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www.emc4me.com. Proprietary and Confidential. DPC: HOW IT WORKS. $35 monthly membership fee plus $25 in person or virtual visits Membership vs FFS: Providers focus on value Labs, Radiology, Cardiac testing all heavily discounted (50-85%)
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www.emc4me.com Proprietary and Confidential
DPC: HOW IT WORKS • $35 monthly membership fee plus $25 in person or virtual visits • Membership vs FFS: Providers focus on value • Labs, Radiology, Cardiac testing all heavily discounted (50-85%) • Medication prices dramatically lowered through Rx advocacy • Published procedure price list substantially below Blue Book • Multi-portal, near instant access: Text, email, phone, virtual, in-person, walk-in or scheduled Proprietary and Confidential
How We Save Employers • Providers aligned with employers/brokers and patients to keep expenses minimized • Providers help patients find least expensive medications • Providers help avoid unnecessary procedures and referrals • Increased Primary Care access dramatically lowers healthcare expense Proprietary and Confidential
Savings through Reduced Waste IOM 2012 report estimated 30% of health spending was unnecessary ($750B) Categories of Waste DPC Addresses • Failures of care delivery • Failures of care coordination • Overtreatment • Administrative Complexity Proprietary and Confidential
""Health Policy Brief: Reducing Waste in Health Care," Health Affairs, December 13, 2012. http://www.healthaffairs.org/healthpolicybriefs/
Evolve & Health Insurance • Vertical integration with current health plan • Improves rating methodology • Medical carrier file • Evolve can provide hypothetical savings based on industry standards • Evolve will provide actual savings based on previous year as benchmark • Reporting will be provided quarterly (Hint.com) • Cancel membership at anytime Proprietary and Confidential
Direct Primary Care: Utilization Proprietary and Confidential
Direct Primary Care: Savings Proprietary and Confidential
Potential Savings Mechanisms: Premiums • Higher deductibles (up to $12,000) permitted by ACA • Higher deductible without excessive out-of-pocket cost • Decreased through-insurance spend reduces future premium (Rating methodology improved dramatically) • Allows for increase of co-pay to ER, Urgent, etc • Facilitates corporate self-insurance • Insurance industry accounts for 40% of premium Proprietary and Confidential
5 smart ways small firms can slash health-care costs Jan 8, 2015 #5 "Direct primary care, coupled with a high-deductible health insurance plan, can oftentimes be an outstanding and relatively affordable solution…When direct primary care is combined with a high-deductible plan, it can often save 12 percent to 15 percent over what a firm would spend for traditional health insurance.* *http://www.cnbc.com/id/102306190 Proprietary and Confidential
Heritage Foundation Study on DPC DPC fixes problems with third-party payment, paperwork, and government bureaucracy. Data shows excellent outcomes, reduced costs. Policymakers should create less restrictive regulations for DPC: … Reform the tax code to allow DPC payments through HSAs DPC encourages innovation and competition unlike the dysfunctional status quo Growing Model: Roughly 4,400 DPC physicians in 2012 up from 756 in 2010 and a mere 146 in 2005
CDC: Employer Benefits Beyond Savings • Lower health care and disability costs • Enhanced employee productivity • Reduced employee absenteeism • Decreased rates of illness and injuries • Enhanced corporate image • Improved employee morale • Improved employee recruitment and retention Source: http://www.cdc.gov/workplacehealthpromotion/businesscase/benefits/ Proprietary and Confidential
CDC: Employee Benefits • Increased well-being, self-image, and self-esteem • Improved coping skills with stress or other factors affecting health • Improved health status • Lower costs for acute health issues • Lower out of pocket costs for health care services • Increased access to health promotion resources and social support • Improved job satisfaction • Safer and more supportive work environment Source: http://www.cdc.gov/workplacehealthpromotion/businesscase/benefits/ Proprietary and Confidential
Capacity: Staffing & Facility • 1 MD and 2 Nurse Practitioners • Each provider manages 1,000-1,500 lives (50% industry standard) • Team-based approach • 30 minute visits • Facility • Large, spacious reception • 7 Exam rooms • 3 Virtual stations • Virtual drive-thru Proprietary and Confidential
Summary • Increased access: 85% of employee needs (primary & urgent care) • Employees view as a substantial perk (retention/recruitment tool) • Extended hours and weekends • Virtual or in-person; text/email/call • Lower premiums • Raise deductible as high as $12k • Free urgent care membership for children of employees ages 6-25 • Free annual well exams Proprietary and Confidential
Awards • Anne Arundel County Chamber of Commerce Entrepreneur of the Year, 2015 • Baltimore Business Journal Healthcare Innovator, 2015 • Chesapeake Family Favorite Docs, 2015 • Capital Reader’s Choice Top Docs, 2015 • All 5 Star Reviews: Google, Yelp, Facebook Proprietary and Confidential
Founder and CEO • Board Certified Internist; 17+ yrspractice • Member of National Direct Primary Care Steering Committee • Extensive executive committee background at AAMC • Experience in developing and managing large multi-specialty clinics • Comprehensive management experience in high volume primary and urgent care settings Proprietary and Confidential
www.evolvemedicalclinics.com Proprietary and Confidential