Boston Business Journal, care delivery, courage, entrepreneurial physicians, health care system, health insurance, innovative models of care delivery, Iora Health, reinventing primary care, Rushika Fernandopulle
‘What everyone else is trying to do is improve existing practices, making incremental improvements,’ he said. ‘We figured out that maybe what we need to do is start from scratch.’
Fernandopulle is a Schweitzer Fellow for Life (Boston, 1993-94) and the CEO of Iora Health — a startup that operates employer-sponsored clinics in Las Vegas, Nevada and Hanover, New Hampshire, and that will soon expand to Burlington and Dorchester, Massachusetts.
Fernandopulle believes that Iora’s model addresses a number of the issues that make our existing health care system problematic. As he told us in an earlier interview, “Think of what happens when you go to a doctors office or visit an emergency room — the process is rife with potential errors, disrespectful of your time, and ends up costing much more than it needs to. All these problems are even worse for the poor and vulnerable, who too often when insured are used by unscrupulous providers to generate more income, with little or no benefit to the patient themselves.”
The Iora model simplifies the health care process: employers pay a set monthly fee for each employee (instead of going through insurance and paying per visit). Each employee is assigned a personal health coach, who communicates closely and clearly between visits to the doctor to help the employee stay motivated and on track to meet customized health goals.
Though the monthly fee per employee is higher than typical monthly insurance premiums, Iora banks on the idea that early, consistent investment in primary care and prevention will decrease the occurrence of costly and chronic health conditions down the line. Per the BBJ, the results of Fernandopulle’s earlier forays with this delivery model support that idea:
“Iora Health is the successor to Renaissance Health, which Fernandopulle founded in 2004. That company helped to set up a handful of primary care practices in the U.S. with a similar delivery model, including practices in in Atlantic City and Seattle. The result, after one year, was an average 48 percent drop in emergency room visits and a net spending reduction of 12.6 percent in Atlantic City and 20 percent in Seattle.”
As a Schweitzer Fellow nearly twenty years ago, Fernandopulle collaborated with The Alliance for the Homeless, where he visited shelter clinics and assisted clinicians. He created an orientation manual for volunteers working with shelters on soliciting donations, liability issues, and health care concerns — and he has maintained his entrepreneurial approach to solving health and social problems ever since.
“We need the courage to remember the job of the health care system ought to be to serve its customers — us, the consumers and patients — and not just those who profit from it,” Fernandopulle says.
Fernandopulle will speak at our Schweitzer Leadership Conference on November 3, co-headlining a breakout session called Innovative Models of Care Delivery in the Age of Health Reform with Health Dialog’s Peter Goldbach, MD. CLICK HERE to register. Student and member rates are available.