Keep away from Fee for Service

Companies have tried the High Deductible thing. If the goal was to control costs, the evidence is clear they don’t accomplish that goal. They just make people spend their own money in an extremely opaque, hostile industry. And they penalize the sickest. So if high deductibles failed, what’s next? “Go online first to get care” plus a bundle of cost-saving services on top of that … Continue reading Keep away from Fee for Service

Go online first instead of doing what you used to do.

Think about that statement for a second. That’s the secret behind Google, Uber, Lyft, Seamless, Ticketmaster, Waze, Airbnb, Silvercar, Hotel Tonight, etc, etc, etc. If you go online first, new processes can emerge. Those new processes are designed to scale at a fraction of the cost of the past. Sure, the library could bring in a computer instead of microfiche, but it’s still a trip … Continue reading Go online first instead of doing what you used to do.

How to find the lowest cost to treat anything

A doctor gets sick and visits his doctor friend. The sick doctor is in a very weird situation where he is uninsured this month (long story) and has to spend cash on determining a diagnosis and getting treated. So, he and his doctor friend talk through the situation with two goals in mind: How can we confirm the diagnosis at the lowest cost? How can … Continue reading How to find the lowest cost to treat anything

Costs can change only if there are new different processes to solve the same problems.

Last week, I defined the characteristics of each new primary care model in America and, in the following post, determined the kind of person who would most benefit from each new model. This is important because primary care is literally just a process. And you’ve got to design and build the process that’s best able to solve specific problems. Since we all don’t have the … Continue reading Costs can change only if there are new different processes to solve the same problems.

A summary of today’s primary care models in America

This is Part I of two posts. Part II outlines how each model fits into the unique needs of different kinds of healthcare users. One of the very few redeeming qualities of healthcare in America is entrepreneurs are free to create healthcare services and people can purchase those services with their hard earned money. It spurs innovation and it offers Americans a choice. We are … Continue reading A summary of today’s primary care models in America

What would happen if we blew up the concept of the doctor office visit?

Doctors get paid exclusively for office visits. So, they keep happening, because money. But what would happen if the primary means of communicating with your doctor and care team was online and a message could be sent at any time of any day and you could expect a response within 12 minutes? Or, if needed, you could pick up the phone or jump on a … Continue reading What would happen if we blew up the concept of the doctor office visit?

Primary care was made for simpler times. It’s time to reconsider.

Traditionally, when things were simpler, people had a primary care doctor. He looked and acted a lot like Marcus Welby or Doc Hollywod. But something huge happened that changed everything. The general field of medicine became overly complex. Atul Gawande, in his commencement speech, Cowboys and Pit Crews, addresses this complexity problem: The core structure of medicine—how health care is organized and practiced—emerged in an … Continue reading Primary care was made for simpler times. It’s time to reconsider.

What does it mean to scale primary care?

Direct Primary Care doesn’t geographically scale to all employees everywhere in America. And 10 minute video visits are severely limited and can only treat ~30 simple low-cost conditions. Sherpaa combines the relationship-driven continuity of care seen in Direct Primary Care with the geographic reach of telehealth to deliver geographically scalable, broad-scoped primary care. I created Virtual Primary Care (Sherpaa) with a mission to scale primary … Continue reading What does it mean to scale primary care?

The most expensive thing in healthcare is the doctor’s pen.

However, most plan interventions are set in motion after the order has been made. There are services that try to redirect a patient to a lower cost imaging center, but after the doctor already faxed the order to the imaging center run by their golfing buddy. There are PBMs that fulfill a ridiculously expensive Rx from a doctor who’s 100% ignorant about how much that … Continue reading The most expensive thing in healthcare is the doctor’s pen.

Comparing costs and claims in a group of 1,000 people in traditional settings vs. Sherpaa

Let’s take a group of 1,000 and analyze how they use healthcare for a year. First, we’ll look at their traditional usage leveraging PCP office visits, specialist visits, urgent care centers, and ERs. Then, we’ll look at how they use healthcare with Sherpaa. Traditional Usage per 1,000 employees Sherpaa Usage per 1,000 Employees First, some background. Sherpaa encourages people to reach out to our doctors … Continue reading Comparing costs and claims in a group of 1,000 people in traditional settings vs. Sherpaa