The Future of Medicine is Here

How rising costs and limited access to care mean something has to change

In 2011, healthcare spending in America reached $2.7 trillion or about $8,600 per person. That represents 17.9% of our GDP. As Stephen Brill points out in his book Bitter Pill: Why Medical Bills Are Killing Us, “we’ve changed the rules related to who pays for what, but we haven’t done much to change the prices we pay.” As the US population continues to age, the cost of healthcare will continue to climb. We have a moral responsibility to avoid bankrupting the next generation.

I’ve spent the last six months in a crash course learning healthcare by building a health-tech startup. There’s the Affordable Care Act (ACA), or as it’s frequently referred to: “Obamacare”, which intended to make sure everyone can get care regardless of income level or pre-existing medical conditions. Underscoring this increase in the population of insured Americans is the practice of capitation. To manage the risk associated with insuring millions of people, a Healthcare Management Organization (HMO) passes on that risk to the provider groups (the doctors and nurse practitioners). The groups are paid for each patient assigned to them based on average projected annual healthcare costs per patient.

An Accountable Care Organization (ACO) is a group of providers that come together voluntarily as a way to receive savings when they meet certain goals caring for patients as part of the Medicare program.

The interplay between the ACA, the Managed Care Organization (MCO) — of which an HMO is just one of many — capitation and ACOs is complex and difficult to untangle. But ultimately, all of this legislation, organizational infrastructure, and risk management is intended to make sure people have access to medical care that is affordable.

In 2014, in the top 15 markets, the average wait time to see a doctor was 18.5 days. As the insured population continues to grow, the time to get an appointment to see a doctor will also increase. We’re heading towards a dangerous place where access to physicians will be the new obstacle to receiving care instead of an inability to pay for that care.

Because of these long wait times, there are more and more people who don’t see a primary care physician (PCP) and instead use urgent care and the emergency room as primary care. In 2010, a study that analyzed 6.5 million visits to the emergency room found that 65% of those visits didn’t require emergency care and an additional 6% were preventable if the patient had received non-emergency care prior to the visit.

With better access to primary care, we can reduce the need for emergency care. Waiting days or weeks to see a doctor, to give up and visit an ER instead, illustrates the inefficiencies of the current state of healthcare in America.

But what if we could see a doctor quickly, affordably and preventively? Could we actually lower the overall use of healthcare by treating illness early, prioritizing regularly healthy check-ups like annual physicals, and building a record of health information that’s accessible by patient, doctor and specialists? I’d like to think that we can, and I believe that we must.

That’s exactly why we created Heal. Heal provides access to primary care doctors like pediatricians and family practitioners through a simple app. These doctors are already accessible to 3 million people living in California. The physicians come to the patient’s home or office, arrive in under an hour, and can do everything you’d expect from a typical doctor’s office visit — without being at a doctor’s office. The visit is $99 out-of-pocket today, with insurance coverage bringing the cost to the patient even lower soon.

I’m biased but I believe this is the future of medicine. We’re trying to remove the inefficiency and waste from the current system. Eliminating things like overhead, paperwork, and extra staff all brings costs down. As a result, the doctors can see fewer patients, spend more time with them, and provide better care.

Imagine Heal in the 25 largest cities in America. That’s 35 million people (or more than 10% of the country’s population) with access to in-home, high-quality primary care. That’s millions of people avoiding costly ER visits because they didn’t have to wait weeks to see a doctor. That’s millions of people with access to a doctor when they’re well and when they’re sick. That’s millions of people choosing a better way to take care of themselves and their families, bringing down the total economic burden of healthcare for everyone. By next year, we hope to turn this vision into reality.

75% of Americans have a smartphone. Starting today, Heal is available for Android and iPhone. That means people can get a great doctor just like they can book a car, order groceries or clean their home with a tap on their phone.

The future of medicine is here. And with Heal, I believe that future is bright.