Top Primary Care Innovators To Watch (Part 2 Of 2)

In the previous blog post on primary care innovators, we talked about why primary care is an exciting space to watch. We talked about CareMore and ChenMed, two innovators in the space. In today’s post, we will provide an overview of three additional innovators that will impact how primary care is delivered across the nation: Iora Health, Oak Street Health, and VillageMD.

Iora HealthIora Health blog

Iora Health is an advanced primary care healthcare provider that serves Medicare Advantage (MA), Medicare, and direct-pay patients through high-touch, team-based practices across the country. Iora’s expansion strategy targets low-income, underserved locations where the company builds new facilities and customizes its approach in each of its markets to fit the varying needs of patients while also working under various payment models. Iora utilizes health coaches (nonphysician staff members) from the community to assist in coordinating care delivery and educating patients.

  • KEY DIFFERENTIATORS: Iora Health was among the first organizations to enter the high-touch primary care market, providing extensive experience in treating low-income, underserved populations. The company’s usage of community-based health coaches enables Iora Health to maintain a higher level of care coordination and improved patient satisfaction while reducing overall costs. The company serves a greater range of patients than other high-touch providers, ranging from relatively sick to fairly healthy. The system will be participating in the CMMI Direct Contracting model starting in April 2021.
  • FOOTPRINT & GROWTH: Iora Health has 48 locations that serve thousands of Medicare beneficiaries. The company has experienced a two-year compound annual growth rate of over 70%. Patients averaged four visits in 2019 with twice as many electronic interactions with care teams.
  • TARGET MARKET: Medicare Advantage, traditional Medicare patients, and self-insured employers.
  • CARE DELIVERY MODEL: Iora Health builds new facilities and customizes its treatment approach in each of its markets to fit the needs of the community’s patients. Health coaches (nonclinical workers) who “speak the same language” as patients are hired directly from local areas and join primary care teams in coordinating care. Iora designs its clinics to be relatively small, often consisting of 2 – 3 primary care providers. Iora charges a flat monthly fee that is often covered by insurance.

Oak Street HealthOak Street blog

Oak Street Health’s business model involves full risk contracting for Medicare patients with complex conditions. The organization embeds itself into local communities by opening waiting rooms to individuals who are not patients to access internet services or participate in daily educational sessions and social events. Oak Street includes variable compensation for employees at all levels of the organization, based on quality metrics. The company created a Patient Dashboard that allows care teams to compare patient populations to help identify heavy utilizers.

  • KEY DIFFERENTIATORS: Oak Street’s business model has garnered the attention of investors, resulting in significant funding to fuel its high-growth initiatives. Prior to the company’s $328 million IPO, Oak Street had raised roughly $230 million in the private markets. This influx of funding amidst the COVID-19 pandemic provides a competitive advantage for Oak Street to continue its expansion efforts while others are in a cost-savings mode. The company announced it will be investing significantly in data science and its proprietary Canopy technology platform. Oak Street will be participating in the CMMI Direct Contracting model starting April 2021.
  • FOOTPRINT & GROWTH: Oak Street Health currently operates 80+ total locations across 11 states while serving an estimated 99,688 covered lives. The company opened 28 new centers in 2020 and plans to be selective about its partnerships and M&A activity, with a focus on acquiring smaller practices to add new patients.
  • TARGET MARKET: Medicare patients in high-density urban and suburban areas. It further focuses on areas that have traditionally high healthcare costs.
  • CARE DELIVERY MODEL: Oak Street’s care team includes a primary care doctor, patient relations managers, in-center specialists and at-home services. Initial visits for patients are 90-minutes and are followed by the care team stratifying patients into a four-tier category (Good, Fair, Serious, and Critical) based on data and physician judgement. Tiers determine the frequency of visitations and allocation of care management resources.

VillageMDVillageMD blog

VillageMD primary care offers in-person and technology-based visits to a wide variety of patients. The company equips providers with a technology platform that drives quality improvement through data analytics, support services, and care coordination. VillageMD’s care model is centered around the relationship between physicians and patients. Physicians are focused on providing personalized care and are paid a salary for their efforts. The business operations of each location are handled by VillageMD as an organization.

  • KEY DIFFERENTIATORS: One of VillageMD’s greatest strengths is its partnership with Walgreens. Since the closing of all Walgreens clinics in 2019, this new partnership has allowed for co-location and investments. VillageMD will be participating in the CMMI Direct Contracting model starting April 2021.
  • FOOTPRINT & GROWTH: VillageMD has 24,368 estimated lives covered and approximately 2,800 physicians throughout its locations in nine states. VillageMD plans to be co-locating with Walgreens under the name Village Medical in the next five years. On January 12, 2021, VillageMD announced the opening of four locations in the Atlanta area.
  • TARGET MARKET: VillageMD patients include those on private insurance, Medicare, and Medicaid.
  • CARE DELIVERY MODEL: VillageMD is a team-based, physician-led primary care delivery model that customizes its approach depending on the needs of communities. Care is offered virtually, through home visits, and clinic visits. The innovative model is designed around the patient-physician relationship with three steps: pre-visit planning, clinic workflow solutions, and post-visit follow-up.

These blog posts have provided an overview of some of the key primary care innovators to watch going into the future. While we have only profiled five of the largest companies, there are a number of companies deploying these types of primary care models across the country. The pandemic has shown that these primary care models work, and support and momentum for these models is increasing through additional investment and partnership opportunities. It appears that these organizations may be here to stay and have the potential to dramatically change the way that healthcare is delivered across the country.

Healthcare organizations looking to prepare for the future need to understand the market implications that are associated with these primary care models and take actions that will enable them to capitalize on these evolving dynamics into the future.

For more on this topic, see the full series of LP-conducted research on primary care innovation for the ACLC hereherehere, and here.

Read Top Primary Care Innovators to Watch (Part 1 of 2) HERE