1 00:00:01,501 --> 00:00:05,538 And now America's Healthcare Advocate, Cary Hall. 2 00:00:05,939 --> 00:00:08,475 Hello, America. Welcome to America's Healthcare Advocate show. 3 00:00:08,475 --> 00:00:13,313 We're broadcasting coast to coast across the USA here on the HIA Radio Network. 4 00:00:13,446 --> 00:00:14,180 You can find out 5 00:00:14,180 --> 00:00:17,951 more about us by going to the website AmericasHealthcareAdvocate.com. 6 00:00:18,151 --> 00:00:19,753 All of our shows are posted up there, 7 00:00:19,753 --> 00:00:22,756 as well as our podcast platform and YouTube platform. 8 00:00:23,089 --> 00:00:25,291 By the way, I want to thank everybody, the audience. 9 00:00:25,291 --> 00:00:30,430 We're up to 429,873 views on YouTube and 10 00:00:31,531 --> 00:00:35,435 107,078 plays on our podcast platforms. 11 00:00:35,468 --> 00:00:38,405 Dave Thiessen provided me with all of that information 12 00:00:38,405 --> 00:00:41,074 the other day, and I was quite surprised to see the numbers up so HyVee. 13 00:00:41,074 --> 00:00:42,642 So we thank all of you out there, 14 00:00:42,642 --> 00:00:45,779 and those of you listening on terrestrial radio to our over 15 00:00:45,779 --> 00:00:49,149 200 stations around the country in studio with me today. 16 00:00:49,315 --> 00:00:52,919 We have two guests from HyVee, the Exemplar Care doctor Jon Van 17 00:00:52,919 --> 00:00:56,489 Der Veer is here and Jaci Robson here from HyVee Exemplar Care. 18 00:00:56,523 --> 00:00:58,091 Welcome to the studio today. 19 00:00:58,091 --> 00:00:58,992 Thank you. 20 00:00:58,992 --> 00:01:01,194 We're going to have a fascinating show today. 21 00:01:01,194 --> 00:01:06,533 If you're an individual on an ACA or as I call it Obamacare health insurance 22 00:01:06,533 --> 00:01:09,536 policy, or even if you're a small employer or a large employer, 23 00:01:10,136 --> 00:01:13,073 you've probably dealt with what's going on in this marketplace 24 00:01:13,073 --> 00:01:18,111 in terms of high cost, high deductibles, not a lot of care for your employees, 25 00:01:18,111 --> 00:01:21,147 a lot of dissatisfaction with these plans as the years have gone on. 26 00:01:21,514 --> 00:01:24,717 We're going to talk about a model today that is significantly different. 27 00:01:24,918 --> 00:01:29,255 It's an opportunity for primary care, direct pay, 28 00:01:29,923 --> 00:01:33,026 membership in a program that we think is going to make a big difference 29 00:01:33,026 --> 00:01:34,527 here in the Kansas City metro. 30 00:01:34,527 --> 00:01:37,097 So with that, I want to go to Doctor John Van Veer. 31 00:01:37,097 --> 00:01:37,831 Doctor. 32 00:01:37,831 --> 00:01:41,000 So how did you come up with this model and this concept? 33 00:01:41,000 --> 00:01:42,368 This is your baby. 34 00:01:42,368 --> 00:01:43,770 It's a lot of people's babies. 35 00:01:43,770 --> 00:01:45,438 But yes, this version is mine. 36 00:01:45,438 --> 00:01:48,608 So the, the idea of direct primary care 37 00:01:48,608 --> 00:01:51,911 has kind of been out in the ether, for a while. 38 00:01:51,911 --> 00:01:57,517 And I basically was I, like you said, you are a recovering “broker”. 39 00:01:57,517 --> 00:01:59,519 I am a recovering “fee for service” doctor. 40 00:02:00,520 --> 00:02:02,155 And it took 41 00:02:02,155 --> 00:02:04,757 kind of a breaking point in burnout to really realize 42 00:02:04,757 --> 00:02:08,495 there's a better way to deliver care and then for the patients to receive care. 43 00:02:08,761 --> 00:02:13,366 So this model, just allows for that type of interaction to take place. 44 00:02:13,700 --> 00:02:17,237 So, Jaci, talk a little bit about the membership model and how this works 45 00:02:17,237 --> 00:02:20,573 and how this is significantly different to what we see 46 00:02:20,573 --> 00:02:22,842 in a typical primary care practice. Jaci. 47 00:02:22,842 --> 00:02:26,679 So the membership model is that for a monthly membership, 48 00:02:26,846 --> 00:02:30,450 you can receive all services that we provide in our clinics, 49 00:02:30,750 --> 00:02:34,320 which is all services, primary care or urgent care. 50 00:02:34,387 --> 00:02:37,657 So 80% of what most people's health care needs are. 51 00:02:37,891 --> 00:02:39,993 One of the things that I when I was researching this 52 00:02:39,993 --> 00:02:42,729 and going through the website and looking at, 53 00:02:42,729 --> 00:02:45,965 you know, how this is offered and where it's different than what we see 54 00:02:45,965 --> 00:02:47,467 in typical primary care. 55 00:02:47,467 --> 00:02:51,404 The average time spent with the primary care doctor in this country is 7.5 minutes. 56 00:02:52,405 --> 00:02:55,074 One of the things which is not good, doctor. 57 00:02:55,074 --> 00:02:58,878 One of the things that's emphasized in your model is the time 58 00:02:58,878 --> 00:03:02,815 spent with the patient, the ability to listen to what the patient has to say, 59 00:03:03,016 --> 00:03:05,652 and then be able to translate that into a program 60 00:03:05,652 --> 00:03:09,355 that's going to make a difference in terms of their care, their ongoing care. 61 00:03:09,556 --> 00:03:11,491 Disease management and health care. 62 00:03:11,491 --> 00:03:14,360 So let's talk a little bit about that. You hit that exactly on the head. 63 00:03:14,360 --> 00:03:17,430 So everyone wants to practice evidence based medicine, 64 00:03:17,430 --> 00:03:21,801 but people don't often talk about the fact that the time spent with a patient 65 00:03:21,834 --> 00:03:26,239 often leads to more accurate diagnoses and thus better treatment plans. 66 00:03:27,040 --> 00:03:31,778 And our model, we have 30 minute follow up visits, 60 minute new patient visits. 67 00:03:31,778 --> 00:03:34,447 I've had new visits, as long as two hours. 68 00:03:34,447 --> 00:03:36,849 So it's not that rat race. 69 00:03:36,849 --> 00:03:39,319 Where how fast can you get someone through, 70 00:03:40,386 --> 00:03:41,554 to get on to the next person? 71 00:03:41,554 --> 00:03:45,124 Because in a traditional system, your job is to see them, triage them, 72 00:03:45,124 --> 00:03:49,395 and move them on to whatever specialist or other care piece is downstream 73 00:03:49,562 --> 00:03:53,266 in this par alignment of the better I take care of you, 74 00:03:53,900 --> 00:03:56,269 the better you feel, the less I have to see you. 75 00:03:56,269 --> 00:03:58,871 Which actually goes into a membership model. 76 00:03:58,871 --> 00:04:01,474 The better I'm doing, the less work I have to do. 77 00:04:01,474 --> 00:04:05,311 But at the same time, when you need me, I then have time and availability 78 00:04:05,311 --> 00:04:06,512 to actually spend with you. 79 00:04:06,512 --> 00:04:09,182 So, Jaci, talk a little bit about the convenience of this. 80 00:04:09,182 --> 00:04:11,417 I mean, these are in the Hy-Vee stores now. 81 00:04:11,417 --> 00:04:14,854 We have them here in Lee's Summit in Overland Park in the Kansas City Metro. 82 00:04:14,854 --> 00:04:17,557 You've been in Iowa and Nebraska for some time. 83 00:04:17,557 --> 00:04:19,092 So talk a little bit about that 84 00:04:19,092 --> 00:04:22,996 and how that model works again, differently than the primary care model, 85 00:04:22,996 --> 00:04:27,467 where you may wait two weeks or months to see your primary care doctor. 86 00:04:27,800 --> 00:04:29,168 This is significantly different. 87 00:04:29,168 --> 00:04:30,903 It is significantly different. 88 00:04:30,903 --> 00:04:34,707 And they’re not actually in the Hy-Vee stores, thery’re near 89 00:04:34,707 --> 00:04:38,811 two are close to a Hy-Vee store so that we can work with Hy-Vee 90 00:04:38,978 --> 00:04:42,749 and help them to, take care for their employees. 91 00:04:43,016 --> 00:04:45,852 So they're actually close to it or near to a Hy-Vee. 92 00:04:45,852 --> 00:04:49,022 So yes, we now have one in Lee's Summit and here in Overland 93 00:04:49,022 --> 00:04:52,025 Park, it's at West 135th Street. 94 00:04:52,392 --> 00:04:55,395 And the convenience of it is that 95 00:04:55,528 --> 00:04:58,831 people can come see the longer appointments. 96 00:04:59,065 --> 00:04:59,766 And then once 97 00:04:59,766 --> 00:05:03,636 they've actually established, they can connect with the doctor provider 98 00:05:03,636 --> 00:05:07,607 any way they need to from where they're at, so they can send messages, 99 00:05:07,607 --> 00:05:11,644 they can do virtual, they can have those, calls with them 100 00:05:11,644 --> 00:05:15,281 from whenever they need to, wherever they need to get the care that they want. 101 00:05:15,481 --> 00:05:18,151 And it's all included in that membership. 102 00:05:18,151 --> 00:05:19,986 Can I share an example with me? 103 00:05:19,986 --> 00:05:25,024 So we were driving from, West Des Moines down to Kansas City Market today, 104 00:05:25,024 --> 00:05:29,295 and I received a phone call from a patient who said, hey, I've got a rash. 105 00:05:29,295 --> 00:05:31,030 This is what's been going on. 106 00:05:31,030 --> 00:05:35,201 I said, well, I'm not in Des Moines today, but somebody could see you. 107 00:05:35,201 --> 00:05:36,803 Or if you want to shoot me some pictures, you can. 108 00:05:36,803 --> 00:05:38,237 So he sends me pictures. 109 00:05:39,205 --> 00:05:39,972 I looked at it. 110 00:05:39,972 --> 00:05:43,543 He has shingles and his antibiotic or his antiviral 111 00:05:43,743 --> 00:05:48,681 has now been sent in across the state line, to his regular pharmacy. 112 00:05:48,681 --> 00:05:52,285 And he's getting the care he needs without having to even step foot in a clinic. 113 00:05:52,618 --> 00:05:56,122 So the and that's, that's remarkable because they were able 114 00:05:56,122 --> 00:05:57,390 to resolve that problem right away 115 00:05:57,390 --> 00:05:59,959 and not have to wait to get an appointment and come in. 116 00:05:59,959 --> 00:06:03,296 Can they connect when you're when you're members, your patients connect, 117 00:06:03,296 --> 00:06:04,864 do they come back to the same doctor 118 00:06:04,864 --> 00:06:06,899 each and every time if that doctor is available. 119 00:06:06,899 --> 00:06:08,634 How does that work? They do. 120 00:06:08,634 --> 00:06:13,239 They also we like to view Hy-Vee Health Exemplar care kind of as the provider. 121 00:06:14,040 --> 00:06:17,043 If you're a member in West Des Moines and you're watching a Chiefs game, 122 00:06:17,443 --> 00:06:21,414 you can go into the Overland Park clinic and be seen just like any other member. 123 00:06:21,414 --> 00:06:25,151 So yes, you can see the same person for continuity on the primary care side, 124 00:06:25,151 --> 00:06:26,853 but if you have a need that you just need, 125 00:06:26,853 --> 00:06:30,690 taking care of the entire system is built to take care of members. 126 00:06:30,890 --> 00:06:33,926 And so if they're if they're not in their particular metro, 127 00:06:34,460 --> 00:06:37,897 if they happen to be in Des Moines or I'm back and forth to Nebraska all the time, 128 00:06:38,464 --> 00:06:42,602 you would be able to go into any of the Hy-Vee Exemplar clinics and do this. 129 00:06:42,602 --> 00:06:44,337 And you get moved to the front of the line. 130 00:06:44,337 --> 00:06:46,038 You get treated like a member. 131 00:06:46,038 --> 00:06:47,940 It doesn't matter where you're at. 132 00:06:47,940 --> 00:06:51,210 So what what prompted Hy-Vee to do this partnership with you? 133 00:06:51,210 --> 00:06:53,646 Jaci, talk a little bit about that, because this is unusual. 134 00:06:53,646 --> 00:06:54,814 I think that might be a better Jon question. 135 00:06:54,814 --> 00:06:55,448 Okay. 136 00:06:55,448 --> 00:06:59,952 Obviously Hy-Vee has assets in pharmacy, the PBM space, 137 00:07:00,553 --> 00:07:05,925 specialty pharmacy, dietary, dietitians, all sorts of different components. So, 138 00:07:07,293 --> 00:07:08,761 it made sense that they were moving 139 00:07:08,761 --> 00:07:13,366 towards primary care, and they'd been looking and we, met with Doctor 140 00:07:13,366 --> 00:07:16,469 Fick, who's their chief medical officer, introduced him to our model. 141 00:07:17,203 --> 00:07:21,974 And we walked through what benefits this could have for them, as an employer, 142 00:07:22,108 --> 00:07:26,012 both taking care of employees and then also serving the communities we’re in. 143 00:07:26,212 --> 00:07:28,681 Their employees or actually in this program? 144 00:07:28,681 --> 00:07:30,683 Yes. Absolutely. 145 00:07:30,683 --> 00:07:31,617 So HyVee’s, 146 00:07:31,617 --> 00:07:33,719 this is not just something they're doing in the community 147 00:07:33,719 --> 00:07:36,789 they're invested in this in the standpoint of they're putting 148 00:07:36,789 --> 00:07:39,859 their employees in the program for this care model. Yes. 149 00:07:39,859 --> 00:07:44,430 Wherever we are located, we get access to that set of employees 150 00:07:44,430 --> 00:07:48,768 or as we call them, patients, and start providing services directly to them. 151 00:07:49,268 --> 00:07:51,571 That's very unusual, Jaci. It absolutely is. 152 00:07:51,571 --> 00:07:54,340 And what we're finding is once, 153 00:07:54,340 --> 00:07:58,110 companies are putting their employees into this care model, the engagement 154 00:07:58,110 --> 00:08:02,048 of those employees with their health is significantly increased. 155 00:08:02,381 --> 00:08:06,853 So people who may not have had their annual physical or that's all 156 00:08:06,853 --> 00:08:10,323 they're having, they're actually coming in and having that. 157 00:08:10,990 --> 00:08:13,292 And so they're seeing they're having their annual physical. 158 00:08:13,292 --> 00:08:16,562 And then we're finding rather than somebody who sees adult to once a year, 159 00:08:16,562 --> 00:08:19,098 they're maybe coming in 3 or 4 times a year 160 00:08:19,098 --> 00:08:22,702 because they're using those doctors and providers as advocates 161 00:08:22,702 --> 00:08:26,072 and coaches to be proactive about their health going forward. 162 00:08:26,305 --> 00:08:30,243 Whether it's weight management or help with sleep or mental health, 163 00:08:30,443 --> 00:08:33,446 whereas prior to coming into these programs. 164 00:08:33,746 --> 00:08:37,016 They were managing it themself and maybe talking to Doctor Google. 165 00:08:37,016 --> 00:08:39,585 And a lot of times they were done. I know Doctor Google. My wife talks to Dr Google 166 00:08:41,587 --> 00:08:45,157 a lot, so I understand that comment.. 167 00:08:45,391 --> 00:08:48,561 From the financial standpoint, and employees are often gun shy. 168 00:08:48,561 --> 00:08:50,296 They don't know what something's going to cost. 169 00:08:50,296 --> 00:08:53,966 I mean, a a urine test could be $1.30 or it could be $200. 170 00:08:54,233 --> 00:08:56,269 That's the that's the issue. They don't know. 171 00:08:56,269 --> 00:09:00,273 And in this model, the employers covering their membership and they come in. 172 00:09:00,273 --> 00:09:03,342 And every service we provide in-house is included. 173 00:09:03,342 --> 00:09:04,944 So they know they're not going to pay anything. 174 00:09:04,944 --> 00:09:07,113 So I think you can see this is a very different model. 175 00:09:07,113 --> 00:09:09,315 We're going to go into more of the details regarding the model. 176 00:09:09,315 --> 00:09:11,183 We're going to talk about how if you're an employer, 177 00:09:11,183 --> 00:09:12,952 this could make a huge difference for you. 178 00:09:12,952 --> 00:09:15,254 Also, if you're on an ACA plan, 179 00:09:15,254 --> 00:09:18,157 get ready for some market disruption in the fourth quarter of this year. 180 00:09:18,157 --> 00:09:21,127 So we're going to talk more about that with our guests in studio here. 181 00:09:21,127 --> 00:09:23,095 Stay tuned. We'll be right back after the break. 182 00:09:23,095 --> 00:09:24,463 If you want information. 183 00:09:24,463 --> 00:09:28,134 The website is Exemplar.care. Exemplar.care. 184 00:09:28,134 --> 00:09:31,270 It's not.com. It's just exemplar.care. 185 00:09:31,270 --> 00:09:32,505 They've got a great website. 186 00:09:32,505 --> 00:09:35,308 All the information is up there. You can reach out to them. 187 00:09:35,308 --> 00:09:36,809 They'll be happy to chat with you. 188 00:09:36,809 --> 00:09:39,812 If you're an employer or an individual and you want to see what this model's 189 00:09:39,812 --> 00:09:42,782 all about, or even take a tour of one of their facilities. 190 00:09:43,215 --> 00:09:45,217 Stay right there. We'll be right back after the break. 191 00:09:45,217 --> 00:09:47,653 You're listening to America's Healthcare Advocate 192 00:09:47,653 --> 00:09:50,590 broadcasting here on the HIA Radio Network. 193 00:09:50,590 --> 00:09:53,526 Coast to coast across USA. We've got more. 194 00:10:05,204 --> 00:10:05,938 Welcome back. 195 00:10:05,938 --> 00:10:08,307 You're listening to America's Healthcare Advocate show, 196 00:10:08,307 --> 00:10:10,743 broadcasting coast to coast across USA. 197 00:10:10,743 --> 00:10:12,678 Here on the HIA Radio Network. 198 00:10:12,678 --> 00:10:13,946 My producers today, Mr. 199 00:10:13,946 --> 00:10:15,948 Garner Cowdery behind the microphones and Mr. 200 00:10:15,948 --> 00:10:17,984 Dave Thiessen behind the cameras puts 201 00:10:17,984 --> 00:10:21,120 all these shows together, all those YouTube views, you see, 202 00:10:21,420 --> 00:10:23,689 and those podcast platforms, all 15 of them. 203 00:10:23,689 --> 00:10:25,691 Dave is the one that puts all that up there. 204 00:10:25,691 --> 00:10:28,694 Very happy to have them in studio with us today doing this obviously. 205 00:10:28,761 --> 00:10:32,398 And Doctor Jon Van Der Veer, he is the CEO of Hy-Vee Exemplar Health 206 00:10:32,598 --> 00:10:38,037 and Jaci Robson , he's the VP of Hy-Vee Exemplar Healthcare membership services, 207 00:10:38,037 --> 00:10:42,274 and we're happy to have him in studio talking about this very different model 208 00:10:42,541 --> 00:10:43,943 that's now available here 209 00:10:43,943 --> 00:10:47,079 in the Kansas City Metro, with two clinics in Overland Park at the summit. 210 00:10:47,313 --> 00:10:48,948 We'll talk more about that in a minute. 211 00:10:48,948 --> 00:10:51,517 A little bit about doctor. Doctor VanDerveer is a D.O. 212 00:10:51,517 --> 00:10:54,520 and MBA is a board certified internal medicine physician 213 00:10:54,620 --> 00:10:58,491 and the CEO and founder of Hy-Vee Health Exemplar Care, a membership 214 00:10:58,491 --> 00:11:01,527 based clinic focused on personalized, accessible health care. 215 00:11:01,661 --> 00:11:04,897 He's got 20 years of experience in hospital and internal medicine, 216 00:11:05,097 --> 00:11:08,768 and he brings this patient centered approach to this model. 217 00:11:09,035 --> 00:11:12,805 Jaci Robson is the vice president of member service at Hy-Vee Exemplar Health. 218 00:11:12,872 --> 00:11:16,742 She helps with most of the innovative models and direct care and primary 219 00:11:16,742 --> 00:11:17,677 care and urgent care. 220 00:11:17,677 --> 00:11:19,578 We're happy to have them in studio with us. 221 00:11:19,578 --> 00:11:22,314 So let's continue with this conversation and talk a little bit 222 00:11:22,314 --> 00:11:26,185 about all the services included for this one. 223 00:11:26,185 --> 00:11:27,453 Single membership fee. 224 00:11:27,453 --> 00:11:29,555 No more co-pays, no more deductibles. 225 00:11:29,555 --> 00:11:35,528 I made notes this morning: no more coinsurance, no more out-of-pocket maxes. 226 00:11:35,995 --> 00:11:37,396 All that goes away. 227 00:11:37,396 --> 00:11:40,066 So let's talk about what those services are, doctor. 228 00:11:40,066 --> 00:11:43,069 So, like you said, it's kind of one and done. 229 00:11:43,235 --> 00:11:46,672 There's the monthly membership fee and that includes your in-person visits, 230 00:11:46,972 --> 00:11:49,041 your annual visit, virtual care, 231 00:11:50,309 --> 00:11:52,011 texting portal messages, any 232 00:11:52,011 --> 00:11:55,014 way you choose to communicate to get your care provided. 233 00:11:55,548 --> 00:11:58,017 In addition to the actual care, there's then 234 00:11:58,017 --> 00:12:01,020 lab services included. 235 00:12:01,153 --> 00:12:03,122 Depending on states, there are generic 236 00:12:03,122 --> 00:12:06,092 medications dispensed out of the clinic. 237 00:12:06,158 --> 00:12:08,761 Additionally, we are set up for X-ray. 238 00:12:08,761 --> 00:12:11,964 So for plain films, as markets grow and mature, 239 00:12:11,964 --> 00:12:14,967 we'll have X-ray in all of those locations. 240 00:12:15,201 --> 00:12:18,104 And then additionally there is DME. 241 00:12:18,104 --> 00:12:19,572 So durable medical equipment. 242 00:12:19,572 --> 00:12:21,107 This is the slings or crutches 243 00:12:21,107 --> 00:12:24,176 or things you may need if you have an accident or need something. 244 00:12:24,176 --> 00:12:27,012 I think that hits just about all of them. 245 00:12:27,012 --> 00:12:30,616 So that's basically Jaci, everything that you would get in 246 00:12:30,616 --> 00:12:33,619 a primary care clinic and then more 247 00:12:34,053 --> 00:12:36,122 so you need a lab right now. 248 00:12:36,122 --> 00:12:39,992 Now I got to schedule my labs, a quest or wherever 249 00:12:39,992 --> 00:12:42,962 I have to go that I have to drive there and get that lab done. 250 00:12:43,062 --> 00:12:44,163 If I'm at the Hy-Vee 251 00:12:44,163 --> 00:12:47,933 Exemplar Care Health facility, I get the lab is done right there. 252 00:12:47,967 --> 00:12:48,634 Absolutely. 253 00:12:48,634 --> 00:12:49,435 It's a complete 254 00:12:49,435 --> 00:12:53,339 one stop shop where you're coming in and you're meeting with your provider, 255 00:12:53,539 --> 00:12:57,109 and then you're leaving with whatever you're needing to manage that care 256 00:12:57,109 --> 00:12:58,244 that you need. 257 00:12:58,244 --> 00:12:59,211 I think you should also, 258 00:12:59,211 --> 00:13:03,015 at some points as well, speak about the types of membership costs, 259 00:13:03,315 --> 00:13:06,886 because the membership itself it sends when you're speaking 260 00:13:06,886 --> 00:13:11,157 about membership and people say this is a lot of services that I receive. 261 00:13:11,524 --> 00:13:15,928 So the actual costs for an individual are $89 a month. 262 00:13:16,295 --> 00:13:21,066 So $89 a month for an individual, a $158 263 00:13:21,066 --> 00:13:26,138 a month for a couple, or $216 a month for a family. 264 00:13:26,338 --> 00:13:30,242 And a family would be two adults and two or more children. 265 00:13:30,476 --> 00:13:34,747 So we are speaking affordable here as well, but it's much more 266 00:13:34,747 --> 00:13:35,848 not about the cost. 267 00:13:35,848 --> 00:13:38,651 It's about the quality and the quantity of the services 268 00:13:38,651 --> 00:13:40,419 that you're receiving for that cost. 269 00:13:40,419 --> 00:13:43,422 So you can get care how you want, when you want, 270 00:13:43,689 --> 00:13:47,393 for less than the price of a cup of Starbucks a day. 271 00:13:47,927 --> 00:13:49,128 That's the that's 272 00:13:49,128 --> 00:13:52,531 a, that's a really good comparison of less than a cup of Starbucks a day. 273 00:13:52,932 --> 00:13:57,903 When I look at that versus what I'm going to do on an ACA 274 00:13:57,903 --> 00:14:01,006 Obamacare policy or what I'm going to do on the small group 275 00:14:01,006 --> 00:14:04,276 health insurance policy where you've got copays for labs, 276 00:14:04,476 --> 00:14:07,379 you got the copay to see the primary care doc and you go into a primary care doctor 277 00:14:07,379 --> 00:14:09,582 and it says right on the desk at the receptionist. 278 00:14:09,582 --> 00:14:12,585 You're responsible for the copay before you go see the doctor. 279 00:14:12,718 --> 00:14:14,453 This is completely different. 280 00:14:14,453 --> 00:14:16,622 It's absolutely, completely different. 281 00:14:16,622 --> 00:14:20,125 And what we find is it's also unlimited visits. 282 00:14:20,259 --> 00:14:21,227 We don't encourage it, 283 00:14:21,227 --> 00:14:24,330 but you can absolutely come and see us every day if you wanted to. 284 00:14:24,563 --> 00:14:26,732 But Jon has patients. You're going to get a lot. 285 00:14:27,733 --> 00:14:31,003 Patients who do message him on a regular basis. 286 00:14:31,003 --> 00:14:33,939 He has patients who he speaks to. A different way to go. 287 00:14:33,939 --> 00:14:35,207 Like he was doing this today. 288 00:14:35,207 --> 00:14:37,243 Like he was doing today. 289 00:14:37,243 --> 00:14:40,279 So we do have, people do like the model. 290 00:14:40,412 --> 00:14:43,015 This is the talk to their provider more regularly. 291 00:14:43,015 --> 00:14:46,118 With, with the model Cary, I think one of the most important things 292 00:14:46,118 --> 00:14:49,321 is if you change the financial model, 293 00:14:49,321 --> 00:14:52,892 you change the care model, and that's where everything gets stuck. 294 00:14:53,192 --> 00:14:54,827 The fee for service world. 295 00:14:54,827 --> 00:14:56,228 That exists right now, 296 00:14:56,228 --> 00:15:00,065 it is perfectly incentivized to give us what we all think of as “sick care”. 297 00:15:00,499 --> 00:15:01,166 That's right. 298 00:15:01,166 --> 00:15:04,570 It's built and it delivers exactly what it was designed to do 299 00:15:04,637 --> 00:15:06,005 and accidentally designed. 300 00:15:06,005 --> 00:15:09,742 And this is changing the model and it changes how the care's delivered. 301 00:15:10,142 --> 00:15:13,879 So you talked a little earlier about the fact that people 302 00:15:13,879 --> 00:15:18,083 are managing their, their disease, managing their wellness, their health. 303 00:15:18,517 --> 00:15:21,020 They're doing they're going in to see the doctor more often. 304 00:15:21,020 --> 00:15:22,755 They're doing the things they need to do. 305 00:15:22,755 --> 00:15:26,792 Obviously, not having these roadblocks in front of them with the co-pay 306 00:15:26,792 --> 00:15:28,494 every time they turn around. 307 00:15:28,494 --> 00:15:31,163 I've got to get a piece of durable medical equipment. 308 00:15:31,163 --> 00:15:33,198 I've got a full deductible and co-insurance 309 00:15:33,198 --> 00:15:36,035 I have to pay before I can access that equipment. 310 00:15:36,035 --> 00:15:37,169 I need a lab. 311 00:15:37,169 --> 00:15:40,973 Well, that's that's $150 or $800 depending on the... 312 00:15:41,173 --> 00:15:44,343 So that has to have a direct impact on this. 313 00:15:44,343 --> 00:15:46,845 Yes, absolutely. Can I follow? 314 00:15:46,845 --> 00:15:49,848 Sorry, Jaci, just to tell a quick 315 00:15:49,848 --> 00:15:53,852 DME story, we had a gal who came into, an urgent care 316 00:15:54,286 --> 00:15:57,890 facility of ours and said, I my daughter's here. 317 00:15:57,923 --> 00:15:59,692 She was hurt. She needed a sling. 318 00:15:59,692 --> 00:16:01,427 We said, we'll sell you the sling. 319 00:16:01,427 --> 00:16:04,596 This was she wasn't a member, but we still serve the public as well. 320 00:16:04,797 --> 00:16:06,799 Said we'll sell you the sling for $20. 321 00:16:06,799 --> 00:16:09,435 And she goes, I have the best insurance in the state. 322 00:16:09,435 --> 00:16:11,837 I want to I want to have it billed to my insurance. 323 00:16:11,837 --> 00:16:14,139 She got her bill for $197. 324 00:16:14,139 --> 00:16:18,577 It was our first and only, our first, one star Google 325 00:16:18,577 --> 00:16:22,681 review blasting us for her having to pay $197 for a sling. 326 00:16:22,915 --> 00:16:25,317 We offered to her for $20, and she said, well, 327 00:16:25,317 --> 00:16:27,753 I could have bought the same one for $15 at Walmart. 328 00:16:27,753 --> 00:16:29,722 Well they have better buying power than we do. 329 00:16:29,722 --> 00:16:34,126 So it shows that people don't even understand what their insurance 330 00:16:34,860 --> 00:16:37,296 does, how it's going to impact them financially. 331 00:16:37,296 --> 00:16:40,566 We're this we make it as clear and transparent as possible. 332 00:16:40,599 --> 00:16:44,069 Yeah, well, there's a reason that the big hospital systems that run 333 00:16:44,069 --> 00:16:48,474 these primary care practices don't publish their rates where you can see 334 00:16:48,474 --> 00:16:52,778 what the cost is to have this visit or that visit or another visit. 335 00:16:52,911 --> 00:16:54,346 There's a reason for that. 336 00:16:54,346 --> 00:16:54,913 Okay. 337 00:16:54,913 --> 00:16:57,883 And a lot of that has to do with the negotiated price 338 00:16:57,883 --> 00:17:01,253 they put in place with the primary carriers, the big carriers. 339 00:17:01,253 --> 00:17:04,890 The Blue Cross’s, the United’s, the Aetna’s, is the Cigna's, 340 00:17:05,190 --> 00:17:07,860 you know, the Ambetter’s, go on down the list, okay. 341 00:17:07,860 --> 00:17:10,362 And that's got a lot of impact on how this works. 342 00:17:10,362 --> 00:17:13,132 And that's why people are spending so much money on a lot of this. 343 00:17:13,132 --> 00:17:16,201 What you're doing is you're cutting through all of that saying here 344 00:17:16,502 --> 00:17:20,272 for $89 a month, you can come in here and get everything you need done. 345 00:17:20,506 --> 00:17:23,409 We'll talk about, in the next segment, what happens here to be referred out 346 00:17:23,409 --> 00:17:25,544 and all that, and how all that functions. 347 00:17:25,544 --> 00:17:29,214 But the point is, 90% of what people do is right there with their primary care. 348 00:17:29,214 --> 00:17:30,749 Doc, am I right or wrong?. Absolutely. 349 00:17:30,749 --> 00:17:32,818 That's exactly it's. 100%. 350 00:17:32,818 --> 00:17:36,422 We're also finding the some of the primary care through the hospital systems 351 00:17:36,688 --> 00:17:39,558 are actually billing at hospital rates. 352 00:17:39,558 --> 00:17:43,796 Oh that depends on on their facilities where they're structured. 353 00:17:43,996 --> 00:17:46,799 And so and the problem with that is obviously 354 00:17:46,799 --> 00:17:50,169 all this comes back to the user in terms of premium. 355 00:17:50,502 --> 00:17:53,205 And that's why you see, and that's why you're gonna see this year 356 00:17:53,205 --> 00:17:54,406 in the fourth quarter, 357 00:17:54,406 --> 00:17:55,340 especially if you're on 358 00:17:55,340 --> 00:17:59,011 one of these ACA plans that I intend to talk about this in great detail 359 00:17:59,211 --> 00:18:03,015 in an upcoming broadcast, but you're going to see rate increases 360 00:18:03,015 --> 00:18:07,453 of 25% or better across the board on most of the ACA plans. 361 00:18:07,453 --> 00:18:08,821 Some of that has to do 362 00:18:08,821 --> 00:18:11,790 with Aetna constricting out of the moving out of the market. 363 00:18:11,924 --> 00:18:13,992 You know, all of these things that are going to happen out here. 364 00:18:13,992 --> 00:18:18,597 So this is a model that is here today to serve today 365 00:18:18,764 --> 00:18:22,201 that makes a huge difference in the way care is being delivered and 366 00:18:22,401 --> 00:18:24,103 an even greater difference in the cost. 367 00:18:24,103 --> 00:18:28,607 If you want information, it's Exemplar.care, Exemplar.care. 368 00:18:28,607 --> 00:18:30,242 That's that's the website. 369 00:18:30,242 --> 00:18:31,276 It's a beautiful website. 370 00:18:31,276 --> 00:18:34,079 Ton of information up there. You can go up there and find out about it. 371 00:18:34,079 --> 00:18:36,782 If you're an employer, I urge you to take a look at this. 372 00:18:36,782 --> 00:18:37,916 If you're an individual 373 00:18:37,916 --> 00:18:40,319 and you're paying these high premiums, this is a great way 374 00:18:40,319 --> 00:18:43,555 to get out of that hole and start getting a better form of care. 375 00:18:43,722 --> 00:18:45,991 You're listening to America's Healthcare Advocate 376 00:18:45,991 --> 00:18:48,994 Broadcasting here on the HIA Radio Network. 377 00:18:48,994 --> 00:18:50,929 Coast to coast across the USA. 378 00:18:50,929 --> 00:18:53,499 Stay right there. The doctor's in the house. We'll be right back. 379 00:19:04,910 --> 00:19:05,677 Welcome back. 380 00:19:05,677 --> 00:19:09,081 You're listening to America's Healthcare Advocate Show, broadcasting coast 381 00:19:09,081 --> 00:19:12,284 to coast across the USA here on the HIA Radio Network. 382 00:19:12,484 --> 00:19:17,222 Want to give a shout out to KVGB 1590 Am 97.7 383 00:19:17,289 --> 00:19:21,560 FM on Saturdays from 11 to 12 in Great Bend, Kansas. 384 00:19:21,994 --> 00:19:24,363 One of our best affiliates in the state of Kansas. 385 00:19:24,363 --> 00:19:26,398 Want to say hello to all those folks out there 386 00:19:26,398 --> 00:19:29,301 in that listening audience that listen to our broadcast every week. 387 00:19:29,301 --> 00:19:31,703 So we're going to shift gears now. 388 00:19:31,703 --> 00:19:33,872 There's a lot of disruption coming in the fourth quarter. 389 00:19:33,872 --> 00:19:35,407 I talked a little bit just a minute ago. 390 00:19:35,407 --> 00:19:36,842 Who went out of that segment of what 391 00:19:36,842 --> 00:19:38,577 we're going to see in the individual marketplace? 392 00:19:38,577 --> 00:19:40,345 Well, it's going to be similar to what 393 00:19:40,345 --> 00:19:42,181 we're going to see in the small group space next year. 394 00:19:42,181 --> 00:19:45,184 You're going to see significant increases across the board. 395 00:19:45,450 --> 00:19:48,387 You're also going to see a very narrowing of networks. 396 00:19:48,387 --> 00:19:52,391 This is one of the ways that carriers control costs is by controlling access. 397 00:19:52,691 --> 00:19:53,425 Well, we're going to 398 00:19:54,726 --> 00:19:56,762 look at that versus this model. 399 00:19:56,762 --> 00:20:01,633 But the HyVee Exemplar Care model and talk about what those differences are 400 00:20:02,100 --> 00:20:07,272 and how that works and how that impacts cost, to you as an employer. 401 00:20:07,406 --> 00:20:11,210 So instead of cost shifting, raising the deductibles, 402 00:20:11,210 --> 00:20:12,511 raising the co-pay, 403 00:20:12,511 --> 00:20:16,081 raising the out of pockets and putting that burden on your employees, 404 00:20:16,381 --> 00:20:19,851 you're going to have an opportunity to hear how this program does 405 00:20:19,851 --> 00:20:20,919 just the opposite of that. 406 00:20:20,919 --> 00:20:23,322 So let's just start right there, doctor. 407 00:20:23,322 --> 00:20:26,391 To me and David Hickman just walked in studio here, 408 00:20:26,425 --> 00:20:29,494 broker here in the Kansas City metro I've worked with for about 16 years. 409 00:20:29,494 --> 00:20:34,466 And we've talked about this extensively to me, this is a tremendous alternative 410 00:20:34,466 --> 00:20:39,137 for the small group employer out there that is really getting hammered with it. 411 00:20:39,137 --> 00:20:41,540 The benefits are going down. 412 00:20:41,540 --> 00:20:43,041 The cost is going up. 413 00:20:43,041 --> 00:20:46,578 As I said, there's a lot of cost shifting, pushing it more on to the employer, 414 00:20:47,045 --> 00:20:48,180 the employee. 415 00:20:48,180 --> 00:20:49,581 This is significantly different. 416 00:20:49,581 --> 00:20:52,584 Talk about that a little bit and how this model works for employers. 417 00:20:52,584 --> 00:20:56,188 And what are employers finding in the way of satisfaction with this. 418 00:20:56,188 --> 00:21:00,092 So employers are very satisfied with it. 419 00:21:00,292 --> 00:21:03,895 First off, because it's affordable to them and it helps them manage 420 00:21:03,895 --> 00:21:05,530 some of their costs. 421 00:21:05,530 --> 00:21:09,701 Secondly, it allows them to provide what we've had some employees 422 00:21:09,701 --> 00:21:12,704 define as the only true benefit my company offers me. 423 00:21:12,838 --> 00:21:17,576 And, they said it, we've got a written down the, 424 00:21:19,077 --> 00:21:19,745 the employee 425 00:21:19,745 --> 00:21:23,315 though is the one, like you said, who's been carrying more and more of the burden. 426 00:21:23,582 --> 00:21:27,919 And as we all know, the vast majority of people can't tolerate a $1,000 bill. 427 00:21:27,919 --> 00:21:30,122 But they have a $7,000 deductible. 428 00:21:30,122 --> 00:21:31,857 They can't afford the care that they need. 429 00:21:31,857 --> 00:21:35,460 And in this model, they have a benefit that they know it's paid for. 430 00:21:35,694 --> 00:21:38,897 It's covered, and all the care they get is going to be included. 431 00:21:38,964 --> 00:21:41,433 They're not going to have a surprise bill. There's not going to be a lab fee. 432 00:21:41,433 --> 00:21:44,870 There's not going to be, a visit, a copay, a co-insurance, a deductible. 433 00:21:44,870 --> 00:21:46,538 Nothing's going to show up. 434 00:21:46,538 --> 00:21:48,840 And that's why they view it as a true benefit. 435 00:21:48,840 --> 00:21:51,543 They can get care that they've avoided in the past 436 00:21:51,543 --> 00:21:54,513 because they didn't know what it was going to do to their own finances. 437 00:21:54,713 --> 00:21:58,550 How does that affect the overall health of the employees 438 00:21:58,750 --> 00:22:03,155 as a group and for the employer in terms of things like absenteeism and, 439 00:22:03,422 --> 00:22:05,123 you know, trying to get to a doctor's appointment 440 00:22:05,123 --> 00:22:06,091 but they can't get to 441 00:22:06,091 --> 00:22:09,127 because they can't get there in time, they get to take time off work. 442 00:22:09,328 --> 00:22:11,463 This all changes now, talk a little bit about that. 443 00:22:11,463 --> 00:22:12,798 It absolutely changes. 444 00:22:12,798 --> 00:22:17,569 So we are much healthier, happier employees, more engaged employees, 445 00:22:17,803 --> 00:22:21,573 and from the employer's point of view, as the employees are able to get that 446 00:22:21,573 --> 00:22:26,178 same day or next day appointments, they get seen when they need to be seen. 447 00:22:26,445 --> 00:22:30,449 If they're not able to get into a clinic, they can connect with the provider 448 00:22:30,782 --> 00:22:34,319 and they can manage the care that they need, get that prescription that day 449 00:22:34,619 --> 00:22:39,524 and be back at work, or be getting healthier as they move forward. 450 00:22:39,524 --> 00:22:42,894 If they've had some of those conversations with the provider 451 00:22:42,894 --> 00:22:45,897 regarding long term concerns. 452 00:22:45,897 --> 00:22:48,500 So, the employer can take a high 453 00:22:48,500 --> 00:22:51,503 deductible plan like an HSA or an HRA. 454 00:22:51,536 --> 00:22:54,873 They can wrap it around this model where the primary care 455 00:22:54,873 --> 00:22:58,243 is all handled by the HyVee Exemplar Care primary care model. 456 00:22:58,510 --> 00:23:01,947 And if an employee needs to go out to, 457 00:23:02,848 --> 00:23:06,685 a doctor for an orthopedic surgery or another type of procedure, talk 458 00:23:06,685 --> 00:23:10,322 about how you work within that particular network to help them coordinate that 459 00:23:10,322 --> 00:23:14,126 so they get this, the best level of care in that network, doctor. 460 00:23:14,126 --> 00:23:17,129 So again, because we have the time to go 461 00:23:17,129 --> 00:23:20,966 through people's medical information and you have their insurance plan, 462 00:23:20,966 --> 00:23:25,570 you understand where they can get care and where they can, afford care. 463 00:23:26,204 --> 00:23:30,642 First off, every clinician in every market knows where quality providers are. 464 00:23:31,443 --> 00:23:32,511 So assuming that 465 00:23:33,512 --> 00:23:37,015 the network has quality providers in it, you can direct those people directly 466 00:23:37,015 --> 00:23:40,051 to those providers as long as they're in network, you know, which ones 467 00:23:40,051 --> 00:23:43,054 are going to be more cost effective for those employees. 468 00:23:43,321 --> 00:23:44,723 And if it's, 469 00:23:44,723 --> 00:23:47,492 if it's a different funding model or a level funded, self-funded, 470 00:23:47,492 --> 00:23:50,462 you can actually get the most cost effective for the employer as well. 471 00:23:51,163 --> 00:23:54,266 But ultimately the employee will have choice. 472 00:23:54,266 --> 00:23:56,868 They're going to say this, this is who I recommend. 473 00:23:56,868 --> 00:23:59,604 Oh, I, my neighbors, this person. Okay. They're in-network too. 474 00:23:59,604 --> 00:24:03,809 So you have the time to actually evaluate and send people where they should go 475 00:24:04,075 --> 00:24:07,412 instead of just the oh, well, this is the one that's in their system. 476 00:24:07,412 --> 00:24:10,415 So you go up a system and you go from primary care 477 00:24:10,415 --> 00:24:13,952 to specialty care with no real regard to cost or quality. 478 00:24:14,252 --> 00:24:14,786 So Jaci, 479 00:24:15,754 --> 00:24:17,222 when this occurs now 480 00:24:17,222 --> 00:24:21,259 is the primary care doctor clinician at the HyVee Exemplar Care clinic. 481 00:24:21,393 --> 00:24:24,529 They're following along to see how the care is being delivered. 482 00:24:24,563 --> 00:24:26,898 If there's follow up, whatever the case may be. 483 00:24:26,898 --> 00:24:28,166 Oh, absolutely. 484 00:24:28,166 --> 00:24:30,469 The providers at HyVee Health Examplar Care. 485 00:24:30,469 --> 00:24:33,004 They’re advocates, they’re coaches, they’re navigators. 486 00:24:33,004 --> 00:24:37,175 They will help people to understand the complexity of the health care system 487 00:24:37,409 --> 00:24:40,712 and make sure that their patients, their members, are receiving 488 00:24:40,712 --> 00:24:41,713 the care that they need. 489 00:24:41,713 --> 00:24:44,182 So that there's a coordination between the two groups. 490 00:24:44,182 --> 00:24:45,784 We are the quarterback. 491 00:24:45,784 --> 00:24:47,118 That's how I always view it. 492 00:24:47,118 --> 00:24:51,156 Is the the primary care team at HyVee Health 493 00:24:51,156 --> 00:24:55,427 Exemplar Care is responsible for getting you in and seen. 494 00:24:55,660 --> 00:24:59,397 And then if you do need to go somewhere out to get the care you need, 495 00:24:59,397 --> 00:25:03,435 and then to close the loop and bring you back in and move you forward 496 00:25:03,435 --> 00:25:05,370 with the appropriate recommendations you receive. 497 00:25:05,370 --> 00:25:06,271 So you said something 498 00:25:06,271 --> 00:25:08,006 at the beginning of this segment that was kind of interesting. 499 00:25:08,006 --> 00:25:10,475 It's some of the employees have said: 500 00:25:10,475 --> 00:25:13,712 “this is the only benefit my employer really provides”. 501 00:25:14,045 --> 00:25:15,480 Do you think that that 502 00:25:15,480 --> 00:25:19,784 that that kind of a testimonial to what you're doing, results from the fact 503 00:25:19,784 --> 00:25:23,255 that they are not coming in and getting blown out the door in 7.5 504 00:25:23,255 --> 00:25:27,492 minutes and handed three prescription, and out the door they go, or 505 00:25:27,926 --> 00:25:30,729 how how impactful do you think it is that you said 506 00:25:30,729 --> 00:25:33,999 you've had people spend as much as an hour sitting and talking to you? 507 00:25:33,999 --> 00:25:37,168 You took a call today on the way in here from Iowa, 508 00:25:37,369 --> 00:25:40,639 talking to a man had shingles and got a prescription for him. 509 00:25:40,772 --> 00:25:43,375 So how that's a that's unheard of. 510 00:25:43,375 --> 00:25:46,478 If you try to call a primary care physician, you're first. 511 00:25:46,478 --> 00:25:48,713 You're going to get the nurse if you're lucky, 512 00:25:48,713 --> 00:25:52,217 and then she's going to call you back between the hours of so-and-so and 3:00, 513 00:25:52,217 --> 00:25:53,118 if you're lucky. 514 00:25:53,118 --> 00:25:54,986 And if you miss that or you don't get that call, 515 00:25:54,986 --> 00:25:56,288 you're not going to talk to him at all. 516 00:25:56,288 --> 00:25:58,990 No, but I look at that versus here you are, 517 00:25:58,990 --> 00:26:02,627 the CEO running this whole program and you're taking calls and talking. 518 00:26:02,761 --> 00:26:06,364 How much do you think that statement made by that employee or employees 519 00:26:06,364 --> 00:26:09,968 you've talked to has to do with the fact that they can access this care, 520 00:26:10,068 --> 00:26:11,970 and somebody really gives a damn? 521 00:26:11,970 --> 00:26:13,939 I think that's solely what it is. 522 00:26:13,939 --> 00:26:17,442 Their life matters more than how we want to run our clinic. 523 00:26:17,709 --> 00:26:20,645 So their convenience is their first priority, 524 00:26:20,645 --> 00:26:24,449 their health is their first priority, and we're a delivery mechanism 525 00:26:24,449 --> 00:26:25,650 to meet their need. 526 00:26:25,650 --> 00:26:29,554 Health care has quit being a service organization, and it's a widget 527 00:26:29,554 --> 00:26:32,924 producing factory where here it's all about relationships. 528 00:26:32,924 --> 00:26:35,894 The better you know, somebody, the easier they are to care for. 529 00:26:35,894 --> 00:26:39,631 If you know all their history, you can take a phone call on I-35 530 00:26:39,631 --> 00:26:42,601 and and take care of somebody because you know everything about them. 531 00:26:43,501 --> 00:26:46,504 So those relationships are essential. 532 00:26:46,504 --> 00:26:48,873 And people feel that. 533 00:26:48,873 --> 00:26:53,244 I mean, nobody wants to be hurried through like their cattle. 534 00:26:54,112 --> 00:26:56,281 And unfortunately, this way the system is set up. 535 00:26:56,281 --> 00:27:00,151 And I think, as Jon's exactly said it, it's an experience. 536 00:27:00,151 --> 00:27:01,586 It’s something you need to feel. 537 00:27:01,586 --> 00:27:03,989 You need to come in and feel the difference. 538 00:27:03,989 --> 00:27:06,257 It’s a different way of doing health care. 539 00:27:06,257 --> 00:27:10,662 And until you've actually experienced it, it isn't easy to explain it 540 00:27:10,662 --> 00:27:12,063 and understand how that feels. 541 00:27:12,063 --> 00:27:14,566 It's a little bit that like the Disney magic. 542 00:27:14,566 --> 00:27:17,068 How do you explain what that experience is? 543 00:27:17,068 --> 00:27:17,669 People. 544 00:27:17,669 --> 00:27:21,706 People always say that they it's too good to be true. 545 00:27:21,806 --> 00:27:24,376 This can't be how you take care of people. 546 00:27:24,376 --> 00:27:27,245 And I felt listened to, I felt heard. 547 00:27:27,245 --> 00:27:30,448 I've had this conversation with multiple people in the past. 548 00:27:30,582 --> 00:27:33,952 This is the first time somebody has actually heard what I was saying. 549 00:27:34,352 --> 00:27:36,021 Listen to what I said. 550 00:27:36,021 --> 00:27:37,756 Because they took the time. 551 00:27:37,756 --> 00:27:39,924 All about time and access. 552 00:27:39,924 --> 00:27:44,529 Because as you talked about primary care doctors are taxed with seeing every 553 00:27:44,529 --> 00:27:48,433 how many hundreds of patients they have, moving them through the system 554 00:27:48,433 --> 00:27:50,568 as quickly as they can and getting to the next patient. 555 00:27:50,568 --> 00:27:55,407 Internal medicine 2500 patient panels, family medicine, 3 to 5000 patient panels. 556 00:27:55,740 --> 00:27:56,641 You're serious? 557 00:27:56,641 --> 00:27:59,911 Yeah, and I was at 1900 when I left the fee for service 558 00:27:59,911 --> 00:28:02,180 world on my way to 2500 as an internist. 559 00:28:02,180 --> 00:28:03,882 Average age 76. 560 00:28:03,882 --> 00:28:05,784 Not the easiest population to take care of. 561 00:28:05,784 --> 00:28:07,352 Yeah, I'm 77. 562 00:28:07,352 --> 00:28:10,288 There you. Go. You’re a wonderful 76. 563 00:28:10,288 --> 00:28:13,491 And then now, panels 564 00:28:13,491 --> 00:28:16,628 in direct primary care, 500, 800, a thousand. 565 00:28:16,628 --> 00:28:20,799 If they're, if it's a healthy population, it's a fraction of the people. 566 00:28:20,799 --> 00:28:24,135 And we don't need to see a certain number to bill them. 567 00:28:24,769 --> 00:28:26,838 You just change the model. 568 00:28:26,838 --> 00:28:28,173 Where they paid their membership. 569 00:28:28,173 --> 00:28:30,008 And I'd like to add to a story with that. 570 00:28:30,008 --> 00:28:34,946 I was talking to a cardiologist, and he advised me he sees ten patients a day. 571 00:28:35,113 --> 00:28:38,483 He works in a system where he gets referrals 572 00:28:38,483 --> 00:28:40,351 through the primary care, through the system. 573 00:28:40,351 --> 00:28:40,685 He said. 574 00:28:40,685 --> 00:28:43,688 Of those ten patients a day, he only needs to see three. 575 00:28:43,788 --> 00:28:46,424 And of the other seven, they didn't need to be there. 576 00:28:46,424 --> 00:28:48,660 If the primary care provider had been able, 577 00:28:48,660 --> 00:28:51,529 not the primary care providers' fault, the system. 578 00:28:51,529 --> 00:28:54,132 If the primary care provider would spend the time with them, 579 00:28:54,132 --> 00:28:58,503 each of those ten patients is paying $3,000 each for that visit with him 580 00:28:58,636 --> 00:29:00,004 and seven of them a day. 581 00:29:00,004 --> 00:29:01,740 Do not need to meet with them. 582 00:29:01,740 --> 00:29:04,375 And what do you think has to do with why that? 583 00:29:04,375 --> 00:29:05,977 Why they're doing that? 584 00:29:05,977 --> 00:29:06,211 You know, 585 00:29:06,211 --> 00:29:09,581 that's one reason why United Health Care is under investigation right now 586 00:29:09,581 --> 00:29:13,351 by the DOJ, because of those kinds of referrals and charges 587 00:29:13,351 --> 00:29:15,120 that they are saying are unnecessary. 588 00:29:15,120 --> 00:29:17,422 So, yeah, there's a lot that needs to be fixed. 589 00:29:17,422 --> 00:29:19,624 Its a broken system. It is a broken system. 590 00:29:19,624 --> 00:29:22,494 But this is a great system, and it's a system that can work. 591 00:29:22,494 --> 00:29:23,661 And if it sounds like something 592 00:29:23,661 --> 00:29:27,465 you'd be interested in, you should go to the website Exemplar.care. 593 00:29:29,067 --> 00:29:30,602 You'll see everything up there. 594 00:29:30,602 --> 00:29:33,138 If you're an employer, you can send them a quick message. 595 00:29:33,138 --> 00:29:35,240 They'll be happy to have someone come out and talk with you. 596 00:29:35,240 --> 00:29:37,442 If you’re an individual the same thing. 597 00:29:37,442 --> 00:29:41,379 Or better yet, go to one of the clinics, walk around and see what you think of it. 598 00:29:41,379 --> 00:29:43,548 You'll probably be surprised by what you learn. 599 00:29:43,548 --> 00:29:45,016 We'll be right back after the break. 600 00:29:45,016 --> 00:29:47,418 You're listening to America's Healthcare Advocate. 601 00:29:47,418 --> 00:29:52,190 Broadcasting coast to coast across USA here on the HIA Radio Network. 602 00:29:52,190 --> 00:29:56,094 We're going to shift gears now and talk a little about what do big employers do 603 00:29:56,127 --> 00:29:57,262 when they're on this plan. 604 00:29:57,262 --> 00:29:57,929 Stay right there. 605 00:29:57,929 --> 00:30:00,932 We'll be right back with more. 606 00:30:05,336 --> 00:30:06,104 Welcome back. 607 00:30:06,104 --> 00:30:10,041 You're listening to America's Healthcare Advocate Show, broadcasting coast to coast 608 00:30:10,041 --> 00:30:13,044 across USA here on the HIA Radio Network. 609 00:30:13,044 --> 00:30:14,312 You can find out more about us 610 00:30:14,312 --> 00:30:16,614 by going to our website, America's Healthcare Advocate. 611 00:30:16,614 --> 00:30:19,450 Also 15 podcast platforms, YouTube. 612 00:30:19,450 --> 00:30:20,819 So here's the thing. 613 00:30:20,819 --> 00:30:24,422 Maybe your company is got a health insurance plan and nobody's happy. 614 00:30:24,789 --> 00:30:26,591 Maybe you might want to mention to them. 615 00:30:26,591 --> 00:30:30,829 Hey go up and listen to this broadcast that Cary Hall did with the doctor 616 00:30:30,829 --> 00:30:34,265 in studio and talked about this HyVee Exemplar Care model 617 00:30:34,265 --> 00:30:37,702 and how it works, and see what let them know that it's there. 618 00:30:37,902 --> 00:30:41,072 Because oftentimes when people refer other people to this podcast, 619 00:30:41,239 --> 00:30:44,442 we get a lot of feedback on this, the podcast and the YouTube. 620 00:30:44,709 --> 00:30:48,479 You don't have to be able to relate this whole broadcast back to someone. 621 00:30:48,646 --> 00:30:50,615 If you think there's someone that would be interested in this, 622 00:30:50,615 --> 00:30:53,318 maybe it's a family and you think you maybe it's your wife 623 00:30:53,318 --> 00:30:55,820 and you want to tell your wife to go listen to this podcast. 624 00:30:55,820 --> 00:30:57,222 This is a great way to do this. 625 00:30:57,222 --> 00:30:59,791 We're posted on 15 podcast platforms/channels. 626 00:30:59,791 --> 00:31:02,026 We're on the we have our own YouTube channel. 627 00:31:02,026 --> 00:31:03,995 We got almost a half million views up there. 628 00:31:03,995 --> 00:31:06,998 So this is a great way to disseminate this information. 629 00:31:07,065 --> 00:31:09,667 And this program is very, very different. 630 00:31:09,667 --> 00:31:10,134 And I think 631 00:31:10,134 --> 00:31:13,972 it's really going to come into focus as we get closer in to the fourth quarter. 632 00:31:13,972 --> 00:31:16,374 And the marketplace disruptions that we're going to see. 633 00:31:16,374 --> 00:31:17,876 Its HyVee Exemplar Care. 634 00:31:17,876 --> 00:31:23,181 The website is exemplar.care if you want information. 635 00:31:23,514 --> 00:31:25,450 So now we're going to talk about large employers 636 00:31:25,450 --> 00:31:27,752 because I'm focused a little bit on small employers. 637 00:31:27,752 --> 00:31:30,622 Quik Trip was one of your first clients okay. 638 00:31:30,622 --> 00:31:31,956 And now how many employees? 639 00:31:31,956 --> 00:31:33,157 They have a lot of employees. 640 00:31:33,157 --> 00:31:36,761 But on their on their benefit plan it's around 24,000. 641 00:31:36,761 --> 00:31:39,831 And and we're taking care of, folks 642 00:31:39,831 --> 00:31:43,201 who are in the clinic areas where we've built out clinics. 643 00:31:43,268 --> 00:31:44,535 That's remarkable. 644 00:31:44,535 --> 00:31:48,273 Obviously, just hearing that is an endorsement 645 00:31:48,273 --> 00:31:50,174 into your quality level, what you do. 646 00:31:50,174 --> 00:31:52,911 I shop at Hy-Vee at 151st in Olathe. 647 00:31:52,911 --> 00:31:55,246 I'm in there multiple times a week. Okay. 648 00:31:55,246 --> 00:31:57,048 Thank you. Great people. Great. 649 00:31:57,048 --> 00:31:59,717 But I've never been to a grocery store where they literally stop 650 00:31:59,717 --> 00:32:02,720 whatever they're doing and, I need to know where I can find this. 651 00:32:02,820 --> 00:32:04,656 And they walk you to the aisle and show it to you 652 00:32:06,658 --> 00:32:07,659 that's 653 00:32:07,659 --> 00:32:10,261 the way the employees work there is completely different for them 654 00:32:10,261 --> 00:32:12,630 to have that kind of faith in what you're doing, 655 00:32:12,630 --> 00:32:16,701 and to be able to take their employees, and send them to your facility. 656 00:32:16,701 --> 00:32:19,203 I think that speaks volumes for how this works. 657 00:32:19,203 --> 00:32:20,238 Absolutely. 658 00:32:20,238 --> 00:32:23,308 And I think we are actually headquartered in 659 00:32:23,308 --> 00:32:26,911 Des Moines, Iowa, which is where Hy-Vee's also headquartered. 660 00:32:27,178 --> 00:32:30,348 And our first clinic in, West Des Moines 661 00:32:30,348 --> 00:32:33,484 headquarters clinic is also 24 seven urgent care. 662 00:32:33,685 --> 00:32:37,422 So with Hy-Vee and the types of employees and the demographics, 663 00:32:37,622 --> 00:32:41,459 and then we've got shift workers that absolutely works for them just as well. 664 00:32:41,592 --> 00:32:45,463 That's, you know, outside of us, they can connect with the primary care provider, 665 00:32:45,630 --> 00:32:48,633 or they can come in to urgent care if they have those acute needs. 666 00:32:49,200 --> 00:32:52,403 We do offer fee for service as well in the urgent care. 667 00:32:52,403 --> 00:32:56,374 So we have nonmembers, but our members get priority so they can walk in 668 00:32:56,507 --> 00:32:58,309 and they're the next one to be roomed. 669 00:32:58,309 --> 00:32:59,844 When a room becomes available. 670 00:32:59,844 --> 00:33:05,016 So when you say 24/7 you really mean 24/7 brick and mortar urgent care. 671 00:33:05,049 --> 00:33:05,717 Absolutely. 672 00:33:05,717 --> 00:33:09,620 We opened our doors, nearly five years ago now, and we've never closed 673 00:33:09,620 --> 00:33:11,923 those doors since. I’ve never missed a shift. 674 00:33:11,923 --> 00:33:17,161 And as we grow out and the markets mature, we're going to have it in Omaha. 675 00:33:17,161 --> 00:33:19,530 And here in the Kansas City market as well. 676 00:33:19,530 --> 00:33:24,002 That's that's pretty remarkable because that's not something you typically see. 677 00:33:24,702 --> 00:33:27,205 And again, the employees are coming in. 678 00:33:27,205 --> 00:33:28,439 There's no copay for them. 679 00:33:28,439 --> 00:33:30,241 There's no out-of-pocket costs for them. 680 00:33:30,241 --> 00:33:31,876 Am I going to be able to afford the copay? 681 00:33:31,876 --> 00:33:33,044 Well, I'll wait a couple days. 682 00:33:33,044 --> 00:33:36,381 I'd rather see if I'm not going to have this problem, or the problem gets worse 683 00:33:36,381 --> 00:33:39,917 because they don't want to pay the 50 or 75 or $100 co-pay. 684 00:33:39,917 --> 00:33:42,720 This is completely different. And even more so at night. 685 00:33:42,720 --> 00:33:46,090 Those employees would often be going to an emergency room. 686 00:33:46,290 --> 00:33:49,761 So now you have hours of time lost, thousands of dollars 687 00:33:49,761 --> 00:33:53,231 spent out of their pockets, and even more out of the large 688 00:33:53,231 --> 00:33:56,734 employer level funded, self-funded folks who are paying the bill. 689 00:33:57,435 --> 00:33:58,436 However it comes in. 690 00:33:58,436 --> 00:34:02,140 And it is the least effective dollar for health care spent in this country. 691 00:34:02,140 --> 00:34:03,241 Absolutely. Yeah. 692 00:34:03,241 --> 00:34:06,344 And it's unfortunate, but that's what you said is absolutely correct. 693 00:34:06,344 --> 00:34:08,246 Yeah. They all understand zero. 694 00:34:08,246 --> 00:34:10,248 So they all understand zero. 695 00:34:10,248 --> 00:34:14,018 And we all know that accidents never happen when we want them to happen. 696 00:34:14,018 --> 00:34:18,222 They're always going to be at night or at the weekend or during the holiday. 697 00:34:18,222 --> 00:34:18,890 You you know, 698 00:34:18,890 --> 00:34:23,094 you're at the barbecue with your friends on the 4th of July and something happens. 699 00:34:23,094 --> 00:34:24,362 Where do you go? 700 00:34:24,362 --> 00:34:26,964 Emergency room is usually your only option, 701 00:34:26,964 --> 00:34:29,901 but now we can do the virtual care if needed. 702 00:34:29,901 --> 00:34:33,571 If virtual care will manage the situation, we can do virtual care 703 00:34:33,571 --> 00:34:36,841 or they can come into the clinic for that 24/7 treatment. 704 00:34:36,841 --> 00:34:40,078 So on the break you were talking a little bit about the experience 705 00:34:40,078 --> 00:34:43,414 for the employee and what you have learned over the years 706 00:34:43,614 --> 00:34:46,451 with how the employees feel about this program versus 707 00:34:46,451 --> 00:34:49,520 being on a standard ACA type health insurance program. 708 00:34:49,520 --> 00:34:52,323 Talk a little bit more about that, Jaci because it was fascinating. 709 00:34:52,323 --> 00:34:52,990 Yeah. No. 710 00:34:52,990 --> 00:34:55,760 What we find is that a lot of these employees, 711 00:34:55,760 --> 00:34:58,529 they've not necessarily had regular checks. 712 00:34:58,529 --> 00:35:01,866 So what we actually say to them, some of them are unsure, and they feel 713 00:35:01,866 --> 00:35:03,067 that when they're coming 714 00:35:03,067 --> 00:35:06,070 to a doctor's office, maybe it's a little bit more judgmental. 715 00:35:06,070 --> 00:35:09,907 They come and they visit our clinic and people have got the time for them. 716 00:35:09,907 --> 00:35:13,544 They build that personal relationship with them, and it just feels more real. 717 00:35:13,544 --> 00:35:15,246 They’re coming and talking to a friend. 718 00:35:15,246 --> 00:35:19,183 We also say “doctor in your pocket”, or “that small town doctor” who knows 719 00:35:19,183 --> 00:35:22,820 your family and knows who you are and what matters to you. 720 00:35:22,920 --> 00:35:25,823 We want people to live their healthiest lives, 721 00:35:25,823 --> 00:35:28,926 so if that's playing with your grandchildren, it's 722 00:35:28,926 --> 00:35:32,430 you want to continue to be golfing, or whether it's that 723 00:35:32,430 --> 00:35:36,033 you just want to go and sit and meditate and have coffee with your friends. 724 00:35:36,267 --> 00:35:39,837 We will work with you on whatever health means to you. 725 00:35:40,071 --> 00:35:43,741 And what we do is during that welcome visit, we will take those baseline 726 00:35:43,741 --> 00:35:44,108 labs. 727 00:35:44,108 --> 00:35:48,045 We’ll have those initial conversations of what health means to you, 728 00:35:48,246 --> 00:35:49,247 and then we'll make sure 729 00:35:49,247 --> 00:35:52,884 that we keep your health where it is today or we'll help you to improve. 730 00:35:53,050 --> 00:35:57,522 This is all about proactive preventative health care rather than the “sick care” 731 00:35:57,522 --> 00:35:58,356 that we have across most of healthcare. 732 00:35:58,356 --> 00:36:01,359 Must have time to dig into it all. 733 00:36:01,392 --> 00:36:04,595 If you come in and you've got a couple things you want addressed, 734 00:36:04,962 --> 00:36:06,330 one of them, you might be tired. 735 00:36:06,330 --> 00:36:07,665 You're chronically tired. 736 00:36:07,665 --> 00:36:10,668 If you work shifts, the your sleep's not very good. 737 00:36:11,202 --> 00:36:15,006 You don't eat very well because you work at QuikTrip and a convenience store. 738 00:36:15,907 --> 00:36:19,310 Or you get off work at two in the morning and there's nothing available, 739 00:36:19,577 --> 00:36:20,978 and you can't cook. 740 00:36:20,978 --> 00:36:22,280 We have the time to sit and go. 741 00:36:22,280 --> 00:36:24,582 Okay, let's look at first off. 742 00:36:24,582 --> 00:36:26,984 Yes, we need to figure out your sleep schedule. 743 00:36:26,984 --> 00:36:29,487 Go through all of that. That can be a ten minute conversation. 744 00:36:29,487 --> 00:36:31,622 Then you move on to the diet and the exercise. 745 00:36:31,622 --> 00:36:34,091 The exercise is going to help, sleep. 746 00:36:34,091 --> 00:36:37,261 I remember in the fee for service world, I would get people who would come in 747 00:36:37,562 --> 00:36:39,463 and be like, yep, you need to work on your diet and exercise. 748 00:36:39,463 --> 00:36:41,766 You shouldn't become diabetic. That would be bad. 749 00:36:41,766 --> 00:36:42,667 Thanks. Have a nice day. 750 00:36:42,667 --> 00:36:43,634 Done. Visit over. 751 00:36:43,634 --> 00:36:46,270 7.5 minutes. 7.5 minutes and out the door. 752 00:36:46,270 --> 00:36:48,139 Now have you sit and have a conversation. 753 00:36:48,139 --> 00:36:51,776 You say okay, your A1C comes back at at 6.0. 754 00:36:51,776 --> 00:36:53,144 You're pre-diabetic. 755 00:36:53,144 --> 00:36:57,448 You could become a diabetic if you're A1C gets to 6.5, you're on that trend. 756 00:36:58,549 --> 00:37:01,152 I could give you metformin, a medication that treats diabetes. 757 00:37:01,152 --> 00:37:04,622 And we can relative risk reduction of about 16. 758 00:37:05,056 --> 00:37:08,059 Or you can make wholesale lifestyle changes. 759 00:37:08,092 --> 00:37:12,196 And now I can talk about intermittent fasting, low carb food options, 760 00:37:12,396 --> 00:37:17,335 the types of exercise that, decreases the likelihood of progressing to diabetes. 761 00:37:17,401 --> 00:37:19,237 And that's a 32 fold relative 762 00:37:19,237 --> 00:37:22,240 risk reduction, twice as effective as me giving you a medication. 763 00:37:22,306 --> 00:37:25,309 One of those takes time and effort to explain. 764 00:37:25,343 --> 00:37:27,612 The other one takes writing a prescription and moving on. 765 00:37:27,612 --> 00:37:29,814 And that's the 7.5 minute visit. 766 00:37:29,814 --> 00:37:31,916 And half the patients will say, I kind of like that pill idea, 767 00:37:31,916 --> 00:37:34,619 but this is where you get a chance to really show them 768 00:37:34,619 --> 00:37:37,755 that you care about them and educate them like your health matters. 769 00:37:37,755 --> 00:37:40,791 And if you make these changes, you can head off 770 00:37:40,958 --> 00:37:44,195 one of the most costly long term diseases that you can have. 771 00:37:44,462 --> 00:37:47,431 And that comes back in cost to the employer, 772 00:37:47,498 --> 00:37:49,967 and it comes back with satisfied employees, 773 00:37:49,967 --> 00:37:51,035 and it comes back with 774 00:37:51,035 --> 00:37:55,039 the overall health of his workforce and how they feel about that employer. 775 00:37:55,039 --> 00:37:58,042 Which goes back to that comment you made earlier in the show. 776 00:37:58,542 --> 00:38:01,145 This is the one thing my employer does that’s a real benefit. 777 00:38:01,145 --> 00:38:04,081 So you know what this is though Cary, this is alignment. 778 00:38:04,081 --> 00:38:06,217 So my goal is to make you healthy. 779 00:38:06,217 --> 00:38:07,918 Your goal is to be healthy. 780 00:38:07,918 --> 00:38:11,922 The employer's goal is to provide a good benefit and to save money. 781 00:38:11,922 --> 00:38:12,657 At the same time. 782 00:38:12,657 --> 00:38:16,627 All these things are in alignment where in a fee for service world, 783 00:38:16,627 --> 00:38:19,063 the more you come in, the more I get paid. You have. 784 00:38:19,063 --> 00:38:23,968 I do have disincentives and misalignment that cost people money over time. 785 00:38:23,968 --> 00:38:25,903 And this is a way to to remedy that. 786 00:38:25,903 --> 00:38:28,339 And, you know, I think that's a great way to wrap this up. 787 00:38:28,339 --> 00:38:30,941 You just heard it from doctor. It makes perfect sense. 788 00:38:30,941 --> 00:38:32,910 This is this is an alignment. 789 00:38:32,910 --> 00:38:34,812 It's a alignment that works. 790 00:38:34,812 --> 00:38:38,282 I urge you to take a moment to go to their website and take 791 00:38:38,282 --> 00:38:39,784 a look at this exemplar care 792 00:38:41,185 --> 00:38:42,553 Exemplar.care. 793 00:38:42,553 --> 00:38:43,954 It's is on the website. 794 00:38:43,954 --> 00:38:46,524 All the information is up there if you're an employer, 795 00:38:46,524 --> 00:38:48,726 if you're a human resource director and you're, 796 00:38:48,726 --> 00:38:50,494 you know, you're looking for an alternative 797 00:38:50,494 --> 00:38:52,163 or you know you're going to get 798 00:38:52,163 --> 00:38:55,833 a significant increase next year, or maybe you're just not happy. 799 00:38:56,100 --> 00:38:58,069 You're not happy with the program that you're on. 800 00:38:58,069 --> 00:38:59,303 You're not happy with the carrier. 801 00:38:59,303 --> 00:39:01,639 You're not happy your employees are not happy. 802 00:39:01,639 --> 00:39:02,873 You've been cost shifting. 803 00:39:02,873 --> 00:39:04,942 You're doing all these different things to try to make it work. 804 00:39:04,942 --> 00:39:05,976 It's just not working. 805 00:39:05,976 --> 00:39:07,645 This model works okay. 806 00:39:07,645 --> 00:39:10,614 Hy-Vee and QuikTrip wouldn't be doing this 807 00:39:10,614 --> 00:39:13,617 with thousands of employees if they didn't think it worked. 808 00:39:13,751 --> 00:39:16,320 That's why I asked these folks to come and do this show. 809 00:39:16,320 --> 00:39:19,123 We try to provide information here about things that are different. 810 00:39:19,123 --> 00:39:20,691 On the cutting edge of health care. 811 00:39:20,691 --> 00:39:22,259 This program is different. 812 00:39:22,259 --> 00:39:26,530 The website exemplar.care is the website. 813 00:39:26,530 --> 00:39:28,232 All the information is up there. 814 00:39:28,232 --> 00:39:31,202 And now I leave you with this thought from Albert Einstein. 815 00:39:31,335 --> 00:39:34,572 The one who follows the crowd, they usually get no further than the crowd. 816 00:39:34,772 --> 00:39:39,143 The one who walks alone is likely to find himself in places no one has ever been. 817 00:39:39,443 --> 00:39:41,445 Remember, friends, it's a funny thing about life. 818 00:39:41,445 --> 00:39:44,448 If you refuse to accept anything but the very best. 819 00:39:44,448 --> 00:39:45,783 You most often get it. 820 00:39:45,783 --> 00:39:48,586 Thank you for listening to America's Healthcare Advocate Show 821 00:39:48,586 --> 00:39:51,722 broadcasting coast to coast across the USA. 822 00:39:51,722 --> 00:39:53,124 Goodbye America. 823 00:39:56,127 --> 00:40:03,267 You and you.