expand to 11 in the city by early next year.

The One Medical model is intended to “complement” patients’ regular health-insurance networks, not substitute for it, says Barbaro. Individual memberships cost $90 to $120 a year. Unions can add it as an option to their health plan’s network, and their members aren’t required to switch to it.

One Medical is able to provide faster, cheaper, and more personal care, Barbaro says, because it uses technology to reduce overhead. People can make appointments online or with their smartphones, and all patient records, insurance information, and schedules for which staffers are available are digitized. Instead of receptionists having to take calls from patients, he adds, other staff answer in a back office, and they also follow through to make sure the necessary insurance authorizations have been made. All this technology makes management much more efficient, he explains, saying it “removes 60% of the overhead that exists in a typical primary care setting.”

This also means that doctors see no more than 16 patients a day rather than the typical 25 to 30, says Columbus Circle office manager Dan Shea, so they can “get to know them as a person and not just an ailment.” The office also has an in-house lab so it doesn’t have to send blood work and other tests out, he adds.

One way One Medical saves money is by “virtual care”: Members can contact doctors by phone, email, or video chat at any time, without having to make a copayment or filing a claim with their insurance company. They use this about 40% of the time, says Barbaro, and many ailments can be diagnosed and resolved without an office visit. If a patient has chest pains, he says, that needs to be checked out, but going to the emergency room for a benign fatty deposit wastes everyone’s time and money.

Having easier and better access to primary care, One Medical says, means people get more preventive care and are less likely to go to emergency rooms. It says its customers see an average of 8% reduction in health-care costs, with 32% fewer ER visits, 26% fewer MRIs, and 19% fewer specialty-care visits.

“What we want the health funds to think about is that if someone goes to the emergency room unnecessarily, that’s $2,000,” he says. “If they come here, it’s $150.”

 

September 24, 2016

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