Yesterday, I wrote about how Uber is uber because they gave riders one simple place to remove all the traditional hassles of summoning a taxi. From there, they were able to optimize every single one of their internal processes via reams of data, driving down their costs and maximizing their revenue.
Healthcare for your employees must do the same. You can’t affect costs without solving the same health problems with a fundamentally different process. Sherpaa changes the care process from “fee-for-service doctor visit first” to “What would happen if the primary means of communicating with your own personal doctor and care team was online at any time of any day and you could expect a response within 12 minutes?” Ultimately, what would happen if doctor visits were used only as a tool of last resort? Over the last 7 years, we’ve found an online relationship with your doctor can diagnose and treat ~1,500 conditions, which is 95% of what a traditional office PCP can do. And because of that, 80% of everyday health conditions never need in-person fee-for-service traditional care. And the cherry on top is our business model where, instead of fee-for-service, we charge a flat $100 per Episode of Care.
Just as uber gave people one simple online place to go, Sherpaa gives all employees, everywhere, one simple online place to go to get care.
From there, that unlocks a whole suite of tools Sherpaa doctors use to direct care most appropriately and cost-effectively. So, how do you get started?
Stage One: Build the funnel
Time Frame: Year One
Sample Company: 1,000 Employees
- Decrease pre-paying for traditional inefficient processes via slightly lower premiums/slightly higher deductibles (for example, increase the deductible on each plan offered by $200-300 and reduce the premium by $200-$300).
- Use those savings to offer plan members virtual primary care at no cost to them
- Work with Sherpaa to promote Sherpaa to them as the simple online place to begin care
- Sit back and watch as 80% of everyday health issues are handled exclusively online by Sherpaa doctors and their care team.
What to expect
Over the course of the first 12 months, usage will gradually increase to 50-60% of plan members using Sherpaa as their primary access point.
80% of Episodes of Care will be solved by Sherpaa PCPs and virtual specialists without in-person fee-for-service visits/claims. 20% of Episodes of Care will involve strategic care coordination with local specialists and facilities.
Usage/cost ramps up until it meets a steady state: (~55% usage and each user creates, on average, 2.7 Episodes of Care per year = ~130 Episodes of Care per month = ~$13,000 per month by year’s end (the number of Episodes of Care/cost are small in the first few months and gradually ramp up until steady state in December))
Stage Two: The funnel is built, now maximize Sherpaa’s capabilities
Time Frame: Year Two
Once people use Sherpaa as the primary access point to get care, Sherpaa doctors need more tools to influence care patterns and costs. Throughout Year One, work with Sherpaa to understand services that best work with Sherpaa. Think of it this way. If you have an email thread going with your doctor, who could your Sherpaa doctor invite into that thread to augment your Sherpaa doctor’s care? For example, we already have a relationship with a Virtual Specialist group and our doctors can loop in a dermatologist to get their opinion and treatment recommendations. This avoids ~70% of in-person specialist visits. What are the other services?
- Imaging contracts at fixed costs per study
- Lab contracts at fixed costs per lab
- Online lab testing like Everlywell for common, non time-sensitive labs
- Medication cost information so Sherpaa doctors can see how much their prescriptions will cost and employees can, within Sherpaa’s app, send their prescription to the lowest cost pharmacy.
- Surgical bundled-pricing services like Sano Surgery.
- Best in class Cancer Care coordinators who work with Cancer Centers of Excellence like Edison Health.
- Based on the geographic location of employees, a tighter, lower cost, higher quality, better patient experience specialist and facility network Sherpaa doctors coordinate care with during the 20% of Episodes of Care that need local, in-person care.
- Second opinion services like Grand Rounds
- A forward-thinking TPA like Apostrophe
What to expect
Over year two, Sherpaa usage will reach a steady state and increase to just above 60% (based on our 7 years of data, for a group of 1,000 with 60% usage, this will equate to ~135 Episodes of Care per month with a total cost of ~$13,500 per month).
- 80% of Episodes of Care will continue to be solved by Sherpaa PCPs and virtual specialists without in-person fee-for-service visits/claims.
- Specialist visits decrease
- Urgent care visits decrease
- ER visits decrease
- Imaging costs decrease
- Lab costs decrease
- Medication costs decrease as more and more medications are prescribed by Sherpaa doctors.
As more and more plan members use Sherpaa and trust their Sherpaa doctor and care team, employees use Sherpaa for more and more complicated situations. Sherpaa identifies more of the rare, high impact situations like predictable procedures and new cancer diagnoses to drive more people to lower cost bundled pricing facilities.
And, as you see, by giving employees one simple online place to go powered by doctors who are on a mission to practice cost-effective medicine, you can have a huge impact on care patterns, costs, and simplifying your employees’ lives.