Uber, Walmart, Amazon and Berkshire Hathaway Get into Healthcare; And Now Uber Launches Service To Get People To The Doctor’s Office!



28059229_1452381504891504_6986021347674518630_nUber wants to get you from your home to your doctor’s office — and you won’t even need to open the Uber app. The company announced Thursday that it’s teaming up with healthcare organizations to provide transportation for patients going to and from medical appointments.

Receptionists or other staffers can schedule the rides for patients through doctor’s offices. And they can be booked for immediate pickup or up to 30 days in advance. That means patients without a smartphone — who wouldn’t be able to use Uber otherwise — can become Uber customers.

Instead of operating through an app, Uber Health will send its passengers’ ride information through an SMS text message. The company also plans to introduce the option for passengers to receive a call with trip details to their landline instead. Drivers will still use the Uber smartphone app to pick up these passengers.

“Transportation barriers are the greatest for vulnerable populations,” says Chris Weber, the general manager of Uber Health. “This service will provide reliable, comfortable transportation for patients.”

Transportation is, indeed, a barrier to good health care. Affordable access to a vehicle is consistently associated with increased access to medical care, according to a study. Around 3.6 million Americans miss doctor’s appointments or delay medical care due to a lack of transportation every year, according to the National Conference of State Legislatures.

To meet the medical privacy standards outlined in the federal HIPAA law, drivers won’t know which of their passengers are using Uber Health. Like a typical Uber ride, only a passenger’s name, pickup and drop-off addresses will be given to the driver. So Uber drivers won’t be able to opt into the health service the same way that they opt into Uber Eats, a food delivery service.

Peter Whorley, who drives a Honda Odyssey minivan for Uber in Fort Lauderdale, Fla., often picks up passengers who need the extra space, including patients traveling to and from doctor’s offices.

“I just picked up someone with back surgery the other day,” he says. “I like to help people, if they need extra assistance, I personally don’t have that problem. But some people might be squeamish, and not want to.”

Whorley, who has been driving for Uber for more than two years, is more skeptical about picking up people without smartphones. He thinks location tracking on smartphones is vital to the efficiency of the ride-hailing service. “When you’re a good passenger, you should be able to have your phone out to communicate with your driver,” he says.

Uber’s Weber says that because health care providers will use their best discretion in scheduling the rides, they won’t call Ubers for people in need of urgent medical attention. “It’s not a replacement for ambulances,” he says, but a reliable means of transportation to non-urgent medical services that he hopes will curb missed appointments.

One hundred healthcare organizations in the U.S., including hospitals, clinics, rehab centers, senior care facilities, home care centers, and physical therapy centers have already used Uber Health’s test program. The service will be rolled out to healthcare organizations gradually. The only part of this program is that they plan on billing the physicians and their organizations. I can’t agree with this concept, especially with the discounted insurance reimbursements.

And Here Comes The Uber Of Healthcare. CONCIERGE KEY Health is the first mobile app to provide healthcare consumers with on-demand access to elite physician specialists, urgent care clinics, and hospitals. Founder Robert Grant thinks that app-based healthcare is about to take off, digital journal.

The aim of CONCIERGE KEY Health is to eliminate excessive appointment and in-office wait times in the U.S. health system, through a consumer subscription-based membership. The app is based on concierge medicine model and it includes elite providers in all fields, from general practitioners to dentists.

The model enables patients to expedite the process of connecting to and consulting with elite top-tier doctors across the healthcare spectrum. Speed, convenience, and connecting with elite medical providers are the basis of the business model.

To find out more about this different approach to securing medical services, Digital Journal spoke with the founder, Robert Grant. Grant has previously had tenures at the ALPHAEON Corporation, Bausch+Lomb Surgical, and Allergan Medical.

We began by asking about the state of U.S. healthcare.

Digital Journal: What are the major challenges facing healthcare?

Robert Grant: “Healthcare has been upside down for a long time now because it has forgotten who the ultimate customer is: the patient.

“The overly complex and highly opaque healthcare third-party based ecosystem of today prioritize in the following order: payors (insurance companies), pharma, physicians, and finally, patients. This is due in part to the well-organized lobby and narrative of the industrial complex of healthcare, which is made up largely of payors and pharma corporations.

“We believe the healthcare ecosystem should be prioritized in exactly the opposite way of how it is structured today: first, patients; second, physicians providing care; third, products and finally payors.

“Because today’s industrial complex prioritizes the benefit of payors and pharma above physicians and patients, the entire analysis begins and ends with the ‘see-saw’ and the purported zero-sum game of cost versus quality of care. Forgetting that the ultimate customer of healthcare is the patient, today’s ecosystem is not focused on the patients/customer experience.

DJ: Why has health care become so bureaucratic?

Grant: “Because it is not clear who the customer is. When your doctor writes a prescription for medication to you, who exactly is the customer of that pharmaceutical product? Is it the pharmacy that inventories it? Or, is it the patient that picks it up from the pharmacy? Or, is it actually the third-party payor (insurance company) that pays for it? Or, is it really the doctor who wrote the prescription in the first place? Or, is it actually the patient who pays the premiums to the payors in the first place?

“It is an extraordinarily complex and opaque ecosystem, with all parties self-interested to maximize returns, and it isn’t clear that the patient is actually the customer. That way there is so much dissatisfaction in healthcare among patients.”

DJ: How can digital technology and automation help?

Grant: “Technology empowers consumers and further clarifies and magnifies the link and balance between vendors and customer. Vendors must serve the needs and demands of their customers.

“In virtually every other non-monopolized industry, vendors who fail to adequately serve their customers cease to exist. Cost and quality are not the only measures of performance. Customer experience and satisfaction play a major role in the so-called ‘Experience-Economy,’ which has penetrated every industry with widespread adoption by vendors and customers alike. Healthy competition sustains this balance between vendor and customer. Healthcare has been and continues to be the exception thus far.”

DJ: Please explain your new app and how it aids the patient.

Grant: “The CONCIERGE KEY Health app upgrades the healthcare experience for consumers. It provides personalized and on-demand access to the world’s elite physicians, including specialists, urgent care facilities and hospitals.”

DJ: What are the advantages with the app for healthcare institutions?

Grant: “Institutions will benefit from the CONCIERGE KEY Health app as it will reduce their financial dependence on payors and improve the healthcare experience for their customers, the patients. It will also provide a new service and revenue source that consumers want and are willing to pay for.”

DJ: What has the interest been from the medical community?

Grant: “The interest for CONCIERGE KEY’s “on-demand” service has been very high from the medical community. It appeals equally to patients and doctors alike. Longer doctor wait times, a better process to inform doctor selection than paid advertising and Yelp provide and the desire for a distinctive and personalized health experience are the major drivers of consumer demand.”

DJ: Which demographic groups do you think the app will appeal to most?

Grant: “Recent third-party surveys of approximately 900 consumers across 11 metro areas nationwide revealed a very high demand among 25 to 50-year-old consumers. There is a strong bias in the data toward family participation in CONCIERGE KEY.”

DJ: How have you addressed data security concerns?

Grant: “Our CONCIERGE KEY on-demand app includes state-of-the-art security protections and is HIPAA compliant.”

DJ: What else are you working on?

Grant: “We are laser-focused on perfecting our on-demand service. The market potential for this first patient-centric service is massive. Once we achieve our initial goals of widespread adoption of our on-demand service here and abroad, we see CONCIERGE KEY as an innovative platform for patient-centered and simple solutions to other healthcare needs, where we can help untangle unnecessary complexity and upgrade the overall healthcare experience for our subscription members.

DJ: How else do you envisage healthcare technology evolving?

Grant: “The entire healthcare debate has focused solely on the see-saw of cost versus quality of care. To us, these are simply the hygiene factors of healthcare. No company has embedded a truly keen focus and understanding of the patient experience. Healthcare is the largest industry in the United States, representing almost one of every five dollars spent by Americans every year. No other industry is so late to emphasize the motivators for consumers related to the customer experience as healthcare is.

“While new technologies to treat our various ailments emerge every year by gaining FDA approval, we believe the next leap of technology expansion will address the personalization and overall experience of patients within the healthcare economy and we intend to lead that effort.”

While CONCIERGE KEY Health is the first mobile app that provides on-demand access to specialists, urgent care clinics and hospitals for U.S. patients, it will be intriguing to see if an Uber-like model can develop in the healthcare space.

Uber Cofounder’s ‘Uber For Healthcare’ Startup Raises $14 Million.

While dozens of startups today look to Uber as a template for how to bring on-demand convenience to a long-standing market, one “Uber for healthcare” startup has an advantage. Its co-founder Oscar Salazar, who helped build the first Uber prototype, knows a thing or two about the $46 billion-plus valuation company first-hand.

Pager announced Tuesday it had raised $14 million from Ashton Kutcher’s Sound Ventures and New Enterprise Associates, with existing investors Goodwater Capital, Lux Capital, and Montage Ventures rejoining. The money’s aimed at expanding the New York City-focused service to new markets including San Francisco and Los Angeles and building out the product.

While services like ZocDoc and Doctors On Demand have made it possible for customers to find and book doctors more easily by computer or phone, Pager tries to take the process further by making your appointment instant and for a flat fee. A first-time urgent care visit is $50, and $200 after that. A physical is $100 and a phone consultation $25.

The parallels to Uber are peppered throughout Pager’s product. The service finds and verifies doctors for its network and bills you automatically over a linked credit card. There’s a $10 cancellation fee if you bail on an appointment after more than 5 minutes. And because the service is out of network, for now, it favors those for whom convenience can come at a premium to healthcare network costs.

That’s why it’s no surprise that Salazar is involved. Since building the prototype of the Uber app with billionaires Garrett Camp and Travis Kalanick, Salazar’s become something of an on-demand Uber exporter. He’s got a co-founder title with Ride, an app to bring Uber-like convenience to carpooling. Last month he linked up with another startup to work on an “Uber for trash.” Salazar doesn’t work full-time or daily at any of these startups.

“I don’t build companies, I help people build companies,” says Salazar. “It’s part of my strategy to work with companies like Uber because I can do my job faster and I want to have value to add.”

As Salazar helps with high-level product issues and builds out technical teams, it’s up to operators lesser known than Kalanick to execute at each one. At Pager, that’s the job of CEO Gaspard de Dreuzy. “Pager is focused on delivering a broader range of care options on demand” that exist today, de Dreuzy says. “It could be a tele-consult via phone or messaging, or an in-person visit in the home, or a referral to the right specialist. We like to think of ourselves as the Amazon for healthcare.”

Eventually, Pager will build partnerships with national providers to improve their own customer reach, says new investor and NEA partner Mohamed Makhzoumi. That’s where Pager’s vision may translate into large numbers of users, as its technology helps push the rest of the industry to improve its tech. Otherwise, Pager’s pricing and pitch could come off—as Uber once did—as a service of convenience for the well-heeled Donotpaginate

The influence of Salazar’s background helped with investors and with the product. It also helps Pager stand out among a dozen of startups striving for attention. But Salazar himself makes it plain that he’s not helping any of his startups score major Uber partnerships trading off his reputation at Uber HQ.

Salazar’s already got a new area where he’s looking for an “Uber for X”: education. “ They all share a narrative, Salazar says. “All the projects I’m involved in have a social impact. That’s where startups can change the world faster.”

Amazon, Berkshire Hathaway, And JPMorgan Chase Launch New Health Care Company. Health care costs are “a hungry tapeworm on the American economy,” Berkshire Hathaway Chairman and CEO Warren Buffett says, and now his firm is teaming up with Amazon and JPMorgan Chase to create a new company with the goal of providing high-quality health care for their U.S. employees at a lower cost.

The new company will be “free from profit-making incentives and constraints” as it tries to find ways to cut costs and boost satisfaction with the health care plan for employees of Amazon, Berkshire Hathaway, and JPMorgan Chase. The trio unveiled their new venture in a news release.

“The initial focus of the new company will be on technology solutions that will provide U.S. employees and their families with simplified, high-quality and transparent healthcare at a reasonable cost,” the companies said.

The enterprise unites three of the largest and most envied companies in their respective sectors — from retail to banking, and including Berkshire’s wide portfolio of companies such as Geico and Fruit of the Loom. And in Buffett, Amazon’s Jeff Bezos and JPMorgan’s Jamie Dimon, the companies also have veteran leaders who have shown an ability to solve vexing business problems.

According to recent annual reports, taken together the three companies employ more than 950,000 people worldwide. The three CEOs say they’re aware of the enormous challenges they face. “The health care system is complex, and we enter into this challenge open-eyed about the degree of difficulty,” said Jeff Bezos, Amazon founder, and CEO. “Hard as it might be, reducing health care’s burden on the economy while improving outcomes for employees and their families would be worth the effort.”

Responding to the announcement Tuesday morning, White House economic adviser Gary Cohn told CNBC “we agree in that philosophy. We think that individual workers should have to pay less for health care.”

Still, the Trump administration already “created association health-care plans, which is the exact same thing that those companies did,” Cohn said, referring to an executive order last October that sought to make it easier for employers to combine efforts in offering insurance. That order also opened the possibility some groups could get coverage across state lines — “a move that Republicans have long advocated as a way to lower costs,” NPR’s Scott Horsley explained at the time.

“Smaller businesses could pool their employees together to get more purchasing power,” Cohn added Tuesday, “so they could save money on health care.” NPR’s Scott Hensley tells Morning Edition there is a precedent for the case of a non-health care company wading into the healthcare business — “in fact, it has happened repeatedly.”

“One of the most prominent examples is what is now Kaiser Permanente, a big provider of health care in this country. It started with the Kaiser shipyards and providing, first, workers comp kind of care and, later, more integrated health care for employees,” Scott explains. “So it is possible.”

The particulars remain scarce at the moment, though. Details such as the company’s name, a base of operations and long-term leadership weren’t included in a joint news release about the new company that was sent out Tuesday morning.

At the start, the new company will be led by executives from each of the troika of giant firms: Marvelle Sullivan Berchtold, a managing director of JPMorgan Chase; Todd Combs, an investment officer of Berkshire Hathaway; and Beth Galetti, a senior vice president at Amazon.

JPMorgan’s Dimon said, “The three of our companies have extraordinary resources, and our goal is to create solutions that benefit our U.S. employees, their families and, potentially, all Americans.”

Everyone seems to want to get the market for health care and thinks that they know what the solution is to the healthcare crisis. Remember that in 2014 Walmart decided to get into Primary care. Walmart’s New Primary Care Clinics Shake up Healthcare Market

Walmart has recently launched half a dozen primary care clinics across South Carolina and Texas, with plans to open six more before January. Staffed by nurse practitioners, in a partnership with QuadMed, these clinics are fully owned by the company and branded explicitly as one-stop shops for primary care.

Prior to this, Walmart’s 100-plus retail clinics were hosted through leases with local hospitals. With a walk-in visit price of a mere $40 (and $4 if you are a Walmart employee), Walmart’s goal for these clinics is to be a low-cost alternative to traditional options.  Additionally, the clinics will also stand out from competitors as they will be open for 12 hour days on the week and 8 hours (per day) on the weekend.

The rollout of clinics is beginning in rural areas, where doctors are scarce.  When comparing the number of hospitals in urban versus rural areas, Definitive Healthcare’s hospital database’s search accounts for 2,228 hospitals located in rural areas, but 3,871 hospitals located in an urban geographic location.

Previously, Walmart only offered what is known as “convenient-care-clinics” or “retail clinics,” which treat uncomplicated minor illnesses and provide preventative health care services.  Besides Walmart, CVS offers their Minute Clinic through this model, as well as Target’s Target Clinic.  With their new clinics, Walmart will be able to support a broader range of services such as chronic disease management.

The New York Times examines this news on Walmart, by also comparing their model to Walgreens.  In 2013 Walgreens also began offering primary care services in their 400 clinics across the country.  They were the first-ever chain retailer to become a direct provider of primary care services.  Walgreens, however, differs in that they are still reluctant to call their facilities primary care clinics, while Walmart put that label front and center.

Additionally, Walgreens differs because also last year, they became the first mover when they began partnerships with ACOs.  Their partnership with three providers, Advocare Walgreens Well Network (New Jersey), Diagnostic Clinic Walgreens Well Network (Florida), and Scott & White Healthcare Walgreens Well Network (Texas), was aimed at participation in the Medicare Shared Savings Program (MSSP).  This was the first retailer/provider partnership that will try and improve care and reduce costs of Medicare.

Definitive Healthcare’s healthcare database tracks intelligence on 600+ accountable care organizations (ACOs), including those affiliated with Walgreens. In addition to the three MSSP ACOs, Walgreen is also in collaboration with four other ACOs, such as Centura ACO Health of Colorado.  Definitive Healthcare’s database provides intelligence on 34 members of that ACO, as well as tracks their technology modules of HIE and EHR/EMR.

Instead of replacing one’s primary care physician, as what is intended with Walmart’s goal, Walgreens instead stresses that their collaboration will provide a comprehensive experience for the consumer.  They still want the majority of care coming from the patient’s physician group or health system, but Walgreens would just add distinct value to the ambulatory network, etc.

While it still is a bit too early to tell, The Advisory Board Company has already written on how the Walgreens’ ACO partnership is on the right track. As Walmart continues to roll out these physician centers, it will be interesting to track the success of these new clinics. Walmart’s clinics will accept Medicare but currently does not accept third-party insurance.  The timing of these new clinics could benefit greatly from the changes resulting from the Affordable Care Act.

And as another article reported Thomas M. Loarie Walmart To Put MRI Scanners In Stores and Will Charge $400/Scan. The US Healthcare System is Anti-Middle Class Says Healthcare Executive /  Middle-Class Friendly Walmart to Place MRI Units in its 3000 Stores by 2018. James Orlikoff, President of Orlikoff and Associates (Chicago), outlined the economic pressures related to healthcare that are going break the middle-class if we “do not break rather than bend the healthcare cost curve.” His comments were made during a pre-meeting workshop, “Something Disruptive This Way Comes: Preparing for Consumerism in Healthcare” at last week’s 23rd Annual Health Forum and American Hospital Association Leadership Summit in San Francisco.

“Rapidly increasing deductibles and co-pays along with means testing by Medicare are pushing healthcare financial risk to the patient.” And with a slow growth economy, personal income growth is being more than offset by healthcare expenses.

Orlikoff went on to say that despite the enactment of the Accountable Care Act (Obamacare), healthcare spending is forecasted to accelerate this year and continue for the foreseeable future.  The modest increase in healthcare spending over the last few years was due largely to the recession.

He went on to say “We have known this train wreck has been coming but we did nothing about it.” Its effects extend beyond healthcare to the general economy as healthcare continues to take a big bite out at 18% of GDP. We are at a significant competitive disadvantage with emerging economies where healthcare represents only 3-5% of GDP. He added that competitiveness is critical. Without it, we will be unable to create the jobs and income critical for the middle class that pays for healthcare.

“Even healthcare systems cannot afford to buy their own product for their employees.”

These economic factors are attracting consumer companies to the healthcare services market. CVS, Walgreens, Rite-Aid, Target, Walmart, Apple, and others eye the $30 trillion to be spent on healthcare over the next decade as an opportunity and see the consumer as the new decision-maker.  The retail pharmacies and rapidly growing urgent care centers are improving access, quality, and convenience while reducing cost.

As healthcare moves from wholesale to retail, cost-based pricing is being transformed to price-based costing. Walmart today offers a “truss” for those who have inguinal hernias in lieu of having surgery – $50 versus $5800-$10,000. Walmart has announced it will put MRI’s (diagnostic imaging) in all of its stores by 2018.Orlikoff said Walmart plans to price an MRI at $400.

Can they, the Walmarts, the Ubers, Amazon and Berkshire Hathaway know anything about healthcare or the solutions to health care?

Back to the discussion of a Single payer healthcare system!

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