Can Concierge Care Achieve Its Potential?

Among the many emerging models of primary care from outside disruptors in the field, concierge medicine has been steadily gaining traction with patients. And over the past couple of years, a growing number of health systems have been partnering with One Medical, whose model has been linked to reductions in avoidable downstream health care costs.

The tech-savvy primary care company, which offers in-person and virtual care services, recently expanded into the Dallas-Fort Worth area, its 19th market nationally and third in Texas. It also entered into a partnership with Baylor Scott & White Health, the largest nonprofit health system in the state.

Since its initial public offering in late January 2020, the company has expanded its network from nine in-person markets to 22, representing nearly 40% of the commercially insured population in the country, the company notes. It also has more than 8,000 enterprise clients and a high retention rate.

Health systems that partner with One Medical have been attracted to the benefits of access to a new patient base, its consumer-friendly platform, more personalized patient care and reduced administrative burdens for physicians.

But that’s only part of the story. The larger issue for investors and those in the financial community is whether One Medical specifically — and concierge medicine in general — can generate the kind of growth to become a key sector within primary care.

3 Things to Know About One Medical

Physician-Friendly Technology and Business Model

Providers are paid on a salary basis, not fee for service. Physicians also see far fewer administrative burdens, with 44% fewer electronic health record tasks than the national average, according to the company.

Win-Win Strategic Partnerships

What separates One Medical in this market is its ability to forge key strategic partnerships in which all participants — payers, providers and patients — benefit. The company’s data scientists process huge volumes of data to gain insights, so members receive more personalized health care. This also gives employers a better sense of outcomes and managing rising employee medical costs. According to a peer-reviewed study published in JAMA Network Open, One Medical’s model was linked to a 45% reduction in an employer’s total health spending, including 54% lower spending on specialty care, 43% lower on surgery, 33% lower on emergency department care and 26% lower spending on prescriptions.

Health Networks Are Partners, Not Competitors

One Medical has invested heavily in integrating platforms to deliver a more seamless experience for provider organizations and patients, who have access to a variety of specialists and facilities. Health systems partnering with One Medical include:

• Partners Health Care, Boston.
• Advocate Aurora Health in Illinois.
• Mount Sinai, New York City.
• Providence St. Joseph Health, Renton, Wash.
• UCSF Health.
• Dignity Health, San Francisco.
• UC San Diego Health.

In May, One Medical expanded its reach with employers by partnering with employee benefits provider ParetoHealth. One Medical’s primary care services will be offered to ParetoHealth’s 1,400 employers with more than 440,000 covered lives nationally.

Even with recent successes like this, however, One Medical hasn’t lived up to investor and analysts’ growth expectations. Its first-quarter earnings per share loss was double what analysts expected and sent One Medical’s stock price tumbling. And now, nearly 15 years after One Medical was founded, questions remain about the potential size and scope of this sector within primary care. Likewise, it’s still up for debate whether sufficient numbers of consumers value this care approach enough to pay for it so that the sector can achieve significant sustainable growth.