Rethinking Primary Care: Thompson Aderinkomi on How NICE Healthcare Is Changing the Way Employees Access Care (Lunch & Learn)

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You're listening to risk and results.
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We're leadership business in risk management column.
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Bring you real conversations, sharp insights, and strategies for success.
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And now for your host, Ben Compris Humber.
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I wanted to give you a little insight to um how I came across Nice Healthcare, uh, who was founded by our speaker.
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Um, we actually have some customers that are located in Minnesota.
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And back in 2018 or 2019, um we were up meeting with uh with a it's actually a church up there talking about health insurance and health care.
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Um they're like, Ben and Ryan was there as well.
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Ricky might have been too.
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But they're like, guys, this sounds great.
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We're really interested in the health insurance piece.
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And they were like, but don't mess with nice health care.
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I was like, what is a nice health care?
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I've never heard of such a thing.
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I was like, that's kind of a strange comment to make.
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Um, but it's this concept around direct primary care where uh it's empowering people to uh get access to free primary care and everything that comes with that.
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And Thompson's gonna talk about that uh to come.
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But what that always stuck in my mind around don't touch nice health care.
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And actually, we had Minnesota customers that uh then began purchasing nice healthcare.
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Um and then I heard in 2022 on a podcast uh an individual talking about uh how she was a consultant in Idaho and how nice healthcare came to Idaho.
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And I was like, well, if they can go from Minnesota to Idaho, they certainly can go from Minnesota to Indianapolis.
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So that is where uh that uh came into be is this idea around doing primary care different.
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And the landscape in Indiana has been um if you know, over the last couple decades, uh the evolution of primary care is around clinics and employers having on-site clinics, um, which has been a decent model for employers, but you have to be of size for that to work.
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And even then, there is quite the effort.
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And uh it's an environment where if you have employees that are sick or needing care, they still have to drive in to the workplace.
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So you're bringing sick people to work.
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It might not even be a convenient drive and the financials of not only providing care, but uh brick and mortar and everything that goes into that can be uh pretty difficult to navigate.
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Um, so that's been uh the iteration uh in Indiana.
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Um, there's been some near site clinics, but again, some similar challenges that it just kind of still feels like a doctor's office and it's the same logistics as a doctor's office.
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So that's why we felt it was really important not just to add another thing in Indiana, but to add something that was really unique that changed changes healthcare delivery uh for employees uh in Indiana.
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So I just wanted to give you that as context.
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Um Thompson's gonna come up here and share about nice healthcare, and then we will have some QA um after the fact.
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So uh we have a world-class, I'm setting the bar high, I guess, but it's true.
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We have a world-class presenter uh in Thompson and just an incredible uh individual that uh is an incredible human, but has really changed uh healthcare uh for the better.
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So I'm really pleased to bring uh Thompson to speak to everyone today.
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Thanks, Ben.
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All right, good morning, everybody.
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Or good afternoon.
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It's still morning for me uh for a little bit longer on central time.
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And we're here to talk about direct primary care.
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And I was just thinking as Ben was talking, like on-site clinics are a type of direct primary care.
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I mean, it's primary care and you're contracting directly with them.
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And so let's first start off with why direct primary care at all?
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You know, why isn't the current fee for service system working for us?
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And what comes to mind for me is I really I like to garden.
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I like to lift weights and I like to garden.
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Those are like my two things, you know, that don't normally go together, I guess.
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You know, and and since I live in Minnesota, I have a bunch of house plants that get me through the winter when I can't garden outside.
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So I have a fiddle leaf fig tree, and these guys are they're so finicky, they complain about everything, you can't do anything right, you know, and no matter what, they just seem to always be dropping their leaves, right?
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So I have this fiddle leaf that is probably at this point about seven or eight years old, in my possession.
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I don't know how old the plant is, and it came to me with a very slender trunk, if you know what a fiddle leaf looks like.
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And I was determined to get it to grow stronger, to get thicker, so it'd be a robust tree.
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But because of where I placed it, it just kept going straight up and got all spindly and to the point where it got to probably, if I would have straightened it all out, probably about 20 feet tall.
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And so it was just incredibly top-heavy.
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The leaves are about half the size of my body, and I kept looking at it year after year, trying to figure out what am I gonna do with this fiddle leaf tree?
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Like it's getting weaker and weaker at the bottom.
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The top is growing out of control.
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I know the right thing to do, I'm just afraid to do it, which is to give it a hard prune back.
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There's apical dominance happening, it's never gonna recover at the bottom, it's never gonna get thicker and stronger.
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And that is how I think about what has happened to primary care and what introduced the concept of direct primary care.
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Because you see, what has happened is in primary care, there's been all this growth at the top that's not actual care, and it's just growing and growing, getting bigger and bigger, heavier and heavier, and styming the growth of what we all actually want, which is a strong root system and a strong trunk.
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And the system is never going to prune itself, right?
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A hard can you imagine the system doing a hard prune?
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It's never gonna do it.
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Someone else has to come in and do that hard prune.
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I I gave that fiddle leaf a hard prune about four weeks ago, and it already looks fantastic.
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Like it's it's amazing how it responded so quickly to taking all that excess junk.
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It looked beautiful, it looked nice, big shiny leaves, but it was completely holding back the base, which is a thing that we actually wanted to grow.
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That is what direct primary care does.
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I was talking to someone yesterday in Idaho, one of our partners in Idaho, a different one than uh Ben mentioned, and she asked me, she said, Okay, I got you one-on-one, Thompson.
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I just have to ask, how do you guys do this so cheaply?
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She's like, it's it seems like there's got to be a catch.
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It doesn't make any sense.
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How do you do it?
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And what I told her is the first thing you have to do is reorient yourself around what it actually costs to provide primary care.
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The what you think it costs to provide primary care is not the real cost.
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So, of course, if you're looking at that price and looking at my price and you see the gap, it seems completely infeasible.
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It doesn't make any sense.
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And you don't wonder, no one ever wonders when I talk to them, well, what are they doing over there that their primary care costs so much?
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They always ask me, what are you doing over here that your primary care costs so little?
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Like, isn't that odd that we that we've been so brainwashed that that is the line of thinking and questioning that we would go down versus questioning those overgrown leaves at the top that are holding back the trunk and the root system?
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That's what direct primary care is.
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Whether it's from nice, whether it's from a DPC down the street, I believe you're buying something better.
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Now, of course, I think nice healthcare is the best.
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So I'm going to explain to you why I think it's the best.
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When direct primary care came on the scene about 16 years ago, I was one of the earliest champions of direct primary care.
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I was screaming it from the streets.
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I started a website that started tracking all the direct primary care practices across the country.
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I wrote a thesis on how direct primary care prices need to fall to$25 PEPM for it to reach scale.
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And if it doesn't, it never will, which it hasn't 16 years later.
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And I also call out some of the deficiencies in the delivery model, which are also part of the deficiencies of an on-site clinic.
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Because you how do you get the care to everybody when you when you're limiting your care to a physical location?
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But how do you get into the full scope of primary care if you limit yourself to virtual only?
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Are you with me?
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This this is what nice healthcare has fundamentally solved with a bunch of other bells and whistles.
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But as you watch and as you listen, you'll be like, really, like, how much is this gonna cost?
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Like, really, like you can do all that.
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Like, how much am I gonna have to pay for that?
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Do people really use it?
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I can assure you, even operating for nine years, people love it, as you heard Ben say.
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So let's get right into it.
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So, this this is gonna be a little bit more uh of a deep dive than my normal presentations.
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Um, our SVP of growth, Jory, he was supposed to be here today, but his wife is gonna have a baby in a couple days, and she didn't want him to leave.
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And so he's like, Can you go instead?
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And so, like, we did a I rearranged my schedule and we made it happen.
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So, so I'm I'm uh I'm not going to be as polished, you know, as I normally am, just kind of bringing you down from Ben's accolades uh a little bit.
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All right.
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So we all so this is what I've gone through.
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You know, nice healthcare is here to solve a problem.
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People ask me, what do I do?
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And sorry, Ben, you're you've now gonna hear all my stuff, all my tricks.
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So, so what what do I do?
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I oh wow, perfect.
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I love it, I love jazz.
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So bring that brass.
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So I tell people, this is what I'm passionate about.
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I'm passionate about my wife.
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She's my best friend.
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I I'm basically my children almost hate it that I'm basically optimized my life around spending as much time with my wife as possible.
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And then after that, it's taking care of my children, being a good son, being a good sibling, exercising, gardening, everything else, all the rest of my time is basically devoted to bending the healthcare cost curve.
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Like, I can't stop thinking about it.
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My wife, she's like, What were you doing at four in the morning?
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Like, I was like, Yes, you're right.
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I was thinking about bending the healthcare cost curve.
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I was down in my home office working on things.
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Like, I'm I am genuinely obsessed with changing healthcare after all of that other stuff, which is much more important.
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And we all know why healthcare isn't nice.
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It's because of the cost, it's because of the inconvenience, it's because when we want it most, it seems to be the most difficult for us to manage.
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I'm gonna look back here just to make sure I don't go over schedule.
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My son, my oldest son, who is the inspiration for nice healthcare when he was one year old.
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He was the inspiration for nice healthcare.
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We went to the clinic, it was expensive, back and forth, for visits.
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I was like, there's gotta be a better way.
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I was a statistician, economist.
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I was like, being a statistician isn't gonna make healthcare any better.
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So I jumped into the entrepreneurship and started a business that ended up being nice healthcare.
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Again, my son, inspiration.
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Um, he's a heavy user of nice healthcare.
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Uh, about a couple weeks ago, he's a mountain biker.
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He's on a downhill mountain biking team, very aggressive, very scary stuff.
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My wife can barely watch it.
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And of course, he falls 12 feet off of a ramp.
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And he didn't get hurt, amazingly.
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All the training that they did around how to fall and how to protect yourself, his full face helmet cracked but protected his head.
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He didn't even have a concussion based on the medical analysis.
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However, everybody wanted him to get that concussion analysis, everybody wanted him to get checked for broken bones, and we got to do that conveniently from our house.
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Conveniently from our house.
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We didn't have to go anywhere, and even better, we didn't have to pay anything.
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I'm gonna get into more about how that episode happened as we go through this presentation.
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So, what is nice healthcare?
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Nice healthcare is a DPC.
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We're direct primary care practice.
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Uh, so think of us like a clinic.
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So don't think of us as a tech company, don't think of us like Teledoc.
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Think of us as you would any other clinic that you might see down the street.
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And then basically, what I'm gonna do is I'm gonna go through a list of things that make us different than a regular clinic and different than a regular direct primary care practice.
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So, what do we do?
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Nice healthcare employs all of our clinicians.
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So, all of our staff are employees of Nice Healthcare.
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We're not renting a network, we're not uh contracting with people who are moonlighting in between their shifts uh at the emergency department.
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These people are our employees and they range from primary care RNs, nurse practitioners, physicians assistants, uh, mental health therapists, physical therapists.
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These are the core of our work staff.
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And then what we did is we layered ancillary services around them.
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So we offer over about 500 prescriptions that are free, included in our membership.
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We offer 35 labs and tests that are free included in our membership, and we offer imaging and extra and EKGs for free in our membership.
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All of this takes place virtually or in the person's home or at the workplace if the uh member or the patient or employee can get a private room for us to see them in the workplace.
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They never have to leave their room or they never have to leave work if they don't want to.
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They don't have to leave their house if they don't want to.
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They never pay for those 500 prescriptions, those 35 labs and tests, those EKGs.
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It's all covered by the DPC fee that we charge, which is a PEPM, and I'll get into that in a little bit.
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And I always fail to mention this.
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We have live care coordinators that are sitting behind our application.
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Those live care coordinators are there.
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You just open up the app, you start talking, and they can answer any question that you have.
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They can get your Rx refill ordered, they can transfer your medical records, they will help you understand how to use a nice healthcare system.
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You don't we don't need to train people how to do it.
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If they can download an app and type, they know how to use nice healthcare, and there's someone there that'll help them understand it if they're confused.
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So, when do you use nice?
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So, this is again where it gets a little bit different.
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We do consider ourselves a primary care clinic.
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So we do wellness and we do acute care.
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If you have an ear infection or a sore throat, we want to see you.
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If you have a sports physical or an annual exam, or you just want to work on your nutrition, we have nutritionists in-house that'll work with you on crafty and accustomed diet to help you reach your goals.
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We have various programs such as perimenopause, diabetes, hypertension, almost all the things that you can think of that you would consider are managed at a primary care clinic.
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We at Nice Healthcare manage that, but all from the comfort of your home or your work seat, wherever you happen to be, we can meet you there, we can make it happen.
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So, how does it work?
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So, I'm not gonna tell you about how what the patient experience is like.
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So, the first thing is who's eligible.
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That's that's up to you, the employer.
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You know, your partner at Connor Insurance is gonna help you define who the population is.
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We don't define who that is, you define who is eligible for nice health care.
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The really cool thing that we did from the get-go is even if one of your employees' dependents is not on your health plan, they can still use nice health care.
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Why?
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Because we don't charge for the dependent, we only charge for the employee.
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So if there's one dependent, we don't mind.
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If there's 10 dependents, and I'm not making that up, that's totally fine too.
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We still charge the same PEPM, they don't have to be on your benefit plan.
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But again, you're gonna work, want to work with your partner at Connor Insurance to figure out what's right for you and what you're comfortable doing.
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So I'm gonna skip a couple slides here and get right to the patient experience.
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So the first thing that usually happens as a patient is you download the app and you create an account and then you schedule a visit.
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It's very easy, it takes about 30 seconds to schedule a visit.
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You can pick the time, you can pick the provider you want to see.
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If you want to see the same person over and over again, you have that availability to do that.
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The app will even tell you, hey, you saw this person last time.
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Do you want to see them again?
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In case you didn't remember their name.
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And so we really are trying to encourage real primary care to develop a relationship to really manage and optimize health.
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And in that virtual visit, we'll do all the normal things that you'd expect would be done at a primary care clinic.
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But so because in time, but suppose that you cannot resolve the issue virtually.
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Imagine a strep test that or looking inside the ear.
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Imagine it's you know, a bone might be broken, perhaps.
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Or maybe we we just actually want to be there in person to be 100% sure we understand what's going on.
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This is where we start to differ from a pure telehealth service.
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We come to you and we'll come to you at your home, we'll come to you at your work.
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I used to joke with people, come to you in the back alley, you know, if you want to, like wherever you want to meet, we'll do it.
00:17:26.960 --> 00:17:30.720
In the early days, we had employers that were outside our service area.
00:17:30.880 --> 00:17:34.319
So we would meet people at libraries, we would meet them at gas stations.
00:17:34.480 --> 00:17:34.880
Why?
00:17:35.039 --> 00:17:41.839
Because it was better for them to drive to the local library and meet us than pay their copay or their deductible or whatever it happens to be.
00:17:42.000 --> 00:17:46.160
And we'll come and do the rapid strep tests, we'll come and do the blood draws, the labs.
00:17:46.400 --> 00:17:48.480
People absolutely love it.
00:17:48.720 --> 00:17:49.440
They love it.
00:17:49.599 --> 00:17:52.000
And some people ask, well, how often do you do it?
00:17:52.160 --> 00:17:54.079
And it's it depends on the age group.
00:17:54.319 --> 00:17:57.519
For children, we're probably coming out about 50% of the time.
00:17:57.759 --> 00:18:11.200
And parents love it because it's like, I would much rather be at home with my one sick child and two healthy children than have to figure out how to get them all somewhere, get someone to come watch them, you know, take them out of school unnecessarily.
00:18:11.359 --> 00:18:18.319
I can't tell you how many times we've had a visit, virtual or in-person, come to our home before we sent the children to school.
00:18:18.559 --> 00:18:23.119
You get that treatment going faster, then children can go back to school sooner.
00:18:23.279 --> 00:18:24.480
Same thing for adults.
00:18:24.640 --> 00:18:30.640
And one of my favorite parts of our in-home visits is the uh multi-person visit.
00:18:30.880 --> 00:18:36.000
A multi-person visit is something that the traditional healthcare system would never do.
00:18:36.240 --> 00:18:37.200
They'll never do it.
00:18:37.359 --> 00:18:44.640
They don't care if you have three children, same diagnosis, same treatment, 30 seconds of doctor time each.
00:18:44.799 --> 00:18:48.240
They're gonna bill you for every single one of those visits.
00:18:48.319 --> 00:18:53.599
And they're probably not even gonna let you build uh schedule those visits back to back because they don't have time in their schedule to do it.
00:18:53.680 --> 00:19:00.799
So now you're scheduling multiple visits, and now you're like, oh, maybe the one healthy child does actually have strep, but they're not presenting as having strep.
00:19:01.039 --> 00:19:05.440
Like, do you schedule a visit for them and then get billed for it only to find out they don't have strep?
00:19:05.680 --> 00:19:09.839
Like, I mean, you can just keep going on and on with how crazy the system is.
00:19:10.000 --> 00:19:12.799
That's why at nice healthcare, we do multi-person visits.
00:19:13.039 --> 00:19:15.839
Like, it just makes it simple, it makes it easy.
00:19:16.000 --> 00:19:18.079
Uh, Ben heard me tell this story earlier today.
00:19:18.160 --> 00:19:23.279
In the early days when we started this company, uh, everybody had to do everything, including me.
00:19:23.440 --> 00:19:29.440
I grew up cleaning the bathrooms and toilets at my parents' company when I was growing up, so I'm not shy to do hard work.
00:19:29.519 --> 00:19:33.759
So in the early days, I was a courier for the company, in addition to being the CEO.
00:19:34.000 --> 00:19:44.480
I remember one very freezing cold January Sunday, a mother with about nine or eight children really wanted to visit because her husband was traveling for work.
00:19:44.640 --> 00:19:47.599
She had about three of her children that she knew had strep.
00:19:47.680 --> 00:19:48.640
How'd she have strep?
00:19:48.880 --> 00:19:49.599
How'd she know?
00:19:49.680 --> 00:19:50.319
She's a mother.
00:19:50.400 --> 00:19:51.519
She knows they have strep.
00:19:51.680 --> 00:19:55.440
But the the other ones were healthy and she didn't know how to get treatment.
00:19:55.920 --> 00:19:57.680
Because I actually asked her, she had a minivan.
00:19:57.759 --> 00:20:00.640
I was like, how do you get the whole family, you know, from one place to the other?
00:20:00.720 --> 00:20:02.079
And she's like, we have to take two cars.
00:20:02.160 --> 00:20:04.000
So I mean, like, I mean, she she admitted it.
00:20:04.160 --> 00:20:09.119
You know, so um the nurse couldn't get there in the early days because we didn't have as much staff.
00:20:09.200 --> 00:20:17.599
And so they're like, Thompson, okay, you gotta go to this family's house, go to the warehouse, grab a bunch of strep tests, and I'll walk you through how to do a rapid strep test.
00:20:17.680 --> 00:20:19.920
And so we don't do this anymore, so don't worry about it.
00:20:20.079 --> 00:20:22.480
So, like, I I don't I don't do that anymore.
00:20:22.559 --> 00:20:25.920
But these are these this are these are the early days, the very early days.
00:20:26.079 --> 00:20:47.920
And so we did a strep test on every child in that house, even the ones that the mother wasn't sure if they were sick, and sure enough, you know, the reason I remember this story so well is that some of the ones that she thought weren't sick were actually sick, you know, and she we just made her life incredibly easy that day to just and then of course in those days we actually carried the prescriptions on us.
00:20:48.160 --> 00:20:55.599
So I actually like I mean, it's not totally legit, you know, but like I like I dispensed, I dispensed the medications, you know.
00:20:55.759 --> 00:21:02.000
Now we got you know security officers and medical advisor, and they would never let me touch a patient in any way, shape, or form.
00:21:02.240 --> 00:21:05.279
So like just just trust me that we are a legit clinic.
00:21:05.440 --> 00:21:13.519
But in the early days, in the early days, we did anything, whatever it took, we did it for the patient and their family.
00:21:13.920 --> 00:21:15.440
Now there's rules.
00:21:15.759 --> 00:21:19.839
Uh so we're we have some pretty broad hours of operations.
00:21:20.000 --> 00:21:22.480
Um, so um, we've recently changed this to local time.
00:21:22.559 --> 00:21:28.160
It used to be super confusing because we started off in central and then we started moving, you know, to west, and then we got some east.
00:21:28.240 --> 00:21:29.920
So now it's just local time.
00:21:30.880 --> 00:21:32.799
Uh let's see, our coverage area.
00:21:32.880 --> 00:21:34.799
So, this is the part I'm most excited about.
00:21:34.960 --> 00:21:37.599
We wouldn't be here today without Connor Insurance.
00:21:38.079 --> 00:21:41.359
Okay, like I wouldn't be in this room without Connor Insurance.
00:21:41.519 --> 00:21:43.839
Indiana was not on our roadmap.
00:21:44.000 --> 00:21:45.920
Um, nothing against Indiana.
00:21:46.000 --> 00:21:50.319
We just had our sights on some other states that we um were looking at.
00:21:50.559 --> 00:21:56.720
And really, you can see we started in Minnesota, so naturally we went to Wisconsin, you know, right away.
00:21:56.799 --> 00:21:58.640
We went up here, we skipped these guys.
00:21:58.799 --> 00:21:59.759
Sorry, like not enough.
00:22:00.240 --> 00:22:04.799
Not enough people, but you can see we try to be contiguous, is what we were trying to do.
00:22:04.960 --> 00:22:14.960
And so it was a big discussion, you know, when Jory came, he was like, Hey, you know, they want us to come to Indiana, uh, because it's it's like jumping a state, Illinois.
00:22:15.039 --> 00:22:25.759
We don't operate in Illinois um for various uh reasons, and so we're here and we opened up with a pretty big service area, like a little bit larger than we normally do.
00:22:25.920 --> 00:22:32.480
And so by service area, what I mean is this is the area that we do those in-person visits.
00:22:33.039 --> 00:22:34.640
Those in-person visits.
00:22:34.799 --> 00:22:48.640
And when we start off in Minneapolis, you know, in Minneapolis, we probably start off in the area about this big, and we just kept expanding year after year, now to the point we cover about 80% of the population of Minnesota.
00:22:48.799 --> 00:22:58.079
So this is just the beginning, and we're already in talks to expand a little bit this way, a little bit that way, and we just partner with Connor and our partners to figure out where we go next.
00:22:58.160 --> 00:23:00.960
So I wouldn't read this map as this is the limit.
00:23:01.119 --> 00:23:07.839
I would read it as this is the beginning, you know, of NICE Healthcare's full service area in the state of Indiana.
00:23:08.000 --> 00:23:14.079
Now, when it comes to our virtual access, our virtual access is available throughout the entire state.
00:23:14.319 --> 00:23:20.559
So wherever you are in Indiana, you can use our virtual access, so you can use our primary care, our mental health, physical therapy.
00:23:20.799 --> 00:23:30.480
You can still get access to all those prescription drugs, you can, but you can't get access naturally to the x-rays, EKGs, uh things of that nature.
00:23:32.720 --> 00:23:35.119
All right, so I'm gonna keep it moving here.
00:23:36.160 --> 00:23:39.920
We're at 20 minutes, the food is coming out, so I'm gonna talk a little bit while you eat.
00:23:40.000 --> 00:23:42.720
So please feel free to eat, you know, make yourself comfortable.
00:23:42.880 --> 00:23:44.160
I'm gonna keep going.
00:23:44.799 --> 00:23:47.119
So again, I've talked about the medications.
00:23:47.279 --> 00:23:52.559
So the way the medications work is there's about 500 prescription drugs that our providers will prescribe.
00:23:52.640 --> 00:23:58.960
Now, our providers can prescribe any drug that we allow clinically, so we do not prescribe controlled substances.
00:23:59.119 --> 00:24:00.559
That's a choice that we've made.
00:24:00.640 --> 00:24:05.119
But outside of that, you know, we prescribe most anything that a traditional clinic would prescribe.
00:24:05.279 --> 00:24:15.759
But out of that um universe of drugs, about 500 of them, if we prescribe it, what happens is there's a pharmacy card inside our app.
00:24:16.079 --> 00:24:18.880
And so the patient goes to their pharmacy of choice.
00:24:19.119 --> 00:24:21.119
Unfortunately, uh, not Walgreens.
00:24:21.279 --> 00:24:23.599
Walgreens uh does not participate in our program.
00:24:23.759 --> 00:24:29.039
And if they present that pharmacy card, the drug is free, they won't pay for anything on that drug list.
00:24:29.759 --> 00:24:33.119
Our mental health therapy uh is very popular.
00:24:33.519 --> 00:24:37.119
I was actually just talking to one of our clients that is an EAP.
00:24:37.440 --> 00:24:40.000
So they're a client of NICE, they're an EAP.
00:24:40.079 --> 00:24:44.400
So they of course have their own mental health therapy within their own product.
00:24:44.559 --> 00:24:56.480
And she admitted to me kind of sheepishly that her staff prefer our mental health to their mental health in their EAP, and they actually tell their clients about NICE health care is mental health.
00:24:56.559 --> 00:25:08.400
So kind of awkward, but we're gonna talk about how to uh we're gonna talk about how to uh partner on that, but a very popular program and very short wait times relative to getting mental health out in the broader market.
00:25:08.960 --> 00:25:12.559
Our virtual physical therapy, again, is very good.
00:25:12.880 --> 00:25:14.079
Uh, people love it.
00:25:14.240 --> 00:25:24.079
And one of the things I like about it is we are helping people explore another path before they go down the surgery path, which is critical for holding down costs.
00:25:24.880 --> 00:25:28.559
And then our specialized programs, I touched on this a little bit already.
00:25:28.720 --> 00:25:35.519
Uh, we have a diabetes, hypertension, weight management with nutritionists, and a perimenopause, menopause program.
00:25:35.759 --> 00:25:38.079
None of this costs anything extra.
00:25:38.400 --> 00:25:43.920
Any one of your employees can open up the app and they can say, Hey, I want to work on nutrition.
00:25:44.160 --> 00:25:47.440
Hey, I want to work on my getting my diabetes under control.
00:25:47.599 --> 00:25:52.720
Like whatever it is, they just help our care coordinators will assign them to the right provider.
00:25:52.799 --> 00:25:58.240
We have specialties within our clinical group that specialize in each of these programs.
00:25:58.960 --> 00:26:01.440
Uh, last but not least, this is a little bit newer.
00:26:01.680 --> 00:26:06.079
Uh, we're introducing it uh for 2027 intelligent referrals with Garner.
00:26:06.319 --> 00:26:11.279
Uh, we I just signed the contract with them uh before I left yesterday uh to get here.
00:26:11.359 --> 00:26:21.119
And what we're doing is we always realize that we have a lot of power because we're referring patients to downstream, complex, more expensive care.
00:26:21.279 --> 00:26:32.880
And we always thought to ourselves, wouldn't it be nice if we could be sure that we're referring them to the lowest cost, highest quality specialists, surgical center, hospital, what have you?
00:26:33.039 --> 00:26:34.720
Now we're gonna be able to do that.
00:26:34.880 --> 00:26:46.799
And so without you lifting a finger, we are going to be routing your members, your employees to the lowest cost, highest quality provider within their network using the trusted data at Garner.
00:26:47.039 --> 00:26:50.799
And again, at no additional cost above what we normally charge.
00:26:52.319 --> 00:26:53.920
So, how do we how do we work?
00:26:54.079 --> 00:27:00.640
We've designed nice healthcare to work with employers of any size, of any type, with any plan type.
00:27:00.799 --> 00:27:04.160
So our smallest clients have 10 employees.
00:27:04.400 --> 00:27:06.240
We love small businesses.
00:27:06.400 --> 00:27:08.960
I grew up with a family that has owned small businesses.
00:27:09.119 --> 00:27:13.759
Our largest client has 10,000 employees in the state of Washington.
00:27:13.920 --> 00:27:16.000
So we can work with everybody in between.
00:27:16.160 --> 00:27:24.960
We work with all industries, professional, restaurants, service, public works, like cities, counties, schools, universities, what have you.
00:27:25.119 --> 00:27:29.359
It doesn't work better or worse for any one industry, and we don't have a preference.
00:27:29.519 --> 00:27:34.720
We just want to help people get access to care, and we want to get them that care as affordably as possible.
00:27:35.039 --> 00:27:40.319
With uh, it works with HSAs, it works with HRAs, it works with copay plans.
00:27:40.720 --> 00:27:45.759
We can make it work, but again, your partner at car insurance is going to be the best one to talk about that.
00:27:46.960 --> 00:27:48.720
So, why choose NICE?
00:27:49.119 --> 00:27:52.240
So, here I'm gonna brag a little bit about us at NICE Healthcare.
00:27:52.319 --> 00:27:53.519
It's our clinical excellence.
00:27:53.599 --> 00:27:57.680
And again, I've I've touched on all of this stuff, so I'm not gonna go through it one by one.
00:27:57.759 --> 00:28:02.400
But one thing that I will hit on very heavily is our privacy and security.
00:28:02.640 --> 00:28:14.480
We have invested millions of dollars in privacy and security, and this is where, again, you start to see some differences between nice healthcare and a traditional direct primary care DPC practice on the street.
00:28:14.640 --> 00:28:20.640
They don't have the resources to invest in a technology and security program the way we have at nice healthcare.
00:28:20.720 --> 00:28:28.559
And we've just found, especially when we're working with uh cities, governments, schools, large employers, that security was a really important thing for them.
00:28:28.720 --> 00:28:36.960
So, about four years in, we made the took the plunge and got SOC 2 type 2 certified, and we are maintaining that uh on an annual basis.
00:28:38.880 --> 00:28:41.200
All right, so I'm gonna keep us going here.
00:28:42.720 --> 00:28:44.400
Skip over a couple slides.
00:28:44.559 --> 00:28:50.160
You know, every digital health service, everybody in nice, everybody in the healthcare industry says that we have a high NPS, right?
00:28:50.319 --> 00:28:58.960
Like, why how how couldn't you love a service that's free to you as an employee and we come to your house, you know, and we take care of your children so naturally you love it.
00:28:59.119 --> 00:29:02.480
The thing that I really want you to look at is this utilization rate.
00:29:02.720 --> 00:29:05.359
The utilization of nice healthcare is strong.
00:29:05.599 --> 00:29:10.880
Once we introduce it to a population, people do use a service and they use it heavily.
00:29:11.039 --> 00:29:19.200
We have a client success team that has spent the last nine years perfecting their playbooks and how to engage employers of any type.
00:29:19.440 --> 00:29:24.559
So in the early days, I talked to employers and say, Oh, I don't think my employees will use that for this and that reason.
00:29:24.720 --> 00:29:32.480
They don't have phones, they don't have, you know, they don't have emails, they don't do this, they don't do that, they don't have phone numbers.
00:29:32.720 --> 00:29:43.759
I mean, we can work with employees of any type, and we have a playbook and a team that's willing to dig deep and do the work to get them engaged, which is evidenced by a very high engagement rate.
00:29:44.640 --> 00:29:53.359
Of course, people love the service, and I'll tell you this one story of uh I was um out in the field, as I like to say.
00:29:53.519 --> 00:29:56.640
I was at child uh Gillette Children's Hospital in uh St.
00:29:56.799 --> 00:29:57.759
Paul, Minnesota.
00:29:57.839 --> 00:30:01.839
They're a client of Nice Healthcare, and they were doing a mid-year benefits fair.
00:30:01.920 --> 00:30:06.799
They decided that it'd be good to educate their employees on their benefits uh outside of open enrollment.
00:30:06.960 --> 00:30:08.640
Really smart move, in my opinion.
00:30:08.799 --> 00:30:15.920
And so they had a benefits fair, and it started at 6:30 in the morning, so that was pretty early, you know, to be ready and suited up at 6 30 in the morning.
00:30:16.000 --> 00:30:18.160
So I was there with all of their other benefits vendors.
00:30:18.319 --> 00:30:26.880
Blue Crossblue Shield was there, their 401k vendor was there, a whole bunch of other vendors that they offered to their employees at Gillette Children's Hospital in St.
00:30:26.960 --> 00:30:28.079
Paul, Minnesota.
00:30:28.319 --> 00:30:33.359
And employees would walk by, and the first one walked by all the vendors and came over to me.
00:30:33.440 --> 00:30:34.799
They didn't know I was a CEO.
00:30:35.200 --> 00:30:36.319
I was just there representing nice.
00:30:36.640 --> 00:30:39.440
They'd walk by all the vendors and say, I love nice healthcare.
00:30:39.599 --> 00:30:42.480
Another one comes in, they'd walk by all the vendors, I love nice healthcare.
00:30:42.640 --> 00:30:43.839
And this just kept happening.
00:30:43.920 --> 00:30:47.279
And all the other vendors were like side-eyeing me like the whole time.
00:30:47.440 --> 00:30:52.799
And finally, this one woman came in and she screamed at the door, nice health care.
00:30:53.119 --> 00:30:56.400
And she walked over to me and we talked about her experiences at nice health care.
00:30:56.640 --> 00:31:01.599
And Blue Crossbook Shield of Minnesota was next to me at the next table, and she kind of she looked over at them.
00:31:01.759 --> 00:31:04.319
She's like, I don't like you guys as much as I like.
00:31:04.400 --> 00:31:18.079
And I and she walked over there and started complaining about some claims issue uh that she was having, you know, and but the thing is, people do love nice health care, and once they get used to it, they only learn to use it more.
00:31:18.240 --> 00:31:30.079
And the more they use it, the more savings that are driven and more ROI is produced for you, the employer, on top of saving them time, saving them money, improving their health, everybody is better off.
00:31:30.799 --> 00:31:35.920
And so, as you can see here, here's an example of a public school that's been with us since 2022.
00:31:36.000 --> 00:31:42.240
They have 91 uh employees on their plan, and the utilization rate has continued to increase year over year.
00:31:42.319 --> 00:31:47.279
So, again, as people use it, they learn about it, they learn how to use it more, they tell other people about it.
00:31:47.440 --> 00:31:57.039
Here's a state county that's been using NICE since 2022, slightly larger, but again, you can see that trend of their utilization going up year over year.
00:31:57.279 --> 00:32:02.000
Here's a medical manufacturer, same trend again, clients since 2022.
00:32:02.079 --> 00:32:04.880
We have some clients that have been with us for over six years.
00:32:05.039 --> 00:32:09.200
Here's a human services organization, a little bit larger than the first ones I showed you.
00:32:09.359 --> 00:32:11.279
Again, you see that trend climbing up.
00:32:11.440 --> 00:32:16.160
And so, because and the reason I show you this is because we're a capitated model, right?
00:32:16.319 --> 00:32:27.680
Like there's a membership fee, and then you would think that I would think that I don't want you to use a service too much because it costs me money and then it depresses my margins.
00:32:27.839 --> 00:32:28.960
That is not the case.
00:32:29.119 --> 00:32:30.400
This is what we want.
00:32:30.640 --> 00:32:33.920
We want you to use a service as much as possible.
00:32:34.079 --> 00:32:40.160
And I'm very proud to tell you all that we are entering our third year at nice healthcare where we have not raised our prices.
00:32:40.720 --> 00:32:41.759
So imagine that.
00:32:41.920 --> 00:32:48.240
Like we have not raised our prices despite the utilization increasing every year from our members.
00:32:48.319 --> 00:32:53.119
And the reason we've been able to do that is investing in technology, investing in process.
00:32:53.359 --> 00:32:59.359
But I have a saying inside our company that I coined a couple years ago, and I call it we operate on an ethical margin.
00:32:59.519 --> 00:33:07.119
Like we believe that you can, as Ben said earlier, you can take two opposing views and make them work together.
00:33:07.279 --> 00:33:12.319
Just because we're a for-profit company providing care doesn't mean we can't make a profit.
00:33:12.400 --> 00:33:18.640
And just because we want to make a profit doesn't mean we can't do the right thing by our members and our clients.
00:33:19.519 --> 00:33:22.240
So last but not least, the pricing.
00:33:22.319 --> 00:33:27.839
So I'll share the pricing, but again, your partner at Connor Insurance is gonna be the best person to talk to about this.
00:33:28.079 --> 00:33:29.519
This is some high-level stuff.
00:33:29.680 --> 00:33:31.039
Um, so let's get to it.
00:33:31.200 --> 00:33:35.440
So our basic pricing is$45 per employee per month.
00:33:35.599 --> 00:33:37.519
You can ignore all this stuff down here.
00:33:37.599 --> 00:33:40.079
We had to do this because of some stupid government regulation.
00:33:40.240 --> 00:33:41.279
We had to break it out.
00:33:41.440 --> 00:33:44.880
So it's$45, you know, for our service.
00:33:45.039 --> 00:33:49.200
That's the full service, the in-home plus virtual, the pharmacy, everything like that.
00:33:49.440 --> 00:33:57.359
And then for um members that cannot access our full service model, uh, it's eight dollars plus all these things.
00:33:57.519 --> 00:34:01.359
And again, we have to display it like this because of a new government regulation.
00:34:01.680 --> 00:34:08.239
So it's about$14 for virtual only members,$45 for the full service.
00:34:08.480 --> 00:34:17.840
For some of our clients that are over 250 employees in size, they prefer to launch on our activation-based pricing or utilization-based pricing.
00:34:18.000 --> 00:34:23.360
And with that, we basically scale up the charge based on utilization.
00:34:23.519 --> 00:34:30.880
And so what we've done here is we've baked in the ROI at every row to reduce the risk of adoption.
00:34:30.960 --> 00:34:35.679
Because sometimes for larger clients, it takes a little bit more work to get that adoption going.
00:34:35.760 --> 00:34:41.679
Whereas in a you know, single office 50-person company, like people start using it right away as soon as we explain it to them.
00:34:41.840 --> 00:34:47.679
And then for our very large clients, um, we're talking over a thousand employees.
00:34:47.840 --> 00:34:53.119
We've created this model where it starts off at five dollars per employee per month.
00:34:53.360 --> 00:34:57.039
So it's just, you know, a thousand employees times five times 12.
00:34:57.199 --> 00:34:57.920
That's the bill.
00:34:58.079 --> 00:35:00.480
And the more they use it, the more we charge.
00:35:00.639 --> 00:35:07.280
But the way we've designed it, same with that other table, is your ROI actually increases the more that it's used.
00:35:07.440 --> 00:35:15.360
Unlike most services where we start charging you more, we're actually charging you less per unit of utilization as you scale down that table.
00:35:15.519 --> 00:35:19.360
Again, that's our commitment to the healthcare industry and to an ethical margin.
00:35:21.199 --> 00:35:27.599
And then last but not least, that intelligent referral by Garner is included at no cost.
00:35:27.760 --> 00:35:32.400
So we're not charging extra for that, we're bundling that into our service.
00:35:32.480 --> 00:35:35.599
And that's pretty much in line with the way we've done things at nice healthcare.
00:35:35.679 --> 00:35:40.159
When we started the company in 2017, we only launched with primary care.
00:35:40.320 --> 00:35:41.679
That's the only service we had.
00:35:41.840 --> 00:35:49.679
And then we added pharmacy, then we added mental health, then we added physical therapy, then we add now we're adding intelligent referrals with Garner.
00:35:49.760 --> 00:36:03.920
And whenever we did that, we did our best to not increase the price or not increase it too much and absorb as much of it as we can and instead turn those savings back over to you, the employees and the employers, so that we can maximize savings.
00:36:04.000 --> 00:36:23.199
Because again, as I started out, after I do all the most important things in my life on a day or in a week or in a month, every ounce of my energy is devoted to destroying the healthcare system that is holding us all back, just like that tree I described at the beginning of this talk.
00:36:23.440 --> 00:36:25.119
That's what nice healthcare is doing.
00:36:25.280 --> 00:36:31.840
And the goal for us truly, I know it sounds kind of sappy, but I I want to see all of us thrive.
00:36:32.079 --> 00:36:34.400
I really do want us all to thrive.
00:36:34.639 --> 00:36:41.039
And thriving is not only physical health, it is mental health, and for better or worse, it's financial health.
00:36:41.199 --> 00:36:43.760
And nice healthcare is attacking all those things.
00:36:43.920 --> 00:36:47.440
So I'll stop there and see if there's any questions.
00:36:52.800 --> 00:36:57.119
Can you explain Garner specifically for those that aren't familiar with it in the room?
00:36:57.280 --> 00:36:59.599
Like what's why is why is that so good?
00:37:00.320 --> 00:37:01.360
Yeah, sorry about that.
00:37:01.440 --> 00:37:02.239
That's a really good point.
00:37:02.320 --> 00:37:03.920
So explain what Garner is.
00:37:04.079 --> 00:37:19.119
So Garner is, they would say, and I would tend to agree with them, the industry leader in data around where to send a patient for care that is the highest quality and lowest cost.
00:37:19.360 --> 00:37:23.519
They've amassed millions and millions of rows of data across the entire country.
00:37:23.679 --> 00:37:26.880
They have network data and they've figured out a way to do this.
00:37:27.039 --> 00:37:29.039
And they've now partnered with Nice Healthcare.
00:37:29.119 --> 00:37:47.760
We've partnered with them to incorporate that data into our clinical workflow so that when our primary care clinicians make a referral, say for a surgery or something expensive or complex, we are using that data to guide people to the right place to drive savings and higher out uh better outcomes for employers.
00:37:52.880 --> 00:37:56.000
All right, can you expand upon your delivery method?
00:37:56.159 --> 00:37:58.159
Uh I don't see clinics around here.
00:37:58.239 --> 00:38:06.559
So tell me how you take care of where you take care of uh Yeah, so we take care of employees without any physical clinics.
00:38:06.719 --> 00:38:09.920
So the question is how do we actually take care of patients?
00:38:10.159 --> 00:38:12.639
So most of our care is provided virtually.
00:38:12.880 --> 00:38:18.880
So in our app, a patient downloads our app, they schedule a visit, they get the care, they're done.
00:38:19.039 --> 00:38:23.760
But sometimes we do need to come see you in person, just like a physical clinic does.
00:38:23.920 --> 00:38:38.639
So instead of you driving to a clinic, we come to your house and we do the x-ray in your house, we do the blood draw in your house, we do the physical exam in your house, or we come to your workplace if that's where you choose to be, or we come to wherever you happen to be to do that work.
00:38:38.719 --> 00:38:43.199
And there's a tight integration between that virtual care and that in-person care.
00:38:43.280 --> 00:38:45.599
They're the same team, they're in constant collaboration.
00:38:45.679 --> 00:38:59.599
And one of the most frequent feedbacks that we've gotten is people can't believe how seamless the whole thing is with having a virtual person and an in-home person, they somehow are magically in cahoots making sure that you're getting the best care possible.
00:39:01.360 --> 00:39:05.360
I'm curious about the physicians that are attracted to work with people.
00:39:05.599 --> 00:39:14.159
What what uh what attracts them and kind of what is your retention rate of your physicians and staff?
00:39:14.559 --> 00:39:24.320
Yeah, our our head of HR was actually just talking about this a couple months ago, and our retention rate is about twice that of a normal clinic or a normal hospital.
00:39:24.480 --> 00:39:32.400
Because as you can imagine, you know, the type of person that would come work for us is someone that values the same things that we value.
00:39:32.559 --> 00:39:37.519
They don't want to be burdened by the administrative overhead of the traditional system.
00:39:37.679 --> 00:39:42.639
They want to work for a place that is not only making people physically well, but financially well.
00:39:42.800 --> 00:39:45.840
Uh, we do not employ any physicians per se.
00:39:46.000 --> 00:39:48.559
We do employ nurse practitioners and physicians' assistants.
00:39:48.719 --> 00:39:59.280
That's why, if you look at that map, that map happens to be following the states that allow um nurse practitioners to practice independently and fully, uh, autonomously uh from an MD.
00:39:59.679 --> 00:40:17.199
And um the other reason that people come to work for us is some clinicians, they like going into people's homes because for them it's a much more intimate of relationship and they can get a much better view of someone's environment to inform how they treat and diagnose the patient.
00:40:20.800 --> 00:40:27.039
Are your are the nurse practitioners and physicians assistant, are they contract employees tonight?
00:40:27.280 --> 00:40:29.119
Are they full-time employees?
00:40:29.920 --> 00:40:30.960
Perf great question.
00:40:31.119 --> 00:40:33.280
They are full-time employees of NICE Healthcare.
00:40:33.360 --> 00:40:37.519
So they are not 1099 contractors, and we are not renting a network.
00:40:37.760 --> 00:40:54.800
It's been we have the debate every year, to be honest, you know, because we have other we know other companies that do full contractors, uh, but the problem with that is that feature I mentioned in our app, you know, where the app says, hey, you saw, you know, nurse practitioner Alex, you know, last time.
00:40:54.960 --> 00:40:56.559
Like maybe you want to schedule with them.
00:40:56.639 --> 00:41:07.280
You don't have to schedule with them again, but it does help build that relationship to optimize health if you have at least the ability and awareness to know that you can see the same provider over and over again.
00:41:07.519 --> 00:41:10.000
And the same thing happens with the home visits as well.
00:41:10.239 --> 00:41:25.840
You know, I was talking to one of our paid our clients, and she said the one thing she loves about nice is that basically whenever someone comes to her home, it's always the same two providers, you know, that comes to her because our providers are assigned to regions themselves within the region, and they kind of cover that delivery area, if you will.
00:41:26.000 --> 00:41:34.320
So you do get to know the person coming to your house, they get to know you, your dog, like they get to know how things work, and you do build a relationship over time.
00:41:37.280 --> 00:41:42.960
Um, we have a lot of employees that work remotely throughout the US, mostly East Coast.
00:41:43.199 --> 00:41:48.880
Do you see nice moving into more that kind of state?
00:41:49.519 --> 00:41:56.320
Yeah, the question was do we see nice moving towards the East Coast or maybe in general into states that we don't currently operate in?
00:41:56.480 --> 00:41:57.599
The answer is yes.
00:41:57.760 --> 00:42:03.199
Uh, we like for example, we didn't operate in Indiana uh, you know, 12 months ago.
00:42:03.440 --> 00:42:07.360
You know, so I mean, and now we're here with a really big service area, it can happen.
00:42:07.599 --> 00:42:13.519
We just need the right partner, we need the right anchor clients to get us started, and we don't need that many.
00:42:13.679 --> 00:42:18.079
You know, I I mean my operations team would kill me if I said this, so don't tell them.
00:42:18.239 --> 00:42:22.400
But I say we only need about 500 to 750, like in a new area.
00:42:22.559 --> 00:42:28.079
They say it's 2,000, but we we can compromise, you know, somewhere, you know, uh in between.
00:42:28.239 --> 00:42:40.719
And uh, so yeah, so I was actually about four weeks ago talking to a um agency in Maryland, for example, and they absolutely want us to come to Maryland because they're having some pretty bad access issues uh for their employees.
00:42:43.039 --> 00:42:47.760
A common example among our house, uh especially kids, is ear infections.
00:42:48.159 --> 00:42:52.239
And I got an ear infection, and then I gotta go into the doctor's office, get a prescription.
00:42:52.480 --> 00:42:56.880
Is that something that can be written over the virtual visits, or is that something that has to be?
00:42:58.960 --> 00:43:05.599
So it's a clinical decision, and so this is proof that we don't contract our clinicians.
00:43:05.679 --> 00:43:07.760
It would depend on the clinician that you see it nice.
00:43:08.159 --> 00:43:20.800
Some nurse practitioners with 25 years of experience that have seen a million ear infections, they might be like, hey, this is an ear infection, like virtually, you know, whereas someone else might be like, No, I want to double check.
00:43:20.960 --> 00:43:30.960
You know, also if we've seen three ear infections in the same person, from what my staff tell me, at that point they're just gonna skip the home visit and just you know, write the prescription.
00:43:31.440 --> 00:43:35.920
And is that turnaround time a virtual a uh C in person?
00:43:36.079 --> 00:43:37.039
Is that twenty-four hours?
00:43:37.199 --> 00:43:38.800
Is that 72 hours how it's out?
00:43:39.440 --> 00:43:40.559
It it depends.
00:43:40.719 --> 00:43:42.639
It's typically the same day.
00:43:42.960 --> 00:43:51.360
You know, so for example, with that example with my son, he had a virtual visit at eight in the morning and there was someone in our house at 10 a.m.
00:43:51.920 --> 00:43:53.840
You know, so I mean it it you know depends.
00:43:53.920 --> 00:44:02.719
What I what I tell people when I'm out is because nice doesn't cost you anything, you the patient doesn't cost cost you anything, you no longer have to hesitate.
00:44:03.039 --> 00:44:05.039
Remember how I talked about how we've been brainwashed?
00:44:05.199 --> 00:44:08.480
Another way we've been brainwashed is we've been brainwashed to wait.
00:44:08.719 --> 00:44:21.280
To wait, wait, wait, put it off, put it off until it's just bad enough, you know, that you have to take the plunge and use your time and resources and money to get to care of nice healthcare, that is not the case.
00:44:21.440 --> 00:44:26.960
So one of the hardest things I have found to educate people on is look, schedule the visit at 7 a.m.
00:44:27.119 --> 00:44:27.760
for God's sake.
00:44:27.920 --> 00:44:32.079
Like, you know, like don't don't do it at 7 p.m, you know, or for the next day.
00:44:32.239 --> 00:44:33.360
Like schedule it at 7 a.m.
00:44:33.519 --> 00:44:39.760
Because if you do it then the virtual visit, you know, early in the morning, then we can get someone out to your house late in the morning or in the afternoon.
00:44:39.840 --> 00:44:44.000
But if you wait, wait, wait, and oh my God, actually I didn't actually get better during the day.
00:44:44.079 --> 00:44:46.320
Now you're trying to have a virtual visit at 6 p.m.
00:44:46.559 --> 00:44:49.039
Well now we're not going to be able to get to your house till the next day.
00:44:49.199 --> 00:44:55.039
But people, you know, they're just so conditioned, you know, to not want to um spend money or time.
00:44:55.280 --> 00:45:02.880
So I would say that's the best thing you can do with our program is schedule early, schedule often so that we can take care of you as quickly as possible.
00:45:03.119 --> 00:45:04.480
I saw a hand back there.
00:45:05.039 --> 00:45:06.639
Two questions unrelated.
00:45:07.920 --> 00:45:14.320
How do you do physical therapy in a virtual I mean virtual environment?
00:45:14.880 --> 00:45:22.960
Yeah so our physical therapy doesn't work for every case and for every patient uh but it is incredibly effective.
00:45:23.280 --> 00:45:26.639
It's been documented and researched medical journeys.
00:45:26.800 --> 00:45:34.239
And so our internal team have a medical protocol that will tell someone like look you can't do physical therapy with us.
00:45:34.320 --> 00:45:38.159
They're not going to have you do five sessions and then say oh it's not going to work.
00:45:38.320 --> 00:46:20.320
They'll tell you up front so for example um I can't remember if I told this story before at the end March but you know I I had a goal of you know deadlifting uh 500 pounds and I was really probably overworking myself at my age um and not giving myself enough rest and I injured myself in my deadlift training I was lying on the ground immobile but I had my phone do do do do do like you know got you know got got nice going and they're like sorry boss like we can't take care of you you know so even myself right like they just they just straight up told me like no that that is outside the scope of our physical therapy and you got to go in person to get that rectified next question.
00:46:21.440 --> 00:47:29.280
Do you uh uh since you're in primary care um do you in feed um uh EMR data into some of the um health system uh EMRs uh um for example um yeah so you do you feed primary care both ways into uh some of the um uh the larger EMR providers yeah so this is a technical question and a philosophical question all wrapped into one about whether how much data we share with the the system first technical um we don't have any live data feeds with insurance companies or large health systems but we do release healthcare records you know at the request so the patient has to sign a form and the app allowing us to share that tells us where to send it and we send it and most of the time we're way too fast for the health system anyways you know like they can't even handle how fast we you know handle things so we will we will always share medical records but it has to be initiated by the patient you know to authorize us to do that.
00:47:29.679 --> 00:47:32.719
Just to follow up yes I get the consent.
00:47:32.960 --> 00:48:07.599
Oh okay I got I got that but so after the consent um if you uh generate a a 40 page fax that spits out you know internally to the uh the EMR no one's gonna see it even though you got rid of it but if it populates um lab results and other kinds of data I then the provider on the other side is just gonna be in there with all the other data.
00:48:08.320 --> 00:48:46.639
So that's my question is and then maybe we should talk after yeah yeah we we don't have any control over what they do with the data but we do send all the data um that would be yeah okay so I can definitely see how you utilizing nice data reduces um patients overall care and supposed to reduce the cost for traditional insurer like NATO or united do you have examples of nice people like negotiations to reduce the cost of signing up for the other insurance for traditional insurance?
00:48:47.039 --> 00:48:47.920
Yeah we do.
00:48:48.159 --> 00:49:08.159
In many of the states that we operate our clients that are fully insured uh also self-insured on their stop loss uh get a decrement to their premium you know so for example we just had a client sign up in Minnesota and they got a 2% decrement on their premium you know for implementing nice health care.
00:49:08.719 --> 00:49:12.000
The interesting thing is the insurance companies don't like doing it.
00:49:12.239 --> 00:49:34.480
Like I mean they're not like happy to do it but they've in a way been forced to do it in the markets where we've gotten enough density and enough evidence where they can't ignore it and their you know agency partners broker partners or themselves are advocating for themselves being like look like you've let healthcare run amok so bad that I am now buying a portion of it on my own.
00:49:34.639 --> 00:49:38.079
And so you need to you know reduce the cost of our premium to do that.
00:49:38.239 --> 00:49:45.280
I would say that's the closest and that's that's happening pretty broadly in almost every state that we operate in but not every carrier is willing to do it.
00:49:45.360 --> 00:49:48.320
They have different rules about how they decide to do it.
00:49:48.480 --> 00:50:02.480
And um in some cases I remember there's one extreme case where the the the premium was so large and once they got that percentage decrement that they were effectively getting paid to implement nice health care.
00:50:02.719 --> 00:50:05.119
Very rare you know um but it did happen.
00:50:05.679 --> 00:52:27.039
Real quick to that um in in the ecosystem as we see it um our level funded product for smaller and mid-sized businesses gets a 4% premium decrement for implementing nice health care uh from the underwriter and then in the self-funded space um we do have ROI calculations from nice healthcare that we use in in conversation with with stop loss now just obviously goes all into the negotiations course but uh we have the data that that just doesn't say that hey this is a great employee experience but actually it is delivering a return on investment that hey we're we're paying in$45 PEPN and we're actually creating reduction of you know over$90 PEPM uh of um actual use great thank you um I saw in there for the prescriptions that you do not service through Walgreens and over time we're seeing Walgreens is definitely being faded out of the system um and a lot of our employees live in some smaller towns and go to like the mom and pop pharmacies do you have any other restrictions Walgreens or is just Walgreens yeah so none that I'm aware of the pharmacy card should work um and uh it's it's not a technical issue it's that them refusing or like they're actively refusing the card yeah so I've so any pharmacy could say no I'm not gonna take it but so far only Walgreens has done that that was my question okay oh okay all right excellent bogotion so um uh just with like you know GLPs like lots of products possibly those are huge these days there's your clinicians um are there certain like there's there are certain ends that they must provide more uh a product like a certain BMI or a certain uh you know uh cholesterol anything like that clue things pretty open to do whatever clinician in your practice next place to do they prescribe something like that.
00:52:27.360 --> 00:52:48.719
Yeah that's a hot topic GLP ones do we restrict the prescriptions prescribing of GLP ones uh first of all level set we don't um dispense GLP ones so we're not a seller that's one of the things that we've decided as a company is that we never want to profit on selling things you know to customers so we'll probably never ourselves actually sell GLP ones.
00:52:49.039 --> 00:52:57.039
Um we had a broker call us angrily in Colorado and say you guys need to stop prescribing GLP ones.
00:52:57.119 --> 00:53:03.199
Like just wanted to stop like I was like well I legally can't tell my clinicians how to practice medicine.
00:53:03.360 --> 00:53:05.519
So that's the first issue but we can look into it.
00:53:05.599 --> 00:53:37.679
So we actually spent a couple of months talking about it, you know, going back and forth you know he came to an understanding of what our limitations were and we actually at his prompting kind of just I'll tell you the story to kind of show some how we collaborate with our partners uh we created a program within Nice Healthcare where we now have a specialized group of clinicians who are authorized to prescribe GLP once and the patients need to meet with them, you know, to get that prescription versus before we were just you know we were letting clinicians make their own judgment you know as a soft fit.
00:53:37.760 --> 00:53:44.320
So it's not a restriction uh but it's um I would say we kind of met in the middle with how to handle that.
00:53:48.880 --> 00:54:40.400
Some good questions any other questions all right um thank you Thompson very much and that was a and before everyone leaves if you could the cost of lunch is only a survey response that's it that is the only cost of lunch um so please get your phones out uh and give us some feedback that would be greatly helpful um you know it's interesting um I don't know if this is the best note to leave on but something I've been thinking about with nice healthcare is it's really hard to describe uh so the question uh over here was like can you explain that again like how are you delivering care?
00:54:40.559 --> 00:55:00.079
That's a great question um because it is really it can be really hard to explain um but you know one thing I've been trying to make sure in my communication which is absolutely worse than Thompson's is when I'm talking to an employer to communicate it in a way that doesn't compare it to telemedicine.
00:55:00.320 --> 00:55:02.719
It is so not telemedicine.
00:55:02.880 --> 00:55:04.239
It's something so different.
00:55:04.320 --> 00:55:08.480
And that's why I actually use the example of a clinic to start out.
00:55:08.960 --> 00:56:15.440
But one thing that I was thinking and um there are a lot of direct primary care clinics around where you pay a membership to have a doctor okay and and we've heard of concierge member or medicine where you know these CEOs will spend all of this money to have their own private doctor right and then I got to thinking about well when we have those private doctors what do they give us that is so valuable they give us their cell phone number right and we can contact them directly so what usually happens when the CEO elite class when they have private healthcare how do they start they start by texting or calling their doctor right and that to me was the light bulb when I broke when I broke it down to that because what we're doing with nice healthcare and an access is we're allowing employees to pay zero dollars for all of the things that Thompson just talked about.
00:56:15.840 --> 00:56:37.599
And it starts with texting and calling the doctor and we've given that to all of our employees to have the same access to private concierge medicine uh as as what everyone desires rather than having to go and do the whole madness of taking kids to the doctor for a nine minute visit.
00:56:38.000 --> 00:56:52.639
So thank you for coming today we we are really glad you joined us and we'll catch you we'll catch everyone soon thanks for tuning in to risk and resolve see you next time