And now America's Healthcare Advocate, Cary Hall.
Hello, America. Welcome to America's Healthcare Advocate show.
We're broadcasting coast to coast across the USA here on the HIA Radio Network.
You can find out
more about us by going to the website AmericasHealthcareAdvocate.com.
All of our shows are posted up there,
as well as our podcast platform and YouTube platform.
By the way, I want to thank everybody, the audience.
We're up to 429,873 views on YouTube and
107,078 plays on our podcast platforms.
Dave Thiessen provided me with all of that information
the other day, and I was quite surprised to see the numbers up so HyVee.
So we thank all of you out there,
and those of you listening on terrestrial radio to our over
200 stations around the country in studio with me today.
We have two guests from HyVee, the Exemplar Care doctor Jon Van
Der Veer is here and Jaci Robson here from HyVee Exemplar Care.
Welcome to the studio today.
Thank you.
We're going to have a fascinating show today.
If you're an individual on an ACA or as I call it Obamacare health insurance
policy, or even if you're a small employer or a large employer,
you've probably dealt with what's going on in this marketplace
in terms of high cost, high deductibles, not a lot of care for your employees,
a lot of dissatisfaction with these plans as the years have gone on.
We're going to talk about a model today that is significantly different.
It's an opportunity for primary care, direct pay,
membership in a program that we think is going to make a big difference
here in the Kansas City metro.
So with that, I want to go to Doctor John Van Veer.
Doctor.
So how did you come up with this model and this concept?
This is your baby.
It's a lot of people's babies.
But yes, this version is mine.
So the, the idea of direct primary care
has kind of been out in the ether, for a while.
And I basically was I, like you said, you are a recovering “broker”.
I am a recovering “fee for service” doctor.
And it took
kind of a breaking point in burnout to really realize
there's a better way to deliver care and then for the patients to receive care.
So this model, just allows for that type of interaction to take place.
So, Jaci, talk a little bit about the membership model and how this works
and how this is significantly different to what we see
in a typical primary care practice. Jaci.
So the membership model is that for a monthly membership,
you can receive all services that we provide in our clinics,
which is all services, primary care or urgent care.
So 80% of what most people's health care needs are.
One of the things that I when I was researching this
and going through the website and looking at,
you know, how this is offered and where it's different than what we see
in typical primary care.
The average time spent with the primary care doctor in this country is 7.5 minutes.
One of the things which is not good, doctor.
One of the things that's emphasized in your model is the time
spent with the patient, the ability to listen to what the patient has to say,
and then be able to translate that into a program
that's going to make a difference in terms of their care, their ongoing care.
Disease management and health care.
So let's talk a little bit about that. You hit that exactly on the head.
So everyone wants to practice evidence based medicine,
but people don't often talk about the fact that the time spent with a patient
often leads to more accurate diagnoses and thus better treatment plans.
And our model, we have 30 minute follow up visits, 60 minute new patient visits.
I've had new visits, as long as two hours.
So it's not that rat race.
Where how fast can you get someone through,
to get on to the next person?
Because in a traditional system, your job is to see them, triage them,
and move them on to whatever specialist or other care piece is downstream
in this par alignment of the better I take care of you,
the better you feel, the less I have to see you.
Which actually goes into a membership model.
The better I'm doing, the less work I have to do.
But at the same time, when you need me, I then have time and availability
to actually spend with you.
So, Jaci, talk a little bit about the convenience of this.
I mean, these are in the Hy-Vee stores now.
We have them here in Lee's Summit in Overland Park in the Kansas City Metro.
You've been in Iowa and Nebraska for some time.
So talk a little bit about that
and how that model works again, differently than the primary care model,
where you may wait two weeks or months to see your primary care doctor.
This is significantly different.
It is significantly different.
And they’re not actually in the Hy-Vee stores, thery’re near
two are close to a Hy-Vee store so that we can work with Hy-Vee
and help them to, take care for their employees.
So they're actually close to it or near to a Hy-Vee.
So yes, we now have one in Lee's Summit and here in Overland
Park, it's at West 135th Street.
And the convenience of it is that
people can come see the longer appointments.
And then once
they've actually established, they can connect with the doctor provider
any way they need to from where they're at, so they can send messages,
they can do virtual, they can have those, calls with them
from whenever they need to, wherever they need to get the care that they want.
And it's all included in that membership.
Can I share an example with me?
So we were driving from, West Des Moines down to Kansas City Market today,
and I received a phone call from a patient who said, hey, I've got a rash.
This is what's been going on.
I said, well, I'm not in Des Moines today, but somebody could see you.
Or if you want to shoot me some pictures, you can.
So he sends me pictures.
I looked at it.
He has shingles and his antibiotic or his antiviral
has now been sent in across the state line, to his regular pharmacy.
And he's getting the care he needs without having to even step foot in a clinic.
So the and that's, that's remarkable because they were able
to resolve that problem right away
and not have to wait to get an appointment and come in.
Can they connect when you're when you're members, your patients connect,
do they come back to the same doctor
each and every time if that doctor is available.
How does that work? They do.
They also we like to view Hy-Vee Health Exemplar care kind of as the provider.
If you're a member in West Des Moines and you're watching a Chiefs game,
you can go into the Overland Park clinic and be seen just like any other member.
So yes, you can see the same person for continuity on the primary care side,
but if you have a need that you just need,
taking care of the entire system is built to take care of members.
And so if they're if they're not in their particular metro,
if they happen to be in Des Moines or I'm back and forth to Nebraska all the time,
you would be able to go into any of the Hy-Vee Exemplar clinics and do this.
And you get moved to the front of the line.
You get treated like a member.
It doesn't matter where you're at.
So what what prompted Hy-Vee to do this partnership with you?
Jaci, talk a little bit about that, because this is unusual.
I think that might be a better Jon question.
Okay.
Obviously Hy-Vee has assets in pharmacy, the PBM space,
specialty pharmacy, dietary, dietitians, all sorts of different components. So,
it made sense that they were moving
towards primary care, and they'd been looking and we, met with Doctor
Fick, who's their chief medical officer, introduced him to our model.
And we walked through what benefits this could have for them, as an employer,
both taking care of employees and then also serving the communities we’re in.
Their employees or actually in this program?
Yes. Absolutely.
So HyVee’s,
this is not just something they're doing in the community
they're invested in this in the standpoint of they're putting
their employees in the program for this care model. Yes.
Wherever we are located, we get access to that set of employees
or as we call them, patients, and start providing services directly to them.
That's very unusual, Jaci. It absolutely is.
And what we're finding is once,
companies are putting their employees into this care model, the engagement
of those employees with their health is significantly increased.
So people who may not have had their annual physical or that's all
they're having, they're actually coming in and having that.
And so they're seeing they're having their annual physical.
And then we're finding rather than somebody who sees adult to once a year,
they're maybe coming in 3 or 4 times a year
because they're using those doctors and providers as advocates
and coaches to be proactive about their health going forward.
Whether it's weight management or help with sleep or mental health,
whereas prior to coming into these programs.
They were managing it themself and maybe talking to Doctor Google.
And a lot of times they were done. I know Doctor Google. My wife talks to Dr Google
a lot, so I understand that comment..
From the financial standpoint, and employees are often gun shy.
They don't know what something's going to cost.
I mean, a a urine test could be $1.30 or it could be $200.
That's the that's the issue. They don't know.
And in this model, the employers covering their membership and they come in.
And every service we provide in-house is included.
So they know they're not going to pay anything.
So I think you can see this is a very different model.
We're going to go into more of the details regarding the model.
We're going to talk about how if you're an employer,
this could make a huge difference for you.
Also, if you're on an ACA plan,
get ready for some market disruption in the fourth quarter of this year.
So we're going to talk more about that with our guests in studio here.
Stay tuned. We'll be right back after the break.
If you want information.
The website is Exemplar.care. Exemplar.care.
It's not.com. It's just exemplar.care.
They've got a great website.
All the information is up there. You can reach out to them.
They'll be happy to chat with you.
If you're an employer or an individual and you want to see what this model's
all about, or even take a tour of one of their facilities.
Stay right there. We'll be right back after the break.
You're listening to America's Healthcare Advocate
broadcasting here on the HIA Radio Network.
Coast to coast across USA. We've got more.
Welcome back.
You're listening to America's Healthcare Advocate show,
broadcasting coast to coast across USA.
Here on the HIA Radio Network.
My producers today, Mr.
Garner Cowdery behind the microphones and Mr.
Dave Thiessen behind the cameras puts
all these shows together, all those YouTube views, you see,
and those podcast platforms, all 15 of them.
Dave is the one that puts all that up there.
Very happy to have them in studio with us today doing this obviously.
And Doctor Jon Van Der Veer, he is the CEO of Hy-Vee Exemplar Health
and Jaci Robson , he's the VP of Hy-Vee Exemplar Healthcare membership services,
and we're happy to have him in studio talking about this very different model
that's now available here
in the Kansas City Metro, with two clinics in Overland Park at the summit.
We'll talk more about that in a minute.
A little bit about doctor. Doctor VanDerveer is a D.O.
and MBA is a board certified internal medicine physician
and the CEO and founder of Hy-Vee Health Exemplar Care, a membership
based clinic focused on personalized, accessible health care.
He's got 20 years of experience in hospital and internal medicine,
and he brings this patient centered approach to this model.
Jaci Robson is the vice president of member service at Hy-Vee Exemplar Health.
She helps with most of the innovative models and direct care and primary
care and urgent care.
We're happy to have them in studio with us.
So let's continue with this conversation and talk a little bit
about all the services included for this one.
Single membership fee.
No more co-pays, no more deductibles.
I made notes this morning: no more coinsurance, no more out-of-pocket maxes.
All that goes away.
So let's talk about what those services are, doctor.
So, like you said, it's kind of one and done.
There's the monthly membership fee and that includes your in-person visits,
your annual visit, virtual care,
texting portal messages, any
way you choose to communicate to get your care provided.
In addition to the actual care, there's then
lab services included.
Depending on states, there are generic
medications dispensed out of the clinic.
Additionally, we are set up for X-ray.
So for plain films, as markets grow and mature,
we'll have X-ray in all of those locations.
And then additionally there is DME.
So durable medical equipment.
This is the slings or crutches
or things you may need if you have an accident or need something.
I think that hits just about all of them.
So that's basically Jaci, everything that you would get in
a primary care clinic and then more
so you need a lab right now.
Now I got to schedule my labs, a quest or wherever
I have to go that I have to drive there and get that lab done.
If I'm at the Hy-Vee
Exemplar Care Health facility, I get the lab is done right there.
Absolutely.
It's a complete
one stop shop where you're coming in and you're meeting with your provider,
and then you're leaving with whatever you're needing to manage that care
that you need.
I think you should also,
at some points as well, speak about the types of membership costs,
because the membership itself it sends when you're speaking
about membership and people say this is a lot of services that I receive.
So the actual costs for an individual are $89 a month.
So $89 a month for an individual, a $158
a month for a couple, or $216 a month for a family.
And a family would be two adults and two or more children.
So we are speaking affordable here as well, but it's much more
not about the cost.
It's about the quality and the quantity of the services
that you're receiving for that cost.
So you can get care how you want, when you want,
for less than the price of a cup of Starbucks a day.
That's the that's
a, that's a really good comparison of less than a cup of Starbucks a day.
When I look at that versus what I'm going to do on an ACA
Obamacare policy or what I'm going to do on the small group
health insurance policy where you've got copays for labs,
you got the copay to see the primary care doc and you go into a primary care doctor
and it says right on the desk at the receptionist.
You're responsible for the copay before you go see the doctor.
This is completely different.
It's absolutely, completely different.
And what we find is it's also unlimited visits.
We don't encourage it,
but you can absolutely come and see us every day if you wanted to.
But Jon has patients. You're going to get a lot.
Patients who do message him on a regular basis.
He has patients who he speaks to. A different way to go.
Like he was doing this today.
Like he was doing today.
So we do have, people do like the model.
This is the talk to their provider more regularly.
With, with the model Cary, I think one of the most important things
is if you change the financial model,
you change the care model, and that's where everything gets stuck.
The fee for service world.
That exists right now,
it is perfectly incentivized to give us what we all think of as “sick care”.
That's right.
It's built and it delivers exactly what it was designed to do
and accidentally designed.
And this is changing the model and it changes how the care's delivered.
So you talked a little earlier about the fact that people
are managing their, their disease, managing their wellness, their health.
They're doing they're going in to see the doctor more often.
They're doing the things they need to do.
Obviously, not having these roadblocks in front of them with the co-pay
every time they turn around.
I've got to get a piece of durable medical equipment.
I've got a full deductible and co-insurance
I have to pay before I can access that equipment.
I need a lab.
Well, that's that's $150 or $800 depending on the...
So that has to have a direct impact on this.
Yes, absolutely. Can I follow?
Sorry, Jaci, just to tell a quick
DME story, we had a gal who came into, an urgent care
facility of ours and said, I my daughter's here.
She was hurt. She needed a sling.
We said, we'll sell you the sling.
This was she wasn't a member, but we still serve the public as well.
Said we'll sell you the sling for $20.
And she goes, I have the best insurance in the state.
I want to I want to have it billed to my insurance.
She got her bill for $197.
It was our first and only, our first, one star Google
review blasting us for her having to pay $197 for a sling.
We offered to her for $20, and she said, well,
I could have bought the same one for $15 at Walmart.
Well they have better buying power than we do.
So it shows that people don't even understand what their insurance
does, how it's going to impact them financially.
We're this we make it as clear and transparent as possible.
Yeah, well, there's a reason that the big hospital systems that run
these primary care practices don't publish their rates where you can see
what the cost is to have this visit or that visit or another visit.
There's a reason for that.
Okay.
And a lot of that has to do with the negotiated price
they put in place with the primary carriers, the big carriers.
The Blue Cross’s, the United’s, the Aetna’s, is the Cigna's,
you know, the Ambetter’s, go on down the list, okay.
And that's got a lot of impact on how this works.
And that's why people are spending so much money on a lot of this.
What you're doing is you're cutting through all of that saying here
for $89 a month, you can come in here and get everything you need done.
We'll talk about, in the next segment, what happens here to be referred out
and all that, and how all that functions.
But the point is, 90% of what people do is right there with their primary care.
Doc, am I right or wrong?. Absolutely.
That's exactly it's. 100%.
We're also finding the some of the primary care through the hospital systems
are actually billing at hospital rates.
Oh that depends on on their facilities where they're structured.
And so and the problem with that is obviously
all this comes back to the user in terms of premium.
And that's why you see, and that's why you're gonna see this year
in the fourth quarter,
especially if you're on
one of these ACA plans that I intend to talk about this in great detail
in an upcoming broadcast, but you're going to see rate increases
of 25% or better across the board on most of the ACA plans.
Some of that has to do
with Aetna constricting out of the moving out of the market.
You know, all of these things that are going to happen out here.
So this is a model that is here today to serve today
that makes a huge difference in the way care is being delivered and
an even greater difference in the cost.
If you want information, it's Exemplar.care, Exemplar.care.
That's that's the website.
It's a beautiful website.
Ton of information up there. You can go up there and find out about it.
If you're an employer, I urge you to take a look at this.
If you're an individual
and you're paying these high premiums, this is a great way
to get out of that hole and start getting a better form of care.
You're listening to America's Healthcare Advocate
Broadcasting here on the HIA Radio Network.
Coast to coast across the USA.
Stay right there. The doctor's in the house. We'll be right back.
Welcome back.
You're listening to America's Healthcare Advocate Show, broadcasting coast
to coast across the USA here on the HIA Radio Network.
Want to give a shout out to KVGB 1590 Am 97.7
FM on Saturdays from 11 to 12 in Great Bend, Kansas.
One of our best affiliates in the state of Kansas.
Want to say hello to all those folks out there
in that listening audience that listen to our broadcast every week.
So we're going to shift gears now.
There's a lot of disruption coming in the fourth quarter.
I talked a little bit just a minute ago.
Who went out of that segment of what
we're going to see in the individual marketplace?
Well, it's going to be similar to what
we're going to see in the small group space next year.
You're going to see significant increases across the board.
You're also going to see a very narrowing of networks.
This is one of the ways that carriers control costs is by controlling access.
Well, we're going to
look at that versus this model.
But the HyVee Exemplar Care model and talk about what those differences are
and how that works and how that impacts cost, to you as an employer.
So instead of cost shifting, raising the deductibles,
raising the co-pay,
raising the out of pockets and putting that burden on your employees,
you're going to have an opportunity to hear how this program does
just the opposite of that.
So let's just start right there, doctor.
To me and David Hickman just walked in studio here,
broker here in the Kansas City metro I've worked with for about 16 years.
And we've talked about this extensively to me, this is a tremendous alternative
for the small group employer out there that is really getting hammered with it.
The benefits are going down.
The cost is going up.
As I said, there's a lot of cost shifting, pushing it more on to the employer,
the employee.
This is significantly different.
Talk about that a little bit and how this model works for employers.
And what are employers finding in the way of satisfaction with this.
So employers are very satisfied with it.
First off, because it's affordable to them and it helps them manage
some of their costs.
Secondly, it allows them to provide what we've had some employees
define as the only true benefit my company offers me.
And, they said it, we've got a written down the,
the employee
though is the one, like you said, who's been carrying more and more of the burden.
And as we all know, the vast majority of people can't tolerate a $1,000 bill.
But they have a $7,000 deductible.
They can't afford the care that they need.
And in this model, they have a benefit that they know it's paid for.
It's covered, and all the care they get is going to be included.
They're not going to have a surprise bill. There's not going to be a lab fee.
There's not going to be, a visit, a copay, a co-insurance, a deductible.
Nothing's going to show up.
And that's why they view it as a true benefit.
They can get care that they've avoided in the past
because they didn't know what it was going to do to their own finances.
How does that affect the overall health of the employees
as a group and for the employer in terms of things like absenteeism and,
you know, trying to get to a doctor's appointment
but they can't get to
because they can't get there in time, they get to take time off work.
This all changes now, talk a little bit about that.
It absolutely changes.
So we are much healthier, happier employees, more engaged employees,
and from the employer's point of view, as the employees are able to get that
same day or next day appointments, they get seen when they need to be seen.
If they're not able to get into a clinic, they can connect with the provider
and they can manage the care that they need, get that prescription that day
and be back at work, or be getting healthier as they move forward.
If they've had some of those conversations with the provider
regarding long term concerns.
So, the employer can take a high
deductible plan like an HSA or an HRA.
They can wrap it around this model where the primary care
is all handled by the HyVee Exemplar Care primary care model.
And if an employee needs to go out to,
a doctor for an orthopedic surgery or another type of procedure, talk
about how you work within that particular network to help them coordinate that
so they get this, the best level of care in that network, doctor.
So again, because we have the time to go
through people's medical information and you have their insurance plan,
you understand where they can get care and where they can, afford care.
First off, every clinician in every market knows where quality providers are.
So assuming that
the network has quality providers in it, you can direct those people directly
to those providers as long as they're in network, you know, which ones
are going to be more cost effective for those employees.
And if it's,
if it's a different funding model or a level funded, self-funded,
you can actually get the most cost effective for the employer as well.
But ultimately the employee will have choice.
They're going to say this, this is who I recommend.
Oh, I, my neighbors, this person. Okay. They're in-network too.
So you have the time to actually evaluate and send people where they should go
instead of just the oh, well, this is the one that's in their system.
So you go up a system and you go from primary care
to specialty care with no real regard to cost or quality.
So Jaci,
when this occurs now
is the primary care doctor clinician at the HyVee Exemplar Care clinic.
They're following along to see how the care is being delivered.
If there's follow up, whatever the case may be.
Oh, absolutely.
The providers at HyVee Health Examplar Care.
They’re advocates, they’re coaches, they’re navigators.
They will help people to understand the complexity of the health care system
and make sure that their patients, their members, are receiving
the care that they need.
So that there's a coordination between the two groups.
We are the quarterback.
That's how I always view it.
Is the the primary care team at HyVee Health
Exemplar Care is responsible for getting you in and seen.
And then if you do need to go somewhere out to get the care you need,
and then to close the loop and bring you back in and move you forward
with the appropriate recommendations you receive.
So you said something
at the beginning of this segment that was kind of interesting.
It's some of the employees have said:
“this is the only benefit my employer really provides”.
Do you think that that
that that kind of a testimonial to what you're doing, results from the fact
that they are not coming in and getting blown out the door in 7.5
minutes and handed three prescription, and out the door they go, or
how how impactful do you think it is that you said
you've had people spend as much as an hour sitting and talking to you?
You took a call today on the way in here from Iowa,
talking to a man had shingles and got a prescription for him.
So how that's a that's unheard of.
If you try to call a primary care physician, you're first.
You're going to get the nurse if you're lucky,
and then she's going to call you back between the hours of so-and-so and 3:00,
if you're lucky.
And if you miss that or you don't get that call,
you're not going to talk to him at all.
No, but I look at that versus here you are,
the CEO running this whole program and you're taking calls and talking.
How much do you think that statement made by that employee or employees
you've talked to has to do with the fact that they can access this care,
and somebody really gives a damn?
I think that's solely what it is.
Their life matters more than how we want to run our clinic.
So their convenience is their first priority,
their health is their first priority, and we're a delivery mechanism
to meet their need.
Health care has quit being a service organization, and it's a widget
producing factory where here it's all about relationships.
The better you know, somebody, the easier they are to care for.
If you know all their history, you can take a phone call on I-35
and and take care of somebody because you know everything about them.
So those relationships are essential.
And people feel that.
I mean, nobody wants to be hurried through like their cattle.
And unfortunately, this way the system is set up.
And I think, as Jon's exactly said it, it's an experience.
It’s something you need to feel.
You need to come in and feel the difference.
It’s a different way of doing health care.
And until you've actually experienced it, it isn't easy to explain it
and understand how that feels.
It's a little bit that like the Disney magic.
How do you explain what that experience is?
People.
People always say that they it's too good to be true.
This can't be how you take care of people.
And I felt listened to, I felt heard.
I've had this conversation with multiple people in the past.
This is the first time somebody has actually heard what I was saying.
Listen to what I said.
Because they took the time.
All about time and access.
Because as you talked about primary care doctors are taxed with seeing every
how many hundreds of patients they have, moving them through the system
as quickly as they can and getting to the next patient.
Internal medicine 2500 patient panels, family medicine, 3 to 5000 patient panels.
You're serious?
Yeah, and I was at 1900 when I left the fee for service
world on my way to 2500 as an internist.
Average age 76.
Not the easiest population to take care of.
Yeah, I'm 77.
There you. Go. You’re a wonderful 76.
And then now, panels
in direct primary care, 500, 800, a thousand.
If they're, if it's a healthy population, it's a fraction of the people.
And we don't need to see a certain number to bill them.
You just change the model.
Where they paid their membership.
And I'd like to add to a story with that.
I was talking to a cardiologist, and he advised me he sees ten patients a day.
He works in a system where he gets referrals
through the primary care, through the system.
He said.
Of those ten patients a day, he only needs to see three.
And of the other seven, they didn't need to be there.
If the primary care provider had been able,
not the primary care providers' fault, the system.
If the primary care provider would spend the time with them,
each of those ten patients is paying $3,000 each for that visit with him
and seven of them a day.
Do not need to meet with them.
And what do you think has to do with why that?
Why they're doing that?
You know,
that's one reason why United Health Care is under investigation right now
by the DOJ, because of those kinds of referrals and charges
that they are saying are unnecessary.
So, yeah, there's a lot that needs to be fixed.
Its a broken system. It is a broken system.
But this is a great system, and it's a system that can work.
And if it sounds like something
you'd be interested in, you should go to the website Exemplar.care.
You'll see everything up there.
If you're an employer, you can send them a quick message.
They'll be happy to have someone come out and talk with you.
If you’re an individual the same thing.
Or better yet, go to one of the clinics, walk around and see what you think of it.
You'll probably be surprised by what you learn.
We'll be right back after the break.
You're listening to America's Healthcare Advocate.
Broadcasting coast to coast across USA here on the HIA Radio Network.
We're going to shift gears now and talk a little about what do big employers do
when they're on this plan.
Stay right there.
We'll be right back with more.
Welcome back.
You're listening to America's Healthcare Advocate Show, broadcasting coast to coast
across USA here on the HIA Radio Network.
You can find out more about us
by going to our website, America's Healthcare Advocate.
Also 15 podcast platforms, YouTube.
So here's the thing.
Maybe your company is got a health insurance plan and nobody's happy.
Maybe you might want to mention to them.
Hey go up and listen to this broadcast that Cary Hall did with the doctor
in studio and talked about this HyVee Exemplar Care model
and how it works, and see what let them know that it's there.
Because oftentimes when people refer other people to this podcast,
we get a lot of feedback on this, the podcast and the YouTube.
You don't have to be able to relate this whole broadcast back to someone.
If you think there's someone that would be interested in this,
maybe it's a family and you think you maybe it's your wife
and you want to tell your wife to go listen to this podcast.
This is a great way to do this.
We're posted on 15 podcast platforms/channels.
We're on the we have our own YouTube channel.
We got almost a half million views up there.
So this is a great way to disseminate this information.
And this program is very, very different.
And I think
it's really going to come into focus as we get closer in to the fourth quarter.
And the marketplace disruptions that we're going to see.
Its HyVee Exemplar Care.
The website is exemplar.care if you want information.
So now we're going to talk about large employers
because I'm focused a little bit on small employers.
Quik Trip was one of your first clients okay.
And now how many employees?
They have a lot of employees.
But on their on their benefit plan it's around 24,000.
And and we're taking care of, folks
who are in the clinic areas where we've built out clinics.
That's remarkable.
Obviously, just hearing that is an endorsement
into your quality level, what you do.
I shop at Hy-Vee at 151st in Olathe.
I'm in there multiple times a week. Okay.
Thank you. Great people. Great.
But I've never been to a grocery store where they literally stop
whatever they're doing and, I need to know where I can find this.
And they walk you to the aisle and show it to you
that's
the way the employees work there is completely different for them
to have that kind of faith in what you're doing,
and to be able to take their employees, and send them to your facility.
I think that speaks volumes for how this works.
Absolutely.
And I think we are actually headquartered in
Des Moines, Iowa, which is where Hy-Vee's also headquartered.
And our first clinic in, West Des Moines
headquarters clinic is also 24 seven urgent care.
So with Hy-Vee and the types of employees and the demographics,
and then we've got shift workers that absolutely works for them just as well.
That's, you know, outside of us, they can connect with the primary care provider,
or they can come in to urgent care if they have those acute needs.
We do offer fee for service as well in the urgent care.
So we have nonmembers, but our members get priority so they can walk in
and they're the next one to be roomed.
When a room becomes available.
So when you say 24/7 you really mean 24/7 brick and mortar urgent care.
Absolutely.
We opened our doors, nearly five years ago now, and we've never closed
those doors since. I’ve never missed a shift.
And as we grow out and the markets mature, we're going to have it in Omaha.
And here in the Kansas City market as well.
That's that's pretty remarkable because that's not something you typically see.
And again, the employees are coming in.
There's no copay for them.
There's no out-of-pocket costs for them.
Am I going to be able to afford the copay?
Well, I'll wait a couple days.
I'd rather see if I'm not going to have this problem, or the problem gets worse
because they don't want to pay the 50 or 75 or $100 co-pay.
This is completely different. And even more so at night.
Those employees would often be going to an emergency room.
So now you have hours of time lost, thousands of dollars
spent out of their pockets, and even more out of the large
employer level funded, self-funded folks who are paying the bill.
However it comes in.
And it is the least effective dollar for health care spent in this country.
Absolutely. Yeah.
And it's unfortunate, but that's what you said is absolutely correct.
Yeah. They all understand zero.
So they all understand zero.
And we all know that accidents never happen when we want them to happen.
They're always going to be at night or at the weekend or during the holiday.
You you know,
you're at the barbecue with your friends on the 4th of July and something happens.
Where do you go?
Emergency room is usually your only option,
but now we can do the virtual care if needed.
If virtual care will manage the situation, we can do virtual care
or they can come into the clinic for that 24/7 treatment.
So on the break you were talking a little bit about the experience
for the employee and what you have learned over the years
with how the employees feel about this program versus
being on a standard ACA type health insurance program.
Talk a little bit more about that, Jaci because it was fascinating.
Yeah. No.
What we find is that a lot of these employees,
they've not necessarily had regular checks.
So what we actually say to them, some of them are unsure, and they feel
that when they're coming
to a doctor's office, maybe it's a little bit more judgmental.
They come and they visit our clinic and people have got the time for them.
They build that personal relationship with them, and it just feels more real.
They’re coming and talking to a friend.
We also say “doctor in your pocket”, or “that small town doctor” who knows
your family and knows who you are and what matters to you.
We want people to live their healthiest lives,
so if that's playing with your grandchildren, it's
you want to continue to be golfing, or whether it's that
you just want to go and sit and meditate and have coffee with your friends.
We will work with you on whatever health means to you.
And what we do is during that welcome visit, we will take those baseline
labs.
We’ll have those initial conversations of what health means to you,
and then we'll make sure
that we keep your health where it is today or we'll help you to improve.
This is all about proactive preventative health care rather than the “sick care”
that we have across most of healthcare.
Must have time to dig into it all.
If you come in and you've got a couple things you want addressed,
one of them, you might be tired.
You're chronically tired.
If you work shifts, the your sleep's not very good.
You don't eat very well because you work at QuikTrip and a convenience store.
Or you get off work at two in the morning and there's nothing available,
and you can't cook.
We have the time to sit and go.
Okay, let's look at first off.
Yes, we need to figure out your sleep schedule.
Go through all of that. That can be a ten minute conversation.
Then you move on to the diet and the exercise.
The exercise is going to help, sleep.
I remember in the fee for service world, I would get people who would come in
and be like, yep, you need to work on your diet and exercise.
You shouldn't become diabetic. That would be bad.
Thanks. Have a nice day.
Done. Visit over.
7.5 minutes. 7.5 minutes and out the door.
Now have you sit and have a conversation.
You say okay, your A1C comes back at at 6.0.
You're pre-diabetic.
You could become a diabetic if you're A1C gets to 6.5, you're on that trend.
I could give you metformin, a medication that treats diabetes.
And we can relative risk reduction of about 16.
Or you can make wholesale lifestyle changes.
And now I can talk about intermittent fasting, low carb food options,
the types of exercise that, decreases the likelihood of progressing to diabetes.
And that's a 32 fold relative
risk reduction, twice as effective as me giving you a medication.
One of those takes time and effort to explain.
The other one takes writing a prescription and moving on.
And that's the 7.5 minute visit.
And half the patients will say, I kind of like that pill idea,
but this is where you get a chance to really show them
that you care about them and educate them like your health matters.
And if you make these changes, you can head off
one of the most costly long term diseases that you can have.
And that comes back in cost to the employer,
and it comes back with satisfied employees,
and it comes back with
the overall health of his workforce and how they feel about that employer.
Which goes back to that comment you made earlier in the show.
This is the one thing my employer does that’s a real benefit.
So you know what this is though Cary, this is alignment.
So my goal is to make you healthy.
Your goal is to be healthy.
The employer's goal is to provide a good benefit and to save money.
At the same time.
All these things are in alignment where in a fee for service world,
the more you come in, the more I get paid. You have.
I do have disincentives and misalignment that cost people money over time.
And this is a way to to remedy that.
And, you know, I think that's a great way to wrap this up.
You just heard it from doctor. It makes perfect sense.
This is this is an alignment.
It's a alignment that works.
I urge you to take a moment to go to their website and take
a look at this exemplar care
Exemplar.care.
It's is on the website.
All the information is up there if you're an employer,
if you're a human resource director and you're,
you know, you're looking for an alternative
or you know you're going to get
a significant increase next year, or maybe you're just not happy.
You're not happy with the program that you're on.
You're not happy with the carrier.
You're not happy your employees are not happy.
You've been cost shifting.
You're doing all these different things to try to make it work.
It's just not working.
This model works okay.
Hy-Vee and QuikTrip wouldn't be doing this
with thousands of employees if they didn't think it worked.
That's why I asked these folks to come and do this show.
We try to provide information here about things that are different.
On the cutting edge of health care.
This program is different.
The website exemplar.care is the website.
All the information is up there.
And now I leave you with this thought from Albert Einstein.
The one who follows the crowd, they usually get no further than the crowd.
The one who walks alone is likely to find himself in places no one has ever been.
Remember, friends, it's a funny thing about life.
If you refuse to accept anything but the very best.
You most often get it.
Thank you for listening to America's Healthcare Advocate Show
broadcasting coast to coast across the USA.
Goodbye America.
You and you.