Common Sense is Replacing Health Insurance
Redirect Health’s unique approach to Direct Primary Care solves patient problems, often before they even arise, at a startlingly low cost.
Emergency Room for Asthma? Not Any More!
Redirect Health decreased patient emergency room visits for children with asthma down to “near-zero.” How? According to Dr. David Berg, their co-founder and chairman, Redirect Health “thinks like a mom with a medical degree.”
If her mother had a medical degree, would an eight-year-old girl have to remind her mom to order inhalers? Of course not; mom would just take care of it in the background. If the girl ever called with a medical worry, mom would help her both solve the problem and feel comfortable and safe throughout the process.
Most physicians have personally experienced some version of this story. Dr. Berg’s wife, herself an MD, cares for 20 to 30 friends and family to some degree. Redirect Health is designed to give that same personalized, individualized experience to their 7000 members, many of them minimum-wage workers. Redirect Health routinely goes the extra mile. In the example of the girl with asthma, instead of merely providing the minimum care, her case manager would:
- Ensure there’s an inhaler everywhere the child goes—home, school, grandma’s house, etc.
- Show the family how to buy inhalers from Canada so they cost 1/5th of the price.
- Check in once per month to make sure the family has everything they need.
Every patient gets a 24-hour concierge number to call any time a medical issue arises. Even if she’s not coughing or wheezing, the asthmatic girl can call if she becomes worried because she’s realized that she doesn’t have her inhaler.
“This simple system drastically reduces emergency room visits,” describes Dr. Berg. “It takes them to near-zero by following the similar process that a mom with a medical degree already does for her family. Now, we support it with 200 people and process and technology and strategy and vision, so one mom with a degree can take care of thousands of people, not just her own family.” Since Redirect Health solves each patient problem individually, the depth to which they helped this asthmatic child is the standard of care, not the exception.
How It Works
Unlike insurance, Redirect Health promises that they will care for employers’ employees and their families. They even include this promise in their clients’ job postings, where one includes the declaration “FREE HEALTHCARE BENEFITS.” And the free healthcare is what it looks like: Redirect Health takes care of every one of its members with zero copays for all routine and preventive services. As Dr. Berg puts it “We don’t want people to feel nickel-and-dimed because that would erode confidence.” With minimal action (just call the number whenever you need something), members know Redirect Health will be there to help.
Since Redirect Health focuses so much on member experience, they take care of many of the financial and bureaucratic aspects of care too. In addition to their free preventive visits, they ensure patients get a fair price for prescriptions, specialists, imaging, hospital services, etc. If the member qualifies for a government, public, or private program, Redirect Health helps them understand what they qualify for, and will fill out the paperwork on the member’s behalf. This same ease applies whether a member visits a Redirect Health doctor or while traveling out-of-state. Anywhere a member needs care, Redirect Health will find a local doctor and contract with them directly, on-the-spot, for a one-time member visit, then retrieve all member data to include it in the member’s medical record. And then best part? For the member, this process is seamless.
The Redirect Health program costs $105 per person per month, much less than most health care options. As Dr. Berg puts it, “we don’t mind paying for health care. At fair prices, care is very affordable. Insurance is expensive, copays are expensive, deductibles are expensive, but, they’re expensive due to a lot of waste in the system. Health care is only a third of the cost without the waste and unnecessary administration attached to it.” Surprisingly, to make their system work at only $105 per month, Dr. Berg’s team doesn’t even have to find the lowest price. An x-ray should cost around $30, says Dr. Berg, but he doesn’t care if it’s $27, $37 or $57, so long as it’s “just not exorbitant, like $800 or $1000.”
With this affordability and standard of care, it’s easy to see why Redirect Health has grown to 7000 members in 45 states, all cared for by what he describes as “moms with medical degrees.” The system is improving over time: Dr. Berg’s promise to his own employees and their families costs less than when he started in 2002 because his company understands the system better. As he describes, “We’ve learned how to predict when people will have a need so we can address the need before it becomes a problem – often when the cost is still $0.”
How Redirect Health Arrived at its Unique Approach
If you ask doctors what their patients want, they’ll say patients want better doctors; patients, however tell a different story. As Dr. Berg describes, talk to patients and you’ll find they actually want more human elements. For example patients:
- Should be able to find a parking spot.
- Want doctors to be on time to appointments.
- Want staff to be helpful and friendly, answer the phone, not put them on hold forever, and return their calls promptly.
- Most of all, patients want the confidence that their doctor has a system and team that will take care of them.
After moving to the US from Canada, Dr. Berg was shocked that different players in the healthcare system wanted so vastly different things. He found that:
- Insurance companies wanted CPT codes and ICD-9 codes, contracts, and credentialing.
- Hospitals wanted referrals to their surgeons and expensive imaging centers.
- Doctors wanted lighter schedules and more time with patients.
Redirect Health focuses exclusively on what its members want, obsessing over the customer feeling and experience. They have a company book about it—their “play manual,” that they’ve iterated over and over again, constantly clarifying customer problems and implementing solutions. As soon as he learned that member confidence is the most important element of care, Dr. Berg simply made a promise that his members will be taken care of. As he puts it, “buying insurance is expensive. Getting someone to feel like a good mom or dad, with confidence that they can take care of their family tomorrow? That’s very inexpensive because it’s a promise.”
How did they arrive at these novel insights? Dr. Berg has a five-step problem-solving process that he and the company use to great effect:
- Define the problem, with all the interconnected pieces, components, people, and perspectives well enough that you can communicate it succinctly.
- Propose a solution that fits the problem.
- Predict the results that the solution will have on the problem.
- Implement the solution.
- Compare the real results to the predicted results.
- Restart at step one based on your new understanding of the problem.
According to Dr. Berg, “If you run through that process 2-3 times, you usually get to a pretty good answer that is better than most.”
Insights Gained from Redirect Health’s Unique Approach
Even health insurance, with its much more expensive cost, doesn’t instill the same confidence as Redirect Health’s promise. It’s a commonly quoted statistic that a huge fraction of American bankruptcies stem from medical costs. To Dr. Berg, however, the more surprising number is that a majority of these people with medical bankruptcies had insurance to protect them. Since people buy health insurance to protect them financially, isn’t it a fundamental failure that someone goes bankrupt when they have insurance?
For example, you could give a free insurance policy with a $1000 deductible to the the 69% of Americans without $1000 in the bank, and they can still go bankrupt, suggesting insurance is clearly not the solution. As Dr. Berg describes, “If you define the problem as ‘lack of insurance’, you end up with a very bloated health care system that doesn’t work well for anybody except the most affluent.”
Instead, Dr. Berg and his team know what prices are fair and ask for them. Currently, insurance negotiates what Dr. Berg calls “unfair prices”—high prices, much higher than the self-pay price. As a movement, Direct Primary Care is about removing the insurance company from the middle because they benefit from confusing patients through complexity and hidden costs. Dr. Berg says it’s easy to find a provider once you know the fair price. As he describes, “Don’t be surprised if someone quotes you $3,000 for an MRI. Redirect doesn’t ask a provider, ‘how much is an MRI?’ We say, ‘I’d like to get a $300 MRI. Can you help?’ Once you know the fair price, it’s a lot easier to get.”
A New Vision for Health Care
Redirect Health’s innovative Direct Care model has a new vision for health care because, as Dr. Berg believes, “more insurance isn’t the solution. The Affordable Care Act was a perfect example of a solution that did not correctly define the problem.”
Instead, he recommends you look at your own practice, isolate your problems and find the solutions unique to your practice. Ask yourself, “what’s the problem I’m actually trying to solve?” then create a solution for your customers. The process seems to work incredibly well: Dr. Berg and Redirect Health are keeping its members healthy at minimal expense with a new system designed uniquely for them without the insurance bloat.
Should you need any help asking those questions or solving your problems, Hint is here to help, both directly and through our community. Health care will only be improved through new innovations like Redirect Health. We invite you to join us in the DPC revolution.
 https://www.huffingtonpost.com/simple-thrifty-living/top-10-reasons-people-go-_b_6887642.html https://www.usatoday.com/story/money/personalfinance/2017/05/05/this-is-the-no-1-reason-americans-file-for-bankruptcy/101148136/