Employees love it: “This is the only benefit my employer really provides” and Employers think it’s great and it is the result of wanting to both solve healthcare challenges for members while giving employers lower costs, less absenteeism, healthier teams.
We talk to the founder and CEO, Dr. Van Der Veer whose frustration with traditional healthcare led to creating a better way. Hy-Vee Health Exemplar Care is currently available in select cities in Iowa as well as Overland Park, Ks and Lees Summit, Mo
We're going to talk about a model that is significantly different and 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.
Guests:
Dr. Jon Van Der Veer, DO, MBA, Founder/CEO at Hy-Vee Health Exemplar Care
Jacqueline “Jaci” Robson, Vice President of Member Services at Hy-Vee Health Exemplar Care
To learn more: https://www.exemplar.care and @ExemplarCare on Facebook & LinkedIn
This is Ep 2118 of America’s Healthcare Advocate podcast
Learn more about me, Cary Hall: America’s Healthcare Advocate:
I have a strong desire to empower my fellow Americans and cancel the noise and confusion surrounding the US healthcare system. My goal is to enable you to become the expert for your own healthcare management, saving you time, money, and effort. Learn more: https://www.americashealthcareadvocate.com As always, if you need help or have something to share? Contact me with this form on my website and let me know what's on your mind, the issues you are dealing with, or other health, healthcare, and health insurance questions and concerns. https://www.americashealthcareadvocate.com/contact-us
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
And now America's Healthcare Advocate,Cary Hall.
Hello, America. Welcome to America'sHealthcare Advocate show.
We're broadcasting coast to coast acrossthe USA here on the HIA Radio Network.
You can find out
more about us by going to the websiteAmericasHealthcareAdvocate.com.
All of our shows are posted up there,
as well as our podcast platformand YouTube platform.
(00:23):
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 Thiessenprovided me with all of that information
the other day, and I was quite surprisedto see the numbers up so HyVee.
So we thank all of you out there,
and those of youlistening on terrestrial radio to our over
(00:45):
200 stations around the countryin studio with me today.
We have two guests from HyVee,the Exemplar Care doctor Jon Van
Der Veer is here and Jaci Robson herefrom HyVee Exemplar Care.
Welcome to the studio today.
Thank you.
We're going to havea fascinating show today.
If you're an individual on an ACAor as I call it Obamacare health insurance
(01:06):
policy, or even if you're a small employeror a large employer,
you've probably dealtwith 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 plansas the years have gone on.
We're going to talk about a model todaythat is significantly different.
It's an opportunityfor primary care, direct pay,
(01:29):
membership in a program that we thinkis 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 modeland 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.
(01:51):
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 burnoutto really realize
there's a better way to deliver careand then for the patients to receive care.
So this model, just allows for thattype of interaction to take place.
(02:13):
So, Jaci, talk a little bit aboutthe membership model and how this works
and how this is significantly differentto what we see
in a typical primary care practice. Jaci.
So the membership modelis that for a monthly membership,
you can receive all servicesthat we provide in our clinics,
which is all services,primary care or urgent care.
(02:34):
So 80% of what most people's healthcare needs are.
One of the things that Iwhen I was researching this
and going through the websiteand looking at,
you know, how this is offeredand 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 ofthe things which is not good, doctor.
(02:55):
One of the things that's emphasized inyour model is the time
spent with the patient, the abilityto listen to what the patient has to say,
and then be ableto translate that into a program
that's going to make a difference in termsof 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 practiceevidence based medicine,
(03:17):
but people don't often talk about the factthat the time spent with a patient
often leads to more accurate diagnosesand thus better treatment plans.
And our model, we have 30 minute follow upvisits, 60 minute new patient visits.
I've had new visits, as long as two hours.
So it's not that rat race.
Wherehow fast can you get someone through,
(03:40):
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 specialistor other care piece is downstream
in this par alignment of the betterI take care of you,
the better you feel, the lessI have to see you.
Which actually goes into a membershipmodel.
The better I'm doing, the less workI have to do.
(04:01):
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 bitabout the convenience of this.
I mean,these are in the Hy-Vee stores now.
We have them here in Lee's Summitin Overland Park in the Kansas City Metro.
You've been in Iowa and Nebraskafor some time.
So talk a little bit about that
and how that model works again,differently than the primary care model,
(04:22):
where you may wait two weeks or monthsto see your primary care doctor.
This is significantly different.
It is significantly different.
And they’re not actually in the Hy-Veestores, thery’re near
two are close to a Hy-Vee storeso that we can work with Hy-Vee
and help them to,take care for their employees.
(04:43):
So they're actually close to itor near to a Hy-Vee.
So yes, we now have one in Lee's Summitand here in Overland
Park, it's at West 135th Street.
And the convenience of it is that
people can comesee the longer appointments.
And then once
they've actually established,they can connect with the doctor provider
(05:03):
any way they need to from wherethey're at, so they can send messages,
they can do virtual,they can have those, calls with them
from whenever they need to, whereverthey 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 Moinesdown to Kansas City Market today,
(05:25):
and I received a phone call from a patientwho 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 mesome pictures, you can.
So he sends me pictures.
I looked at it.
He has shingles and his antibioticor his antiviral
has now been sent in across the stateline, to his regular pharmacy.
(05:48):
And he's getting the care he needs withouthaving to even step foot in a clinic.
So the and that's, that's remarkablebecause they were able
to resolve that problem right away
and not have to wait to get an appointmentand come in.
Can they connect when you're when you'remembers, your patients connect,
do they come back to the same doctor
each and every timeif that doctor is available.
How does that work? They do.
They also we like to view Hy-Vee HealthExemplar care kind of as the provider.
(06:14):
If you're a member in West Des Moinesand you're watching a Chiefs game,
you can go into the Overland Park clinicand be seen just like any other member.
So yes, you can see the same personfor continuity on the primary care side,
but if you have a need that you just need,
taking care of the entire systemis built to take care of members.
And so if they'reif they're not in their particular metro,
(06:34):
if they happen to be in Des Moines or I'mback and forth to Nebraska all the time,
you would be able to go into any ofthe Hy-Vee Exemplar clinics and do this.
And you get movedto the front of the line.
You get treated like a member.
It doesn't matter where you're at.
So what what prompted Hy-Veeto do this partnership with you?
Jaci, talk a little bit about that,because this is unusual.
I think that might be a better Jonquestion.
(06:54):
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 beenlooking and we, met with Doctor
Fick, who's their chief medical officer,introduced him to our model.
(07:17):
And we walked through what benefitsthis could have for them, as an employer,
both taking care of employees and thenalso serving the communities we’re in.
Their employeesor actually in this program?
Yes. Absolutely.
So HyVee’s,
this is not just somethingthey're doing in the community
they're invested in this in the standpointof they're putting
their employees in the programfor this care model. Yes.
(07:39):
Wherever we are located,we get access to that set of employees
or as we call them, patients, and startproviding services directly to them.
That's very unusual, Jaci.It absolutely is.
And what we're finding is once,
companies are putting their employeesinto this care model, the engagement
of those employees with their healthis significantly increased.
(08:02):
So people who may not havehad their annual physical or that's all
they're having, they're actually coming inand having that.
And so they're seeingthey're having their annual physical.
And then we're finding rather thansomebody who sees adult to once a year,
they're maybe coming in 3or 4 times a year
because they're using those doctorsand providers as advocates
(08:22):
and coaches to be proactiveabout their health going forward.
Whether it's weight managementor help with sleep or mental health,
whereas priorto coming into these programs.
They were managing it themselfand maybe talking to Doctor Google.
And a lot of times they were done. I knowDoctor Google. My wife talks to Dr Google
a lot, so I understand that comment..
(08:45):
From the financial standpoint,and employees are often gun shy.
They don't know what something'sgoing to cost.
I mean, a a urine test could be $1.30or it could be $200.
That's thethat's the issue. They don't know.
And in this model, the employers coveringtheir membership and they come in.
And every service we providein-house is included.
So they knowthey're not going to pay anything.
So I think you can seethis is a very different model.
(09:07):
We're going to go into more of the detailsregarding the model.
We're going to talk abouthow 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 disruptionin the fourth quarter of this year.
So we're going to talk more about thatwith 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.
(09:28):
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 individualand you want to see what this model's
all about, or even take a tourof one of their facilities.
Stay right there. We'll be right backafter the break.
You're listening to America'sHealthcare Advocate
broadcasting here on the HIARadio Network.
(09:50):
Coast to coast across USA. We've got more.
Welcome back.
You're listening to America'sHealthcare Advocate show,
broadcasting coast to coast across USA.
(10:10):
Here on the HIA Radio Network.
My producers today, Mr.
Garner Cowdery behind the microphonesand 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 upthere.
Very happy to have them in studiowith us today doing this obviously.
And Doctor Jon Van Der Veer,he is the CEO of Hy-Vee Exemplar Health
(10:32):
and Jaci Robson , he's the VP of Hy-VeeExemplar Healthcare membership services,
and we're happy to have him in studiotalking about this very different model
that's now available here
in the Kansas City Metro, with two clinicsin Overland Park at the summit.
We'll talk more about that in a minute.
A little bit about doctor. DoctorVanDerveer is a D.O.
and MBA is a boardcertified internal medicine physician
(10:54):
and the CEO and founder of Hy-VeeHealth Exemplar Care, a membership
based clinic focused on personalized,accessible health care.
He's got 20 years of experiencein hospital and internal medicine,
and he brings this patientcentered approach to this model.
Jaci Robson is the vice president ofmember service at Hy-Vee Exemplar Health.
She helps with most of the innovativemodels and direct care and primary
(11:16):
care and urgent care.
We're happy to have them in studiowith us.
So let's continue with this conversationand talk a little bit
about all the servicesincluded for this one.
Single membership fee.
No more co-pays, no more deductibles.
I made notes this morning (11:29):
no more coinsurance, no more out-of-pocket maxes.
All that goes away.
So let's talkabout what those services are, doctor.
So, like you said, it'skind of one and done.
There's the monthly membership feeand that includes your in-person visits,
your annual visit, virtual care,
(11:50):
texting portal messages, any
way you choose to communicateto 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 marketsgrow and mature,
(12:11):
we'll have X-rayin all of those locations.
And then additionally there is DME.
So durable medical equipment.
This is the slings or crutches
or things you may needif 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
(12:34):
so you need a lab right now.
Now I got to schedule my labs, a questor wherever
I have to go that I have to drive thereand 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 inand you're meeting with your provider,
and then you're leaving with whateveryou're needing to manage that care
(12:57):
that you need.
I think you should also,
at some points as well,speak about the types of membership costs,
because the membership itselfit sends when you're speaking
about membership and people saythis is a lot of services that I receive.
So the actual costs for an individualare $89 a month.
So $89 a month for an individual, a $158
(13:21):
a month for a couple, or $216a month for a family.
And a family would be two adults and twoor more children.
So we are speaking affordablehere as well, but it's much more
not about the cost.
It's about the qualityand the quantity of the services
that you're receiving for that cost.
So you can get care how you want,when you want,
(13:43):
for less than the priceof a cup of Starbucks a day.
That's the that's
a, that's a really good comparison of lessthan a cup of Starbucks a day.
When I look at that versuswhat I'm going to do on an ACA
Obamacare policyor what I'm going to do on the small group
health insurance policywhere you've got copays for labs,
(14:04):
you got the copay to see the primary caredoc and you go into a primary care doctor
and it says right on the deskat the receptionist.
You're responsible for the copaybefore you go see the doctor.
This is completely different.
It's absolutely, completely different.
And what we find isit's also unlimited visits.
We don't encourage it,
but you can absolutely comeand see us every day if you wanted to.
(14:24):
But Jon has patients.You're going to get a lot.
Patientswho do message him on a regular basis.
He has patients who he speaksto. 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 providermore regularly.
With, with the model Cary,I think one of the most important things
(14:46):
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 uswhat we all think of as “sick care”.
That's right.
It's built and it deliversexactly what it was designed to do
and accidentally designed.
And this is changing the modeland it changes how the care's delivered.
(15:10):
So you talked a little earlierabout the fact that people
are managing their, their disease,managing their wellness, their health.
They're doing they're going into see the doctor more often.
They're doing the things they need to do.
Obviously, not having these roadblocksin front of them with the co-pay
every time they turn around.
I've got to get a pieceof durable medical equipment.
(15:31):
I've got a full deductibleand co-insurance
I have to pay beforeI can access that equipment.
I need a lab.
Well, that's that's $150 or $800depending on the...
So that has to have a direct impacton 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
(15:54):
facility of ours and said, Imy 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 toI 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
(16:18):
review blasting us for herhaving to pay $197 for a sling.
We offered to her for $20,and she said, well,
I could have bought the same onefor $15 at Walmart.
Well they have betterbuying power than we do.
So it shows that people don'teven understand what their insurance
does, how it's going to impact themfinancially.
We're this we make it as clearand transparent as possible.
(16:40):
Yeah, well, there's a reasonthat the big hospital systems that run
these primary care practices don'tpublish their rates where you can see
what the cost is to have this visitor that visit or another visit.
There's a reason for that.
Okay.
And a lot of that has to dowith the negotiated price
they put in place with the primarycarriers, the big carriers.
(17:01):
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 impacton how this works.
And that's why people are spendingso much money on a lot of this.
What you're doing is you're cuttingthrough all of that saying here
for $89 a month, you can come in hereand get everything you need done.
We'll talk about, in the next segment,what happens here to be referred out
(17:23):
and all that, and how all that functions.
But the point is, 90% of what people dois 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 primarycare through the hospital systems
are actually billing at hospital rates.
Oh that depends on on their facilitieswhere they're structured.
(17:43):
And so and the problem withthat is obviously
all this comes back to the userin 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 intendto talk about this in great detail
in an upcoming broadcast,but you're going to see rate increases
of 25% or better across the boardon most of the ACA plans.
(18:07):
Some of that has to do
with Aetna constrictingout of the moving out of the market.
You know, all of these thingsthat are going to happen out here.
So this is a modelthat is here today to serve today
that makes a huge difference in the waycare is being delivered and
an even greater difference in the cost.
If you want information,it's Exemplar.care, Exemplar.care.
(18:28):
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 holeand start getting a better form of care.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
(18:48):
Coast to coast across the USA.
Stay right there. The doctor's in thehouse. We'll be right back.
Welcome back.
You're listening to America's HealthcareAdvocate Show, broadcasting coast
(19:09):
to coast across the USA here on the HIARadio Network.
Want to give a shout out to KVGB 1590Am 97.7
FM on Saturdays from 11 to 12 inGreat Bend, Kansas.
One of our best affiliatesin the state of Kansas.
Want to say helloto all those folks out there
in that listening audiencethat listen to our broadcast every week.
(19:29):
So we're going to shift gears now.
There's a lot of disruptioncoming 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 seein the individual marketplace?
Well, it's going to be similar to what
we're going to seein the small group space next year.
You're going to see significant increasesacross the board.
You're also going to seea very narrowing of networks.
This is one of the ways that carrierscontrol costs is by controlling access.
(19:52):
Well, we're going to
look at that versus this model.
But the HyVee Exemplar Care modeland talk about what those differences are
and how that works and how that impactscost, to you as an employer.
So instead of cost shifting,raising the deductibles,
raising the co-pay,
raising the out of pocketsand putting that burden on your employees,
(20:16):
you're going to have an opportunityto hear how this program does
just the opposite of that.
So let's just start right there, doctor.
To me and DavidHickman just walked in studio here,
broker here in the Kansas City metroI've worked with for about 16 years.
And we've talked about this extensivelyto me, this is a tremendous alternative
for the small group employer out therethat is really getting hammered with it.
(20:39):
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 bitand how this model works for employers.
And what are employers findingin the way of satisfaction with this.
So employers are very satisfied with it.
(21:00):
First off, because it's affordable to themand it helps them manage
some of their costs.
Secondly, it allows them to providewhat we've had some employees
define as the only true benefitmy company offers me.
And, they said it,we've got a written down the,
the employee
though is the one, like you said, who'sbeen carrying more and more of the burden.
(21:23):
And as we all know, the vast majorityof 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 benefitthat they know it's paid for.
It's covered, and all the carethey 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.
(21:44):
Nothing's going to show up.
And that's why they view itas a true benefit.
They can get carethat they've avoided in the past
because they didn't know whatit was going to do to their own finances.
How does that affectthe overall health of the employees
as a group and for the employerin terms of things like absenteeism and,
you know,trying to get to a doctor's appointment
(22:05):
but they can't get to
because they can't get there in time,they get to take time off work.
This all changesnow, 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.
(22:26):
If they're not able to get into a clinic,they can connect with the provider
and they can manage the care thatthey need, get that prescription that day
and be back at work, orbe getting healthier as they move forward.
If they've had some of those conversationswith the provider
regarding long term concerns.
So, the employer can take a high
(22:48):
deductible plan like an HSA or an HRA.
They can wrap it around this modelwhere the primary care
is all handled by the HyVeeExemplar Care primary care model.
And if an employee needs to go out to,
a doctor for an orthopedic surgeryor another type of procedure, talk
about how you work within that particularnetwork to help them coordinate that
(23:10):
so they get this, the best level of carein that network, doctor.
So again, because we have the time to go
through people's medical informationand you have their insurance plan,
you understand where they can get careand where they can, afford care.
First off, every clinician in every marketknows where quality providers are.
(23:31):
So assuming that
the network has quality providers in it,you can direct those people directly
to those providers as long as they'rein network, you know, which ones
are going to be more costeffective for those employees.
And if it's,
if it's a different funding modelor a level funded, self-funded,
you can actually get the most costeffective for the employer as well.
But ultimatelythe employee will have choice.
(23:54):
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 evaluateand 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 systemand you go from primary care
to specialty carewith no real regard to cost or quality.
So Jaci,
(24:15):
when this occurs now
is the primary care doctor clinicianat the HyVee Exemplar Care clinic.
They're following alongto see how the care is being delivered.
If there's follow up,whatever the case may be.
Oh, absolutely.
The providers at HyVee HealthExamplar Care.
They’re advocates, they’recoaches, they’re navigators.
They will help people to understandthe complexity of the health care system
(24:37):
and make sure that their patients,their members, are receiving
the care that they need.
So that there's a coordinationbetween the two groups.
We are the quarterback.
That's how I always view it.
Is thethe primary care team at HyVee Health
Exemplar Care is responsiblefor getting you in and seen.
And then if you do need to gosomewhere out to get the care you need,
(24:59):
and then to close the loopand bring you back in and move you forward
with the appropriate recommendationsyou receive.
So you said something
at the beginning of this segmentthat was kind of interesting.
It's some of the employees have said:
“this is the only benefitmy employer really provides”.
Do you think that that
that that kind of a testimonial to whatyou're doing, results from the fact
(25:19):
that they are not coming inand 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 isthat you said
you've had people spend as much as an hoursitting and talking to you?
You took a call today on the way in herefrom Iowa,
talking to a man had shinglesand got a prescription for him.
(25:40):
So how that's a that's unheard of.
If you try to call a primary carephysician, you're first.
You're going to get the nurseif you're lucky,
and then she's going to call you backbetween the hours of so-and-so and 3:00,
if you're lucky.
And if you miss that or you don't get thatcall,
you're not going to talk to him at all.
No, but I look at that versushere you are,
the CEO running this whole programand you're taking calls and talking.
(26:02):
How much do you think that statement madeby that employee or employees
you've talked to has to do with the factthat they can access this care,
and somebody really gives a damn?
I think that's solely what it is.
Their life mattersmore than how we want to run our clinic.
So their convenienceis their first priority,
their health is their first priority,and we're a delivery mechanism
(26:24):
to meet their need.
Health care has quit being a serviceorganization, and it's a widget
producing factorywhere here it's all about relationships.
The better you know, somebody, the easierthey are to care for.
If you know all their history,you can take a phone call on I-35
and and take care of somebodybecause you know everything about them.
So those relationships are essential.
(26:46):
And people feel that.
I mean, nobody wants to be hurriedthrough like their cattle.
And unfortunately, this waythe system is set up.
And I think, as Jon's exactly saidit, it's an experience.
It’s something you need to feel.
You need to come inand 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
(27:10):
and understand how that feels.
It's a little bitthat like the Disney magic.
How do you explain whatthat experience is?
People.
People always say that they it'stoo 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 conversationwith multiple people in the past.
This is the first time somebody hasactually heard what I was saying.
(27:34):
Listen to what I said.
Because they took the time.
All about time and access.
Because as you talked about primary caredoctors are taxed with seeing every
how many hundreds of patientsthey have, moving them through the system
as quickly as they canand getting to the next patient.
Internal medicine 2500 patient panels,family medicine, 3 to 5000 patient panels.
(27:55):
You're serious?
Yeah, and I was at 1900when I left the fee for service
world on my way to 2500 as an internist.
Average age 76.
Not the easiest populationto take care of.
Yeah, I'm 77.
There you. Go. You’re a wonderful 76.
And then now, panels
in directprimary care, 500, 800, a thousand.
(28:16):
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 numberto 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, andhe advised me he sees ten patients a day.
He works in a systemwhere he gets referrals
(28:38):
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 careprovider had been able,
not the primary care providers'fault, the system.
If the primary care providerwould spend the time with them,
each of those ten patients is paying$3,000 each for that visit with him
(28:58):
and seven of them a day.
Do not need to meet with them.
And what do you think has to do withwhy that?
Why they're doing that?
You know,
that's one reason why United Health Careis under investigation right now
by the DOJ, because of those kindsof 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.
(29:19):
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 goto 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 outand 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.
(29:41):
You'll probably be surprisedby what you learn.
We'll be right back after the break.
You're listening to America'sHealthcare Advocate.
Broadcasting coast to coast acrossUSA here on the HIA Radio Network.
We're going to shift gears now and talka little about what do big employers do
when they're on this plan.
Stay right there.
We'll be right back with more.
(30:05):
Welcome back.
You're listening to America's HealthcareAdvocate 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'sHealthcare Advocate.
Also 15 podcast platforms, YouTube.
So here's the thing.
Maybe your company is got a healthinsurance plan and nobody's happy.
Maybe you might want to mention to them.
(30:26):
Hey go up and listen to this broadcastthat Cary Hall did with the doctor
in studio and talked about this HyVeeExemplar Care model
and how it works, and see whatlet them know that it's there.
Because oftentimes when people referother 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 relatethis whole broadcast back to someone.
(30:48):
If you think there's someonethat would be interested in this,
maybe it's a familyand you think you maybe it's your wife
and you want to tell your wife to golisten to this podcast.
This is a great way to do this.
We're posted on 15 podcastplatforms/channels.
We're on thewe have our own YouTube channel.
We got almost a half millionviews up there.
So this is a great wayto disseminate this information.
And this program is very, very different.
(31:09):
And I think
it's really going to come into focusas we get closer in to the fourth quarter.
And the marketplace disruptionsthat we're going to see.
Its HyVee Exemplar Care.
The website is exemplar.careif you want information.
So nowwe're going to talk about large employers
because I'm focused a little bit on smallemployers.
Quik Trip was one of your first clientsokay.
(31:30):
And now how many employees?
They have a lot of employees.
But on their on their benefit planit's around 24,000.
And and we're taking care of, folks
who are in the clinic areaswhere we've built out clinics.
That's remarkable.
Obviously, just hearingthat is an endorsement
into your quality level, what you do.
I shop at Hy-Vee at 151st in Olathe.
(31:52):
I'm in there multiple times a week. Okay.
Thank you. Great people. Great.
But I've never been to a grocery storewhere they literally stop
whatever they're doing and,I need to know where I can find this.
And they walk you tothe aisle and show it to you
that's
the way the employees workthere is completely different for them
to have that kind of faithin what you're doing,
and to be able to take their employees,and send them to your facility.
(32:16):
I think that speaks volumesfor how this works.
Absolutely.
And I think we are actuallyheadquartered in
Des Moines, Iowa, which is where Hy-Vee'salso headquartered.
And our first clinic in, West Des Moines
headquartersclinic is also 24 seven urgent care.
So with Hy-Vee and the types of employeesand the demographics,
(32:37):
and then we've got shift workers thatabsolutely works for them just as well.
That's, you know, outside of us, they canconnect with the primary care provider,
or they can come in to urgent careif they have those acute needs.
We do offer fee for serviceas well in the urgent care.
So we have nonmembers, but our membersget priority so they can walk in
and they're the next one to be roomed.
(32:58):
When a room becomes available.
So when you say 24/7 you really mean 24/7brick and mortar urgent care.
Absolutely.
We opened our doors, nearly five years agonow, and we've never closed
those doorssince. I’ve never missed a shift.
And as we grow out and the marketsmature, we're going to have it in Omaha.
And here in the Kansas Citymarket as well.
(33:19):
That's that's pretty remarkable becausethat'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 havethis problem, or the problem gets worse
because they don'twant to pay the 50 or 75 or $100 co-pay.
(33:39):
This is completely different.And even more so at night.
Those employees would oftenbe 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 folkswho are paying the bill.
However it comes in.
And it is the least effective dollarfor health care spent in this country.
(34:02):
Absolutely. Yeah.
And it's unfortunate, but that'swhat you said is absolutely correct.
Yeah. They all understand zero.
So they all understand zero.
And we all know that accidentsnever happen when we want them to happen.
They're always going to be at nightor at the weekend or during the holiday.
You you know,
you're at the barbecue with your friendson the 4th of July and something happens.
(34:23):
Where do you go?
Emergency roomis usually your only option,
but now we can do the virtual careif needed.
If virtual care will manage the situation,we can do virtual care
or they can come into the clinicfor that 24/7 treatment.
So on the break you were talkinga little bit about the experience
for the employeeand what you have learned over the years
(34:43):
with how the employees feelabout this program versus
being on a standard ACA typehealth insurance program.
Talk a little bit more about that, Jacibecause it was fascinating.
Yeah. No.
What we findis that a lot of these employees,
they've notnecessarily 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.
(35:06):
They come and they visit our clinicand people have got the time for them.
They build that personal relationshipwith 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 areand what matters to you.
We want peopleto live their healthiest lives,
so if that's playingwith your grandchildren, it's
(35:28):
you want to continue to be golfing,or whether it's that
you just want to go and sit and meditateand have coffee with your friends.
We will work with youon whatever health means to you.
And what we do is during thatwelcome visit, we will take those baseline
labs.
We’ll have those initial conversationsof what health means to you,
and then we'll make sure
(35:49):
that we keep your health where it is todayor we'll help you to improve.
This is all about proactive preventativehealth 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 gota couple things you want addressed,
one of them, you might be tired.
You're chronically tired.
If you work shifts, theyour sleep's not very good.
(36:11):
You don't eat very well because you workat QuikTrip and a convenience store.
Or you get off work at two in the morningand 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 sleepschedule.
Go through all of that.That can be a ten minute conversation.
Then you move on to the dietand the exercise.
(36:31):
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 workon 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.
(36:51):
You're pre-diabetic.
You could become a diabetic if you're A1Cgets to 6.5, you're on that trend.
I could give you metformin, a medicationthat treats diabetes.
And we can relativerisk reduction of about 16.
Or you can make wholesalelifestyle changes.
And now I can talk about intermittentfasting, low carb food options,
(37:12):
the types of exercise that, decreasesthe likelihood of progressing to diabetes.
And that's a 32 fold relative
risk reduction, twice as effective as megiving you a medication.
One of those takes timeand effort to explain.
The other one takes writing a prescriptionand 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 chanceto really show them
(37:34):
that you care about themand educate them like your health matters.
And if you make these changes,you can head off
one of the most costly longterm diseases that you can have.
And that comes backin cost to the employer,
and it comes backwith satisfied employees,
and it comes back with
the overall health of his workforceand how they feel about that employer.
(37:55):
Which goes back to that commentyou made earlier in the show.
This is the one thingmy employer does that’s a real benefit.
So you know whatthis 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 providea good benefit and to save money.
At the same time.
All these things are in alignmentwhere in a fee for service world,
(38:16):
the more you comein, the more I get paid. You have.
I do have disincentives and misalignmentthat cost people money over time.
And this is a way to to remedy that.
And, you know, I think that's a great wayto 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 momentto go to their website and take
(38:38):
a look at this exemplar care
Exemplar.care.
It's is on the website.
All the information is up thereif you're an employer,
if you're a human resource directorand 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 programthat you're on.
You're not happy with the carrier.
(38:59):
You're not happyyour employees are not happy.
You've been cost shifting.
You're doing all these different thingsto 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 employeesif they didn't think it worked.
That's why I asked these folksto come and do this show.
We try to provide information hereabout things that are different.
On the cutting edge of health care.
(39:20):
This program is different.
The website exemplar.care is the website.
All the information is up there.
And now I leave youwith this thought from Albert Einstein.
The one who follows the crowd, theyusually get no further than the crowd.
The one who walks alone is likely to findhimself in places no one has ever been.
Remember,friends, it's a funny thing about life.
(39:41):
If you refuse to accept anythingbut the very best.
You most often get it.
Thank you for listening to America'sHealthcare Advocate Show
broadcasting coastto coast across the USA.
Goodbye America.
You and you.
And now America's Healthcare Advocate,Cary Hall.
Hello, America. Welcome to America'sHealthcare Advocate show.
We're broadcasting coast to coast acrossthe USA here on the HIA Radio Network.
You can find out
more about us by going to the websiteAmericasHealthcareAdvocate.com.
All of our shows are posted up there,
as well as our podcast platformand YouTube platform.
(00:23):
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 Thiessenprovided me with all of that information
the other day, and I was quite surprisedto see the numbers up so HyVee.
So we thank all of you out there,
and those of youlistening on terrestrial radio to our over
(00:45):
200 stations around the countryin studio with me today.
We have two guests from HyVee,the Exemplar Care doctor Jon Van
Der Veer is here and Jaci Robson herefrom HyVee Exemplar Care.
Welcome to the studio today.
Thank you.
We're going to havea fascinating show today.
If you're an individual on an ACAor as I call it Obamacare health insurance
(01:06):
policy, or even if you're a small employeror a large employer,
you've probably dealtwith 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 plansas the years have gone on.
We're going to talk about a model todaythat is significantly different.
It's an opportunityfor primary care, direct pay,
(01:29):
membership in a program that we thinkis 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 modeland 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.
(01:51):
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 burnoutto really realize
there's a better way to deliver careand then for the patients to receive care.
So this model, just allows for thattype of interaction to take place.
(02:13):
So, Jaci, talk a little bit aboutthe membership model and how this works
and how this is significantly differentto what we see
in a typical primary care practice. Jaci.
So the membership modelis that for a monthly membership,
you can receive all servicesthat we provide in our clinics,
which is all services,primary care or urgent care.
(02:34):
So 80% of what most people's healthcare needs are.
One of the things that Iwhen I was researching this
and going through the websiteand looking at,
you know, how this is offeredand 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 ofthe things which is not good, doctor.
(02:55):
One of the things that's emphasized inyour model is the time
spent with the patient, the abilityto listen to what the patient has to say,
and then be ableto translate that into a program
that's going to make a difference in termsof 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 practiceevidence based medicine,
(03:17):
but people don't often talk about the factthat the time spent with a patient
often leads to more accurate diagnosesand thus better treatment plans.
And our model, we have 30 minute follow upvisits, 60 minute new patient visits.
I've had new visits, as long as two hours.
So it's not that rat race.
Wherehow fast can you get someone through,
(03:40):
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 specialistor other care piece is downstream
in this par alignment of the betterI take care of you,
the better you feel, the lessI have to see you.
Which actually goes into a membershipmodel.
The better I'm doing, the less workI have to do.
(04:01):
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 bitabout the convenience of this.
I mean,these are in the Hy-Vee stores now.
We have them here in Lee's Summitin Overland Park in the Kansas City Metro.
You've been in Iowa and Nebraskafor some time.
So talk a little bit about that
and how that model works again,differently than the primary care model,
(04:22):
where you may wait two weeks or monthsto see your primary care doctor.
This is significantly different.
It is significantly different.
And they’re not actually in the Hy-Veestores, thery’re near
two are close to a Hy-Vee storeso that we can work with Hy-Vee
and help them to,take care for their employees.
(04:43):
So they're actually close to itor near to a Hy-Vee.
So yes, we now have one in Lee's Summitand here in Overland
Park, it's at West 135th Street.
And the convenience of it is that
people can comesee the longer appointments.
And then once
they've actually established,they can connect with the doctor provider
(05:03):
any way they need to from wherethey're at, so they can send messages,
they can do virtual,they can have those, calls with them
from whenever they need to, whereverthey 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 Moinesdown to Kansas City Market today,
(05:25):
and I received a phone call from a patientwho 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 mesome pictures, you can.
So he sends me pictures.
I looked at it.
He has shingles and his antibioticor his antiviral
has now been sent in across the stateline, to his regular pharmacy.
(05:48):
And he's getting the care he needs withouthaving to even step foot in a clinic.
So the and that's, that's remarkablebecause they were able
to resolve that problem right away
and not have to wait to get an appointmentand come in.
Can they connect when you're when you'remembers, your patients connect,
do they come back to the same doctor
each and every timeif that doctor is available.
How does that work? They do.
They also we like to view Hy-Vee HealthExemplar care kind of as the provider.
(06:14):
If you're a member in West Des Moinesand you're watching a Chiefs game,
you can go into the Overland Park clinicand be seen just like any other member.
So yes, you can see the same personfor continuity on the primary care side,
but if you have a need that you just need,
taking care of the entire systemis built to take care of members.
And so if they'reif they're not in their particular metro,
(06:34):
if they happen to be in Des Moines or I'mback and forth to Nebraska all the time,
you would be able to go into any ofthe Hy-Vee Exemplar clinics and do this.
And you get movedto the front of the line.
You get treated like a member.
It doesn't matter where you're at.
So what what prompted Hy-Veeto do this partnership with you?
Jaci, talk a little bit about that,because this is unusual.
I think that might be a better Jonquestion.
(06:54):
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 beenlooking and we, met with Doctor
Fick, who's their chief medical officer,introduced him to our model.
(07:17):
And we walked through what benefitsthis could have for them, as an employer,
both taking care of employees and thenalso serving the communities we’re in.
Their employeesor actually in this program?
Yes. Absolutely.
So HyVee’s,
this is not just somethingthey're doing in the community
they're invested in this in the standpointof they're putting
their employees in the programfor this care model. Yes.
(07:39):
Wherever we are located,we get access to that set of employees
or as we call them, patients, and startproviding services directly to them.
That's very unusual, Jaci.It absolutely is.
And what we're finding is once,
companies are putting their employeesinto this care model, the engagement
of those employees with their healthis significantly increased.
(08:02):
So people who may not havehad their annual physical or that's all
they're having, they're actually coming inand having that.
And so they're seeingthey're having their annual physical.
And then we're finding rather thansomebody who sees adult to once a year,
they're maybe coming in 3or 4 times a year
because they're using those doctorsand providers as advocates
(08:22):
and coaches to be proactiveabout their health going forward.
Whether it's weight managementor help with sleep or mental health,
whereas priorto coming into these programs.
They were managing it themselfand maybe talking to Doctor Google.
And a lot of times they were done. I knowDoctor Google. My wife talks to Dr Google
a lot, so I understand that comment..
(08:45):
From the financial standpoint,and employees are often gun shy.
They don't know what something'sgoing to cost.
I mean, a a urine test could be $1.30or it could be $200.
That's thethat's the issue. They don't know.
And in this model, the employers coveringtheir membership and they come in.
And every service we providein-house is included.
So they knowthey're not going to pay anything.
So I think you can seethis is a very different model.
(09:07):
We're going to go into more of the detailsregarding the model.
We're going to talk abouthow 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 disruptionin the fourth quarter of this year.
So we're going to talk more about thatwith 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.
(09:28):
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 individualand you want to see what this model's
all about, or even take a tourof one of their facilities.
Stay right there. We'll be right backafter the break.
You're listening to America'sHealthcare Advocate
broadcasting here on the HIARadio Network.
(09:50):
Coast to coast across USA. We've got more.
Welcome back.
You're listening to America'sHealthcare Advocate show,
broadcasting coast to coast across USA.
(10:10):
Here on the HIA Radio Network.
My producers today, Mr.
Garner Cowdery behind the microphonesand 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 upthere.
Very happy to have them in studiowith us today doing this obviously.
And Doctor Jon Van Der Veer,he is the CEO of Hy-Vee Exemplar Health
(10:32):
and Jaci Robson , he's the VP of Hy-VeeExemplar Healthcare membership services,
and we're happy to have him in studiotalking about this very different model
that's now available here
in the Kansas City Metro, with two clinicsin Overland Park at the summit.
We'll talk more about that in a minute.
A little bit about doctor. DoctorVanDerveer is a D.O.
and MBA is a boardcertified internal medicine physician
(10:54):
and the CEO and founder of Hy-VeeHealth Exemplar Care, a membership
based clinic focused on personalized,accessible health care.
He's got 20 years of experiencein hospital and internal medicine,
and he brings this patientcentered approach to this model.
Jaci Robson is the vice president ofmember service at Hy-Vee Exemplar Health.
She helps with most of the innovativemodels and direct care and primary
(11:16):
care and urgent care.
We're happy to have them in studiowith us.
So let's continue with this conversationand talk a little bit
about all the servicesincluded for this one.
Single membership fee.
No more co-pays, no more deductibles.
I made notes this morning (11:29):
no more coinsurance, no more out-of-pocket maxes.
All that goes away.
So let's talkabout what those services are, doctor.
So, like you said, it'skind of one and done.
There's the monthly membership feeand that includes your in-person visits,
your annual visit, virtual care,
(11:50):
texting portal messages, any
way you choose to communicateto 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 marketsgrow and mature,
(12:11):
we'll have X-rayin all of those locations.
And then additionally there is DME.
So durable medical equipment.
This is the slings or crutches
or things you may needif 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
(12:34):
so you need a lab right now.
Now I got to schedule my labs, a questor wherever
I have to go that I have to drive thereand 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 inand you're meeting with your provider,
and then you're leaving with whateveryou're needing to manage that care
(12:57):
that you need.
I think you should also,
at some points as well,speak about the types of membership costs,
because the membership itselfit sends when you're speaking
about membership and people saythis is a lot of services that I receive.
So the actual costs for an individualare $89 a month.
So $89 a month for an individual, a $158
(13:21):
a month for a couple, or $216a month for a family.
And a family would be two adults and twoor more children.
So we are speaking affordablehere as well, but it's much more
not about the cost.
It's about the qualityand the quantity of the services
that you're receiving for that cost.
So you can get care how you want,when you want,
(13:43):
for less than the priceof a cup of Starbucks a day.
That's the that's
a, that's a really good comparison of lessthan a cup of Starbucks a day.
When I look at that versuswhat I'm going to do on an ACA
Obamacare policyor what I'm going to do on the small group
health insurance policywhere you've got copays for labs,
(14:04):
you got the copay to see the primary caredoc and you go into a primary care doctor
and it says right on the deskat the receptionist.
You're responsible for the copaybefore you go see the doctor.
This is completely different.
It's absolutely, completely different.
And what we find isit's also unlimited visits.
We don't encourage it,
but you can absolutely comeand see us every day if you wanted to.
(14:24):
But Jon has patients.You're going to get a lot.
Patientswho do message him on a regular basis.
He has patients who he speaksto. 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 providermore regularly.
With, with the model Cary,I think one of the most important things
(14:46):
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 uswhat we all think of as “sick care”.
That's right.
It's built and it deliversexactly what it was designed to do
and accidentally designed.
And this is changing the modeland it changes how the care's delivered.
(15:10):
So you talked a little earlierabout the fact that people
are managing their, their disease,managing their wellness, their health.
They're doing they're going into see the doctor more often.
They're doing the things they need to do.
Obviously, not having these roadblocksin front of them with the co-pay
every time they turn around.
I've got to get a pieceof durable medical equipment.
(15:31):
I've got a full deductibleand co-insurance
I have to pay beforeI can access that equipment.
I need a lab.
Well, that's that's $150 or $800depending on the...
So that has to have a direct impacton 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
(15:54):
facility of ours and said, Imy 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 toI 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
(16:18):
review blasting us for herhaving to pay $197 for a sling.
We offered to her for $20,and she said, well,
I could have bought the same onefor $15 at Walmart.
Well they have betterbuying power than we do.
So it shows that people don'teven understand what their insurance
does, how it's going to impact themfinancially.
We're this we make it as clearand transparent as possible.
(16:40):
Yeah, well, there's a reasonthat the big hospital systems that run
these primary care practices don'tpublish their rates where you can see
what the cost is to have this visitor that visit or another visit.
There's a reason for that.
Okay.
And a lot of that has to dowith the negotiated price
they put in place with the primarycarriers, the big carriers.
(17:01):
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 impacton how this works.
And that's why people are spendingso much money on a lot of this.
What you're doing is you're cuttingthrough all of that saying here
for $89 a month, you can come in hereand get everything you need done.
We'll talk about, in the next segment,what happens here to be referred out
(17:23):
and all that, and how all that functions.
But the point is, 90% of what people dois 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 primarycare through the hospital systems
are actually billing at hospital rates.
Oh that depends on on their facilitieswhere they're structured.
(17:43):
And so and the problem withthat is obviously
all this comes back to the userin 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 intendto talk about this in great detail
in an upcoming broadcast,but you're going to see rate increases
of 25% or better across the boardon most of the ACA plans.
(18:07):
Some of that has to do
with Aetna constrictingout of the moving out of the market.
You know, all of these thingsthat are going to happen out here.
So this is a modelthat is here today to serve today
that makes a huge difference in the waycare is being delivered and
an even greater difference in the cost.
If you want information,it's Exemplar.care, Exemplar.care.
(18:28):
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 holeand start getting a better form of care.
You're listening to America'sHealthcare Advocate
Broadcasting here on the HIARadio Network.
(18:48):
Coast to coast across the USA.
Stay right there. The doctor's in thehouse. We'll be right back.
Welcome back.
You're listening to America's HealthcareAdvocate Show, broadcasting coast
(19:09):
to coast across the USA here on the HIARadio Network.
Want to give a shout out to KVGB 1590Am 97.7
FM on Saturdays from 11 to 12 inGreat Bend, Kansas.
One of our best affiliatesin the state of Kansas.
Want to say helloto all those folks out there
in that listening audiencethat listen to our broadcast every week.
(19:29):
So we're going to shift gears now.
There's a lot of disruptioncoming 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 seein the individual marketplace?
Well, it's going to be similar to what
we're going to seein the small group space next year.
You're going to see significant increasesacross the board.
You're also going to seea very narrowing of networks.
This is one of the ways that carrierscontrol costs is by controlling access.
(19:52):
Well, we're going to
look at that versus this model.
But the HyVee Exemplar Care modeland talk about what those differences are
and how that works and how that impactscost, to you as an employer.
So instead of cost shifting,raising the deductibles,
raising the co-pay,
raising the out of pocketsand putting that burden on your employees,
(20:16):
you're going to have an opportunityto hear how this program does
just the opposite of that.
So let's just start right there, doctor.
To me and DavidHickman just walked in studio here,
broker here in the Kansas City metroI've worked with for about 16 years.
And we've talked about this extensivelyto me, this is a tremendous alternative
for the small group employer out therethat is really getting hammered with it.
(20:39):
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 bitand how this model works for employers.
And what are employers findingin the way of satisfaction with this.
So employers are very satisfied with it.
(21:00):
First off, because it's affordable to themand it helps them manage
some of their costs.
Secondly, it allows them to providewhat we've had some employees
define as the only true benefitmy company offers me.
And, they said it,we've got a written down the,
the employee
though is the one, like you said, who'sbeen carrying more and more of the burden.
(21:23):
And as we all know, the vast majorityof 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 benefitthat they know it's paid for.
It's covered, and all the carethey 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.
(21:44):
Nothing's going to show up.
And that's why they view itas a true benefit.
They can get carethat they've avoided in the past
because they didn't know whatit was going to do to their own finances.
How does that affectthe overall health of the employees
as a group and for the employerin terms of things like absenteeism and,
you know,trying to get to a doctor's appointment
(22:05):
but they can't get to
because they can't get there in time,they get to take time off work.
This all changesnow, 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.
(22:26):
If they're not able to get into a clinic,they can connect with the provider
and they can manage the care thatthey need, get that prescription that day
and be back at work, orbe getting healthier as they move forward.
If they've had some of those conversationswith the provider
regarding long term concerns.
So, the employer can take a high
(22:48):
deductible plan like an HSA or an HRA.
They can wrap it around this modelwhere the primary care
is all handled by the HyVeeExemplar Care primary care model.
And if an employee needs to go out to,
a doctor for an orthopedic surgeryor another type of procedure, talk
about how you work within that particularnetwork to help them coordinate that
(23:10):
so they get this, the best level of carein that network, doctor.
So again, because we have the time to go
through people's medical informationand you have their insurance plan,
you understand where they can get careand where they can, afford care.
First off, every clinician in every marketknows where quality providers are.
(23:31):
So assuming that
the network has quality providers in it,you can direct those people directly
to those providers as long as they'rein network, you know, which ones
are going to be more costeffective for those employees.
And if it's,
if it's a different funding modelor a level funded, self-funded,
you can actually get the most costeffective for the employer as well.
But ultimatelythe employee will have choice.
(23:54):
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 evaluateand 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 systemand you go from primary care
to specialty carewith no real regard to cost or quality.
So Jaci,
(24:15):
when this occurs now
is the primary care doctor clinicianat the HyVee Exemplar Care clinic.
They're following alongto see how the care is being delivered.
If there's follow up,whatever the case may be.
Oh, absolutely.
The providers at HyVee HealthExamplar Care.
They’re advocates, they’recoaches, they’re navigators.
They will help people to understandthe complexity of the health care system
(24:37):
and make sure that their patients,their members, are receiving
the care that they need.
So that there's a coordinationbetween the two groups.
We are the quarterback.
That's how I always view it.
Is thethe primary care team at HyVee Health
Exemplar Care is responsiblefor getting you in and seen.
And then if you do need to gosomewhere out to get the care you need,
(24:59):
and then to close the loopand bring you back in and move you forward
with the appropriate recommendationsyou receive.
So you said something
at the beginning of this segmentthat was kind of interesting.
It's some of the employees have said:
“this is the only benefitmy employer really provides”.
Do you think that that
that that kind of a testimonial to whatyou're doing, results from the fact
(25:19):
that they are not coming inand 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 isthat you said
you've had people spend as much as an hoursitting and talking to you?
You took a call today on the way in herefrom Iowa,
talking to a man had shinglesand got a prescription for him.
(25:40):
So how that's a that's unheard of.
If you try to call a primary carephysician, you're first.
You're going to get the nurseif you're lucky,
and then she's going to call you backbetween the hours of so-and-so and 3:00,
if you're lucky.
And if you miss that or you don't get thatcall,
you're not going to talk to him at all.
No, but I look at that versushere you are,
the CEO running this whole programand you're taking calls and talking.
(26:02):
How much do you think that statement madeby that employee or employees
you've talked to has to do with the factthat they can access this care,
and somebody really gives a damn?
I think that's solely what it is.
Their life mattersmore than how we want to run our clinic.
So their convenienceis their first priority,
their health is their first priority,and we're a delivery mechanism
(26:24):
to meet their need.
Health care has quit being a serviceorganization, and it's a widget
producing factorywhere here it's all about relationships.
The better you know, somebody, the easierthey are to care for.
If you know all their history,you can take a phone call on I-35
and and take care of somebodybecause you know everything about them.
So those relationships are essential.
(26:46):
And people feel that.
I mean, nobody wants to be hurriedthrough like their cattle.
And unfortunately, this waythe system is set up.
And I think, as Jon's exactly saidit, it's an experience.
It’s something you need to feel.
You need to come inand 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
(27:10):
and understand how that feels.
It's a little bitthat like the Disney magic.
How do you explain whatthat experience is?
People.
People always say that they it'stoo 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 conversationwith multiple people in the past.
This is the first time somebody hasactually heard what I was saying.
(27:34):
Listen to what I said.
Because they took the time.
All about time and access.
Because as you talked about primary caredoctors are taxed with seeing every
how many hundreds of patientsthey have, moving them through the system
as quickly as they canand getting to the next patient.
Internal medicine 2500 patient panels,family medicine, 3 to 5000 patient panels.
(27:55):
You're serious?
Yeah, and I was at 1900when I left the fee for service
world on my way to 2500 as an internist.
Average age 76.
Not the easiest populationto take care of.
Yeah, I'm 77.
There you. Go. You’re a wonderful 76.
And then now, panels
in directprimary care, 500, 800, a thousand.
(28:16):
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 numberto 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, andhe advised me he sees ten patients a day.
He works in a systemwhere he gets referrals
(28:38):
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 careprovider had been able,
not the primary care providers'fault, the system.
If the primary care providerwould spend the time with them,
each of those ten patients is paying$3,000 each for that visit with him
(28:58):
and seven of them a day.
Do not need to meet with them.
And what do you think has to do withwhy that?
Why they're doing that?
You know,
that's one reason why United Health Careis under investigation right now
by the DOJ, because of those kindsof 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.
(29:19):
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 goto 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 outand 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.
(29:41):
You'll probably be surprisedby what you learn.
We'll be right back after the break.
You're listening to America'sHealthcare Advocate.
Broadcasting coast to coast acrossUSA here on the HIA Radio Network.
We're going to shift gears now and talka little about what do big employers do
when they're on this plan.
Stay right there.
We'll be right back with more.
(30:05):
Welcome back.
You're listening to America's HealthcareAdvocate 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'sHealthcare Advocate.
Also 15 podcast platforms, YouTube.
So here's the thing.
Maybe your company is got a healthinsurance plan and nobody's happy.
Maybe you might want to mention to them.
(30:26):
Hey go up and listen to this broadcastthat Cary Hall did with the doctor
in studio and talked about this HyVeeExemplar Care model
and how it works, and see whatlet them know that it's there.
Because oftentimes when people referother 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 relatethis whole broadcast back to someone.
(30:48):
If you think there's someonethat would be interested in this,
maybe it's a familyand you think you maybe it's your wife
and you want to tell your wife to golisten to this podcast.
This is a great way to do this.
We're posted on 15 podcastplatforms/channels.
We're on thewe have our own YouTube channel.
We got almost a half millionviews up there.
So this is a great wayto disseminate this information.
And this program is very, very different.
(31:09):
And I think
it's really going to come into focusas we get closer in to the fourth quarter.
And the marketplace disruptionsthat we're going to see.
Its HyVee Exemplar Care.
The website is exemplar.careif you want information.
So nowwe're going to talk about large employers
because I'm focused a little bit on smallemployers.
Quik Trip was one of your first clientsokay.
(31:30):
And now how many employees?
They have a lot of employees.
But on their on their benefit planit's around 24,000.
And and we're taking care of, folks
who are in the clinic areaswhere we've built out clinics.
That's remarkable.
Obviously, just hearingthat is an endorsement
into your quality level, what you do.
I shop at Hy-Vee at 151st in Olathe.
(31:52):
I'm in there multiple times a week. Okay.
Thank you. Great people. Great.
But I've never been to a grocery storewhere they literally stop
whatever they're doing and,I need to know where I can find this.
And they walk you tothe aisle and show it to you
that's
the way the employees workthere is completely different for them
to have that kind of faithin what you're doing,
and to be able to take their employees,and send them to your facility.
(32:16):
I think that speaks volumesfor how this works.
Absolutely.
And I think we are actuallyheadquartered in
Des Moines, Iowa, which is where Hy-Vee'salso headquartered.
And our first clinic in, West Des Moines
headquartersclinic is also 24 seven urgent care.
So with Hy-Vee and the types of employeesand the demographics,
(32:37):
and then we've got shift workers thatabsolutely works for them just as well.
That's, you know, outside of us, they canconnect with the primary care provider,
or they can come in to urgent careif they have those acute needs.
We do offer fee for serviceas well in the urgent care.
So we have nonmembers, but our membersget priority so they can walk in
and they're the next one to be roomed.
(32:58):
When a room becomes available.
So when you say 24/7 you really mean 24/7brick and mortar urgent care.
Absolutely.
We opened our doors, nearly five years agonow, and we've never closed
those doorssince. I’ve never missed a shift.
And as we grow out and the marketsmature, we're going to have it in Omaha.
And here in the Kansas Citymarket as well.
(33:19):
That's that's pretty remarkable becausethat'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 havethis problem, or the problem gets worse
because they don'twant to pay the 50 or 75 or $100 co-pay.
(33:39):
This is completely different.And even more so at night.
Those employees would oftenbe 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 folkswho are paying the bill.
However it comes in.
And it is the least effective dollarfor health care spent in this country.
(34:02):
Absolutely. Yeah.
And it's unfortunate, but that'swhat you said is absolutely correct.
Yeah. They all understand zero.
So they all understand zero.
And we all know that accidentsnever happen when we want them to happen.
They're always going to be at nightor at the weekend or during the holiday.
You you know,
you're at the barbecue with your friendson the 4th of July and something happens.
(34:23):
Where do you go?
Emergency roomis usually your only option,
but now we can do the virtual careif needed.
If virtual care will manage the situation,we can do virtual care
or they can come into the clinicfor that 24/7 treatment.
So on the break you were talkinga little bit about the experience
for the employeeand what you have learned over the years
(34:43):
with how the employees feelabout this program versus
being on a standard ACA typehealth insurance program.
Talk a little bit more about that, Jacibecause it was fascinating.
Yeah. No.
What we findis that a lot of these employees,
they've notnecessarily 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.
(35:06):
They come and they visit our clinicand people have got the time for them.
They build that personal relationshipwith 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 areand what matters to you.
We want peopleto live their healthiest lives,
so if that's playingwith your grandchildren, it's
(35:28):
you want to continue to be golfing,or whether it's that
you just want to go and sit and meditateand have coffee with your friends.
We will work with youon whatever health means to you.
And what we do is during thatwelcome visit, we will take those baseline
labs.
We’ll have those initial conversationsof what health means to you,
and then we'll make sure
(35:49):
that we keep your health where it is todayor we'll help you to improve.
This is all about proactive preventativehealth 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 gota couple things you want addressed,
one of them, you might be tired.
You're chronically tired.
If you work shifts, theyour sleep's not very good.
(36:11):
You don't eat very well because you workat QuikTrip and a convenience store.
Or you get off work at two in the morningand 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 sleepschedule.
Go through all of that.That can be a ten minute conversation.
Then you move on to the dietand the exercise.
(36:31):
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 workon 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.
(36:51):
You're pre-diabetic.
You could become a diabetic if you're A1Cgets to 6.5, you're on that trend.
I could give you metformin, a medicationthat treats diabetes.
And we can relativerisk reduction of about 16.
Or you can make wholesalelifestyle changes.
And now I can talk about intermittentfasting, low carb food options,
(37:12):
the types of exercise that, decreasesthe likelihood of progressing to diabetes.
And that's a 32 fold relative
risk reduction, twice as effective as megiving you a medication.
One of those takes timeand effort to explain.
The other one takes writing a prescriptionand 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 chanceto really show them
(37:34):
that you care about themand educate them like your health matters.
And if you make these changes,you can head off
one of the most costly longterm diseases that you can have.
And that comes backin cost to the employer,
and it comes backwith satisfied employees,
and it comes back with
the overall health of his workforceand how they feel about that employer.
(37:55):
Which goes back to that commentyou made earlier in the show.
This is the one thingmy employer does that’s a real benefit.
So you know whatthis 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 providea good benefit and to save money.
At the same time.
All these things are in alignmentwhere in a fee for service world,
(38:16):
the more you comein, the more I get paid. You have.
I do have disincentives and misalignmentthat cost people money over time.
And this is a way to to remedy that.
And, you know, I think that's a great wayto 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 momentto go to their website and take
(38:38):
a look at this exemplar care
Exemplar.care.
It's is on the website.
All the information is up thereif you're an employer,
if you're a human resource directorand 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 programthat you're on.
You're not happy with the carrier.
(38:59):
You're not happyyour employees are not happy.
You've been cost shifting.
You're doing all these different thingsto 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 employeesif they didn't think it worked.
That's why I asked these folksto come and do this show.
We try to provide information hereabout things that are different.
On the cutting edge of health care.
(39:20):
This program is different.
The website exemplar.care is the website.
All the information is up there.
And now I leave youwith this thought from Albert Einstein.
The one who follows the crowd, theyusually get no further than the crowd.
The one who walks alone is likely to findhimself in places no one has ever been.
Remember,friends, it's a funny thing about life.
(39:41):
If you refuse to accept anythingbut the very best.
You most often get it.
Thank you for listening to America'sHealthcare Advocate Show
broadcasting coastto coast across the USA.
Goodbye America.
You and you.
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