When Isabella Yearwood, a patient care assistant at Hartford Healthcare, enrolled in the company’s new primary care program for employees, she expected things might be different.
The new delivery approach that HCC is rolling out to employees is the brainchild of Dr. Rushika Fernandopulle, co-founder and CEO of Iora Health, a Massachusetts-based company that — in just four years — has attracted more than $35 million in venture capital and established 12 practices nationwide.
Call it primary care 2.0.
“A lot of people are working to tweak primary care,” Fernandopulle said. “We wanted a new model that started from scratch.”
That has meant creating a much more patient-centric practice with a focus on better understanding health goals and obstacles. “It’s a more team-based approach,” Fenandopulle explained, “not the traditional hierarchy [of the doctor-patient relationship].”
In addition to behavioral health specialists and clinical managers in each practice, each patient — under Iora’s model — is assigned a health coach, a trained professional who not only stays with the patient throughout the visit to ask questions, but can help patients navigate the healthcare system and support an individual or family’s health goals.
While the model places more emphasis and time on front-end medical care, Iora’s approach has garnered patient satisfaction scores — ranging from 85 percent to 90 percent — that are nearly four times the average satisfaction scores for medical practices. “It’s about value over volume,” Fernandopulle said.
And that value is reflected in more than satisfaction surveys; it impacts bottom lines too. According to a recent Thompson Reuters report, $700 billion — one-third of healthcare dollars spent in the U.S. each year — is wasted on unnecessary expenditures, including medical tests, treatments and the overuse of emergency rooms. In fact, of the more than $2 trillion spent annually on health care in America, the U.S. Department of Health and Human Services estimates only about 8 percent is spent of primary care.
“To make health care more efficient, we need to look at things differently,” said Dr. James Cardon, Hartford Healthcare’s chief clinical integration officer, who has been an advocate for HHC employees to enroll in the new program. To date, nearly 600 employees and their families have signed up. “Doctors love the model because it allows them to focus on the bigger patient problems.”
As the lead physician for the new Iora facility for Hartford Healthcare employees, Vasanth Kainkaryam said he sees the benefits of a team-oriented approach to care.
“With the support team — including the health coaches — it allows the doctors and nurses the freedom to talk more about a patient’s needs,” he said, noting that often time, under Iora’s model, medical staff holds daily huddles to discuss patients. “We’re thinking about the patient even when we’re not seeing them.”
Kainkaryam points anecdotally to a patient he treated who wasn’t taking her medication to illustrate the advantages of Iora’s brand of primary care. “She never had anyone explain to her why taking her medication was important and [by having a health coach] we were able to address her fears,” he said. “And we made a difference.”
Iora Health’s Fernandopulle said spending more time with patients up front helps prevent more long-term, costly expenses like hospitalizations. He points to company metrics that show, for instance, Iora patients have reduced high blood pressure-related hospital visits by up 40 percent.
Hartford Healthcare is one of two healthcare organizations (along with the Leahy Clinic in Boston) trying the new primary care model on its employees.
Cardon said it’s imperative for medical groups like his to determine how to deliver quality care when and where it’s convenient for patients.
“There’s no new dollars flowing into the healthcare system,” he said. “We need more innovation and to apply lessons learned to deliver better care.”
