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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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We left an Easter egg on our website a few months ago. Many of you have found it. The Crossover Health Master Plan. It’s a clever, cheeky and point-blank shameless riff of Elon’s Master Plan, and includes our recipe for building an awesome tech-enabled health services company.

It’s also already out-of-date (we move fast here!).

We are moving from a focus on conventional, synchronous care visits (which have always been best-in-class experiences) to one that does not simply incorporate digital, but literally places “digital first” at its core. We will be using the capabilities and expectations of modern communication behavior to change how care is experienced. Crossover is dialing up and doubling down on the idea of asynchronous care, of introducing episodes of care (here, here, and here) as the organizing principle and business model, and of uncovering hidden time for providers so that meaningful care can be delivered to more people, without breaking the back of our business or increasing healthcare costs.

Our evolving Master Plan—as I see it—is expanding to include the concepts embedded in the Connected System of Health. It’s progressing the notion of connectedness, and taking it from using digital tools to accelerate or enhance current practices, into one that (we hope) reinvents what we think “going to the doctor” actually means. Do we actually go in person? Do we necessarily have to see a doctor? Not always, especially given how inefficient and ineffective the old model of in-person “visits” can be. be.

All this said, there are many things, of course, that will stay the same:

  • A primary care foundation, because great primary care is how you conduct and curate the best health plan for a member
  • We’ll always be physician-led, even as others types of clinicians and caregivers provide more central roles in care
  • A broad and truly integrated care team, because no one provider can do it all
  • Expand access to the care model with a “Digital First, Strategically In Person” approach
  • Add new capabilities to manage the Secondary Care spending and experience of (everything outside our four walls where 85% of health care spending occurs)
  • A health model deeply with a Membership architecture the creates a sense of belonging to something special
  • A business model that encourages achievement in care, rather than activity. Away with fee-for-service!

So how would I recast our Master Plan?

1. Change the business model to reward achievement

Fee-for-service simply generates activity without promoting outcomes. That’s no good for patients who feel like they’re simply a means to generating fees, for employers who want to see a real return on their healthcare investments, or providers who truly want the time and ability to solve health challenges. So rather than focusing on generating fees, we’re concentrating on achievement and improving health scores across our populations, and are willing to put some skin in the game by assuming risk when we miss our own goals.

2. Build an awesome “Digital First” Primary Care Platform that people love

I’ve said before that we have to solve the simple—somewhat unsexy—problems inherent in primary care. Some of this problem-solving requires a ton of heavy lifting—work that many others are not willing to do. Attached to that challenge is another one—we have to bring our awesome primary care to our members, not the other way around. Heck, it’s how everything else works today. The way we choose to do that, is by starting our “episodes of care” digitally and asynchronously, alleviating our members’ concerns quickly, helping them start down the care path that’s right for their needs, and then ensuring that the right people on our care team are there for them, not only during an in-person visit but anywhere and anytime. Sometimes they won’t even need to come in—but that’s cool—because the visit isn’t what is important, solving their health issue is.

3. Build Trust through a Relationship

Our Digital First approach should function like so many other aspects of our modern lives. When we want to learn something or have a question, we immediately reach for a phone or tablet and start typing or asking Siri/Alexa/Google for the answers. But modern communication approaches are still very new to healthcare. We anticipate having to work extra hard to ensure that our Digital First model is not only convenient, but actually provides more communication, more thoughtful insights, and builds an equally deep relationship, much like our previous synchronous-only visits. When we succeed with this approach, we earn the trust of our members to move beyond reactive medicing, or “sick care” and towards something far more powerful and impactful—true healthcare.

4. Build It Out at Scale

Trust is a powerful currency. With it, we can build out our awesome platform at scale by:

  • Offering even more value-added services like speciality care, referral coordination, curation of specialist networks, and more, all of which makes the primary care platform the “user interface” to the complex, high-cost “secondary care” arena.
  • Continuing to move up the value chain by adding concierge services that create a membership feel. This will steer and navigate members, engage them in employer-sponsored programs, and open the gates to the high-cost claimants and those with serious chronic disease.
  • Cut through the irrelevant and unvalidated noise of digital health by creating value. We create a centralized primary care context, and connect technology with an ongoing provider touch.
  • Finish it off with an “Up To Date” service that passively monitors, proactively outreaches, and appropriately enrolls members in care programs specific for their care needs, health goals, or performance aspirations.

5. Leverage the heck out of our core technology platform

In the processes described above, we will accept the privilege and responsibility of managing our member’s data. If trust is the currency of our relationship, then the communication platform we are building is the medium of exchange we will utilize to create tremendous, recurring value for our members. To secure that trust, we are simultaneously making investments in a flexible data warehouse, predictive analytics, and contextual identification. These practical, effective technologies will help us identify, manage, and measure the health needs of individuals and populations with objective, demonstrable, and repeatable results. We’ll publish these results in peer-reviewed journals to show the world that our new iteration of membership-based primary care can actually achieve the quadruple aim of lower cost, higher quality, better outcomes, and more satisfied providers.

6. Connect it all, everywhere

Using a combination of digital and physical health services, we’re going to create a nationwide, consistent, integrated, coordinated, and “Connected System of Health” for our network of client employers and member employees that is going to rock the healthcare world. Because change is not only necessary, but also inevitable.

7. Come and Get it

We can’t wait to introduce this to the world as we launch. Bring your “A” game—it’s going to be On! As in—Switch On!

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