What do Amazon founder Jeff Bezos and the Regence Blues have in common? A new subscription-based clinic network with a simple recipe for the Triple Aim and competition for the establishment.
Qliance, a direct primary clinic network backed by Bezos and Regence Blue Shield parent company Cambia Health Solutions, has released a new study of the patients under its primary care health plan. The findings offer some bright news for the trajectory of American healthcare--but might also leave trepidation for traditional healthcare businesses, from hospital systems to group health plans.
A review of two years' worth of claims for patients who subscribe to Qliance clinics in greater Seattle shows that "unlimited primary care" can reduce overall costs while improving patient outcomes and experience, said Qliance CEO Erika Bliss, MD.
Qliance examined claims data from 2013 and 2014 for about 4,000 of its patients covered by employer benefit plans incorporating the clinic's concierge services, comparing their costs to those of non-Qliance patients working for the same employers. The study found a savings of $679,000 per 1,000 patients among the Qliance cohort, about 20 percent less than claims for patients in a traditional health plan.
The study attributed the savings to a significant reduction in emergency room visits, inpatient care, specialist visits, and advanced imaging. At the same time, the study found pretty strong satisfaction among Qliance patients. Polled through the CAHPS survey, they rated Qliance in the 95th percentile in overall satisfaction.
"At a time when our country is struggling to make healthcare less costly, our results confirm that primary care, when made more personalized and accessible to patients, can lower specialty and hospital costs, and keep people healthier and more productive," said Bliss, who also practices at Qliance three days a week.
"We have an opportunity to rebuild our healthcare system to ensure we're delivering the right kind of care in the right place at the right time," Bliss continued. "But we can't do that without investing in primary care that puts the patient and the doctor-patient relationship first."
Bliss co-founded Qliance with her older cousin, Garrison Bliss, MD, in 2008, after considerable frustration with the bureaucracy and financial pressures of "treadmill medicine." The elder Bliss, who's now eligible for Medicare, started the company on the model of direct primary care, where patients or their employers pay a monthly fee and receive unlimited appointments, access to clinicians via phone or email, and basic diagnostics and chronic condition management usually for no additional costs.
Qliance's monthly subscriptions are based on an age band: $59 for people ages 1-19, $79 for those 20-49, and $99 for those 50 and older.
Since its founding, the company has garnered venture capital backing from funds such as Bezos Expeditions, Michael Dell's MSD Capital, Second Avenue Partners and Cambia Health Solutions, the parent company of four Blue-licensed plans and numerous technology and service ventures.
"Our investment in Qliance supports Cambia's vision for a more economically sustainable healthcare system," said Rob Coppedge, Cambia's SVP of strategic investment and development. "The market needs innovation like this."
Today, Qliance is growing, with six locations in greater Seattle serving about 35,000 patients, including employees from the likes of Expedia, Comcast and a Seattle firefighters union--as well as 15,000 Medicaid patients covered by Centene's Ambetter managed care organization.
If Qliance is able to scale its model regionally, it could be a major boon to healthcare consumers, primary care clinicians, and payers, although insurers are also at risk of losing business from the emergence of direct primary care, unless they're able to help finance it and incorporate it into their offerings, as Centene is trying to do.
Another direct primary care company on the East Coast, Physician Care Direct, is specifically marketing to large and small employers with a self-funding model -- a subscription to primary care with services similar to Qliance's, with a network of acute care hospitals and specialists.
It's "a common sense approach to a problem that's been needlessly complicated by insurance companies," boasts next care's CEO and co-founder William B.J. Lawson.
"We're changing the way people pay for healthcare by offering a free market solution that keeps healthcare dollars and decisions where they belong, between doctors and patients," he said last year, announcing a deal with a clinic network in Texas that's being pitched to employers in greater Dallas-Fort Worth.