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December 08, 2021 at 03:32 PM
What You Need to Know
- Health insurers may seem as if they will always be with us.
- Direct primary care could change things.
- COVID-19 could change things, too.
For about a decade, digital health has been slowly winning the battle against health care’s slow pace of change. Digital found an unexpected ally in Covid, as the pandemic forced health systems to adopt virtual solutions wholesale.
As we start to come out on the other side, though, some health systems are contemplating returning to the status quo, especially as they’re feeling acute financial strain.
The majority, however, understand that the pandemic constitutes a sea change in the industry — that there is no more status quo. Competitors are rising up to take the place (and the patients) of health systems who aren’t willing to play by the new stakes.
These competitors are no longer just the health systems down the street, but non-traditional, venture backed organizations that are establishing stand-alone clinics with their own networks of providers — offering patients what they call “direct primary care” and targeting specific populations.
Here’s what health systems need to do to remain competitive.
Understand the new players in the field.
These new models of care began as a way to make care more convenient — companies like One Medical and Forward Health, which started by building and operating primary care clinics. They charge an annual fee to provide personalized and tech-enabled care, and cater to employers and wealthier individuals.
They were the forerunners. Now organizations are taking up the same model and transforming it, going beyond simple convenience to directly challenge the quality/cost equation.
They’re finding better ways to deliver care to higher end commercial patients through technology, but are also successfully taking on capitated risk in areas like Medicaid. They’re building their own clinics to control the cost of care, while using technology to attract patients and deliver better population health.
These organizations understand that in order to win the market, they have to control or reduce costs and show better outcomes across patient populations. In their playbook, this means winning over consumers and redirecting care from more expensive hospitals to less expensive, focused clinics.
Juan Pablo Segura is the president and co-founder of 