PopHealthCare plans to expand from its current list of 19 states to cover the entire country, with a strategy that includes providing healthcare directly at home.
Returning a home call, combined with today’s analysis of data, may be the key to managing the population and shifting healthcare from a service charge to risk-based payments.
That’s what Eric Galvin, the newly appointed CEO of PopHealthCare, said recently. -state footprint to all 50 states.
“We are for a 13-year-old company whose roots are in revenue analysis for health plans,” he said. “This has grown and become a more complete proposal for a risk adjustment program.”
The Emcara Health care team visits patients’ homes and conducts health assessments, including identifying social determinants of health that are apparent during the visit. In some cases, especially in rural areas, they are the main provider of medical care.
“If this is the case, we are largely a quarterback to care and will work with professionals if necessary,” says Galvin.
Eric Galvin, CEO of PopHealthCare. Photo courtesy of PopHealthCare.
In cases where Emcara Health is not a primary care provider, the company interacts with the patient’s primary care physician.
“We’re sending them data so they can effectively manage other parts of the continuum of care for this patient,” Galvin said.
PopHealthCare also bridges the gap between patients and family members, he says, involving those family members in the care the patient receives or should receive.
Although service charge models are consistent, payers like Jacksonville, Florida-based GuideWell, the parent company of PopHealthCare, “want to be in value-based arrangements everywhere,” Galvin said. “The supplier community is not always equipped or ready to go that route.”
Previously, Galvin was executive vice president and chief executive officer for growth and medical expenses at Emblem Health and president of ConnectiCare, which grew under his leadership to a dominant provider of health care managed by the Affordable Care Act in Connecticut.
“The whole idea was that everyone in the ecosystem – hospitals, supplier groups, laboratory companies – put all their resources on the table,” says Galvin. “There has been a consistent theme in my career and that is trying to make healthcare better for consumers and patients.
ConnectiCare has offered the first package payment in the state of Connecticut, focusing on orthopedics, says Galvin.
While at ConnectiCare, Galvin co-founded the nonprofit organization 501 (c) 3, Partners for a Healthier Connecticut.
“We started with a focus on type 2 diabetes,” he says. “We said, ‘Put all your resources on the table. Now forget who does these activities. Let’s talk about who is in the best situation, in the best position to take care of the patient “and we have made great progress.”
An electronic health record tailored to PopHealthCare is a key factor in this conversation, Galvin said.
“A doctor doesn’t have to be there in someone’s living room,” he says. “It can be a whole set of different people with authority who can interact with a patient. And you don’t have to have all these people in the house. We can reach more people in more and more rural areas effectively because of [telemedicine] technology. “
Some PopHealthCare customers pay a monthly fee per member, and in other cases the company assumes full medical risk, Galvin said.
One of his biggest challenges in his new role is to reach out to customers who may have purchased an individual service offered by PopHealthCare and entice them to purchase a package of offers.
“There is significant demand in the self-financing space,” he said. “Geographically, there is still a lot of white space for us to penetrate, and especially with our model, because we are so effective in rural communities.”
During a previous stay at a digital health company, Galvin was able to increase the population served by a factor of 10.
“One of the secrets of this model was to go where the customers were,” he says. “We would have people with a van full of folding chairs, and we would go to the client and hold health seminars.
However, some methods of reaching it are more difficult. Potential patients no longer answer their cell phones if the incoming call is from a number they do not recognize, Galvin said.
The point is to overcome these challenges on behalf of all healthcare, he said.
“We’re not trying to differentiate anyone,” he said. “What we’re interested in is connecting bridges and also being a resource that many vendors can’t afford to use.”
Although Galvin is not a physician, he says his skills in customer engagement, patient engagement, and running an efficient and effective business complement the leadership of physicians at PopHealthCare.
“Some of the best organizations I’ve seen in the healthcare field don’t have a doctor in charge, but they have great doctors,” he said. “Our chief physician is a brilliant physician and his team is amazing. So I will always obey them when it comes to medical issues.”
Payers also need to reduce the number of technology providers they work with, he said.
“They show all the signs that they say, ‘We had these 18 different partners, [and] now we need to start consolidating them and find partners who could be this quarterback for us, ”says Galvin.
Scott Mace is a HealthLeaders contributor.