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Scott Shreeve, MD

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I'm the CEO of Crossover Health, a patient-centered, membership-based medical group that is redesigning the practice, delivery, and experience of health care. We offer urgent, primary, and online care to our members who can access our technology platform, practice model, and provider network from anywhere and anytime to optimize their health. Email Me



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Between Retail and Concierge – Is there a place for branded primary care clinics?

Retail (rē’tāl) n.

  1. Of, relating to, or engaged in the sale of goods or commodities
  2. To sell in small quantities directly to consumers

The “retailization” of health care continues to advance in fits and starts. There are multiple fronts of attack in this movement – everything from general transparency issues such as pricing to physician ratings, to new services and delivery models accentuating convenience and access, and ultimately to new payment models involving risk sharing and financing hybrids.

Somewhere in the middle is the evolving concept of the medical home – which at its heart is a old concept resurfacing as a new innovation trying to solve the timeless conundrum of access, quality, and cost. As I mentioned previously, the notion of the medical home is gaining speed, but it is neither a retail play (access/cost) nor an elite consumer experience (quality/cost). It is designed to be the “homey hearth”, right in the middle of these two spectral ends. In fact, I would suggest that the application of the medical home concept lends itself to the creation of suite spot right within the big bell curve of health care delivery.

Description of the Health Care Continuum delineating a sweet spot for the Medical Home

Description of the Health Care Continuum delineating a sweet spot for the Medical Home

The Medical Home should resonate with that large middling population that actually is employed, has insurance (typically through said employer), and lives in the suburbs with the wife, the 2.2 children, and the family dog in Average Town, USA. It is the typical middle class person who is worried about the financial meltdown, what it portends for the interest rate on his ARM, gas prices at the pump, and food costs that are starting to hit his bottom line. It is also the center of the bell curve where uniquely American trends of obesity, inactivity, and the burden of an aging population with a growing chronic disease burden looms like an innocent iceberg to the approaching health care Titanic.

Interestingly enough, it is also the exact place where the age old concept of a primary care physician – now equipped with modern tools of communication, electronic health records, and population analytics – can have a dramatic impact on the health and well being of patients before future tragedies strike. In theory, this muddling middle is exactly where the level of care described in the medical home concept could very effectively be applied for best return on investment.  Hence, the reason for what I perceive is now a widespread interest, to the implementation of the medical home as the “new new” single point of health care accountability (gatekeepers was never a good analogy anyway!).

To tie this together, it appears to me that the round mound of the bell curve is ripe for a medical home brand to stake a beach head along a specific (price?) point along the curve to deliver on the promise of primary care. In fact, there are multiple potential points along the curve where varying access/quality/cost variations could be offered to appeal to specific segments. For example, a “Target” equivalent offering exceptional consumer value, or a “Nordstroms” equivalent offering higher service levels, as well as every model, price point, and health value equation in between.

A primary care “brand” is destined to emerge, probably several, with each delivering on a specific value promise to health consumers along the wide continuum of the health care delivery bell curve. Looking forward to seeing / helping this become a reality.

2 comments on “Between Retail and Concierge – Is there a place for branded primary care clinics?

  1. Brian says:

    I love the concept. A national chain would have the resources to improve the patient experience far beyond what individual cottage clinics do. My biggest question has to do with national branding versus local branding. The funeral home industry has consolidated a lot over the past couple decades, but has been unable to establish national brands because of the preeminance of the local brand; these companies go out of their way to hide national ownership so that the local community thinks the funeral home is still locally/family-owned.

    Do you think health care is similar? The for-profit chains, e.g. Columbia/HCA, haven’t had great brand perception and have started regional brands to cover their national ones. Mayo has a great international brand, but they may be an exception. And I read an interesting article about retail clinics that quoted a Wallmart SVP as saying that they wanted to do more contracting with local health systems, as opposed to ReadyClinic and the like, because the communities “trust” the local systems.

  2. Brian,

    Excellent question and begs one to defy the age old thought that “health care” is local. For the most part, health care is local. This is reinforced by medical licensure requirements and the requirement to have a trusted relationship given the intimacy required to delivery an effective service (patient-physician relationship cannot be outsourced)

    However, there are many service level companies that have done this affectively. I am thinking of complex service delivery, with many examples in the financial services arena (HR Block, Charles Schwab, etc). I absolutely think it can and should be done in the health care as well.

    Consumer branding is powerful, and it will resonate with health care consumers just as it does in other areas of their life.

    Thanks for your comment and keep reading.

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