Housecalls Are Back and Booming. Are They a Threat to PCPs?

Neil Chesanow

Disclosures

July 20, 2016

In This Article

A Venture Capitalist's Perspective

McKesson Ventures, the venture-capital arm of the healthcare giant McKesson, views "alternative-care delivery models" as a growing trend, says senior vice president Tom Rodgers.

"At commercial payers and the Centers for Medicare & Medicaid Services (CMS), the jury is still out on whether these firms lower costs to the system," Rodgers says. "Are the people who use these services going to get healthy anyway, and you're just increasing overall utilization? Or are you really substituting lower-cost care? I think time will tell. That is a reason CMS and most commercial payers haven't included these services in their networks, and why telehealth is still more of a retail market. Payers want data before they give their endorsement."

"I paid $100 for my last Heal visit," Rodgers recalls. "They sent a doctor and a medical tech to my home, and they were there for 40 minutes. I don't know that the math works that well when you try to scale that."

"RetraceHealth came up with what we think is a more scalable approach, which is to keep the more expensive clinicians centralized and on the phone or doing video, and always making sure you've got somebody operating at the top—not the bottom—of their license," Rodgers says. "So you have nurse practitioners to do the initial triage and consult. And then you send, when necessary, the highly empathetic home health agents to people's homes."

"Retrace," he says, "will deploy a phlebotomist, a social worker, a home health tech, or maybe a nurse practitioner, depending on what is needed, but it will always be the lowest-cost resource who can operate at the top of their license."

"If this model has any chance of working and scaling economically, you must get the recipe right," Rodgers says. "For now, when people are spending venture dollars, that means focusing on top-line growth and optimizing the consumer experience. But very quickly you will need to show that the economics work."

The larger question, Rodgers maintains, is "How does this care model bend the cost curve? How can this model be leveraged to enable better chronic-care management? That's where the real costs are, and where the patients are—as opposed to consumers who may be sick today but not tomorrow."

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