VillageMD co-founder Paul Martino predicts the U.S. healthcare system is returning to its roots whereby primary care physicians — not big hospital systems — drive patient care, along with better, more cost-effective outcomes.
“We think care is going to happen in the community,” Martino told McKnight’s Home Care Daily. “We think care is going to happen in the home. It’s going to be supported by technology and we’ll all need good hospital care for the right set of circumstances for the right patient.”
VillageMD is one of a growing number of companies that is part of the so-called U.S. house call industry. Research firm Grand View Research values the sector at approximately $460 million and projects it will expand at a compounded annual growth rate of 5% over the next six years. Prominent players in the sector include Village MD, Heal, DispatchHealth and Doctor on Demand.
VillageMD exemplifies the rapid growth the sector is undergoing. The company started eight years ago with 13 providers in Houston and has grown to 3,000 providers in 14 markets in 10 states, serving 1.6 million patients. The company employs primary care providers, including physicians, physicians assistants and nurse practitioners, through its free-standing Village Medical clinics and co-branded clinics at 41 Walgreens stores. It also has affiliations with independent primary care practices. It delivers care at clinics through home visits and telehealth.
Martino brought a unique perspective to VillageMD. He spent more than three decades working in the health insurance industry, serving as Anthem’s chief strategy officer in his last role. In his Anthem post, Martino found that 5 cents out of every dollar devoted to a patient’s medical care went to primary care providers; the rest went to specialists and services. From Martino’s perspective, primary care clinicians could do a better job of managing care, keeping patients out of hospitals and reining in healthcare costs.
“As a payer guy I was looking at the landscape, thinking that my best opportunity to drive economic benefit is to partner with those who are the least expensive. That is independent primary care physicians,” Martino said.
‘Worst primary care’
Thomas Cornwell, M.D., VillageMD senior medical director, told McKnight’s Home Care Daily hospitals are not the best sources for primary care. He said he knows because he spent two decades providing primary care to the homebound through Northwestern Medicine, a large network of medical providers and an affiliate of Northwestern Memorial Hospital in Chicago.
“The most complex patients who need the most care are going to the hospital and that is the worst primary care,” Cornwell explained. “You’re not getting diabetes under control, you’re not getting heart failure under control. So it was kind of easy to take these people who were getting virtually no care and give them phenomenal care in the home.”
In-home care partnerships
Health insurers are recognizing the value of in-home care delivery. Humana has partnerships with Heal and DispatchHealth. Aetna has partnered with WellBe. VillageMD is payer-agnostic, working with many healthcare plans. The company recently became the Centers for Medicare & Medicaid Services’ largest participant in the new Direct Contracting Program, serving 56,000 patients in eight states.
The pandemic helped move care back into the home as a result of telehealth and hospital-at-home initiatives. And Martino has no doubt more care will be delivered at home long after the pandemic ends.
“We got away from that because a bunch of doctors became employees of health systems and it was all about the hospital and not about primary care. I think the pendulum is finally beginning to swing the other way,” Martino said.