One Medical Group: Curing the process of healthcare delivery

One Medical Group leveraged user-centric design principles to build a patient management platform, office processes, and physician teams that provide immediate, affordable, personalized care for mass customers.

Symptoms of inefficiency
In 2014, the average appointment for a U.S. family physician carried a wait time of 19 days, and culminated in a doctor visit that lasted just eight minutes.[1,2] Meanwhile, the average annual health expenditure in the U.S. amounted to $9,523 per person, begging the question – are we allocating healthcare as efficiently as possible?[3] One Medical Group doesn’t seem satisfied. Offering a fresh perspective on doctor-patient interactions, the startup is leveraging user-centric design principles to build a patient management platform, office processes, and physician teams that provide immediate, affordable, personalized care for customers. Since 2007, the group has picked up 80,000 patients, enrolled 100 enterprise clients, and raised $65 million in venture funding to pursue its goals.[4]

The business remedy
One Medical has three key constituents. Individual patients can enroll flat fee of $199 per year to receive personalized primary care from highly trained physicians. Appointments are available with zero wait times, and can take place in person (at an office that resembles a health spa), or remotely over video conference, resulting in an experience that is higher quality, lower cost, and more hospitable. Physicians also benefit from the system, spending more time with fewer patients per day, and consequently reporting increased job satisfaction. In the last few years, One Medical has also targeted its service to employers, offering group plans as part of an HR package to increase the health, productivity, and retention of office workers. [5,6]
Performing operations
One Medical is not alone in its pursuit of this value creation, but its emphasis on design, technology, and vertical synergies has uniquely catalyzed its success. The startup uses an innovative technology platform to optimize patient throughput. Video conferencing and electronic messaging are used by physicians and patients to resolve issues without the need for a visit, reducing overall office load. Same day booking and automatic prescription renewals are also incorporated in the platform to minimize administrative overhead and absolve staff of menial tasks. Meanwhile, physical spaces are used to improve the quality of interactions – the spa-like waiting rooms being combined with convenient office locations to deliberately reduce patient stress. In addition, the company seems to have aimed to control its own growth to maintain a highly standard of care. It has spread to patients primarily by word of mouth and through employer benefit packages, while selectively choosing the cities it expands to and the physicians it onboards. This has resulted in an apparently manageable patient-to-doctor ratio that has not jeopardized quality or accessibility. Lastly, the service provides fixed, transparent pricing to further satisfy consumers; it accepts but does not require insurance, with fees that are below $200 per visit in either case, leading to higher patient satisfaction. [5,7]

Diagnosing results
Alignment between the business and operating models has certainly paid off. Controls that mitigate physical office visits have resulted in physicians seeing 35% fewer patients than average, while being able to reduce administrative staff by 62%.[6,9] Those savings have been passed on to patients, who avoid having to subsidize administrative overhead with higher fees, to doctors, who have continued enjoying more time with each patient, and to employers, who report an 8% decrease in healthcare costs by using the service.[8] Most impressively, the service seems to have significantly improved the overall healthcare system, reporting that ER visits decline by 25% and hospital visits decline by 40% by patients who enroll. [10] With a new round of funding recently raised by the startup, one can only hope that One Medical spreads.

 

Works Cited

1. “Physician Appointment Wait Times and Medicaid and Medicare Acceptance Rates.” Merritt Hawkins. 2014. http://www.merritthawkins.com/uploadedFiles/MerrittHawkings/Surveys/mha2014waitsurvPDF.pdf. Accessed 9 December 2015.

2. “For New Doctors, 8 Minutes Per Patient.” New York Times. Pauline W. Chen, MD. 30 May 2013. http://well.blogs.nytimes.com/2013/05/30/for-new-doctors-8-minutes-per-patient/. Accessed 9 December 2015.

3. “NHE Fact Sheet.” Centers for Medicare and Medicaid Services. 2014. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Accessed 9 December 2015.

4. “Innovative San Francisco medical group nabs $65 million in funding.” San Francisco Business Times. Chris Rauber. 8 December 2015. http://www.bizjournals.com/sanfrancisco/blog/2015/12/one-medical-group-jp-morgan-jpm-twtr-adbe-health.html. Accessed 9 December 2015.

5. “One Medical Group.” One Medical Group Website. 2015. http://www.onemedical.com/. Accessed 9 December 2015.

6. “Concierge Medical Care With a Smaller Price Tag.” New York Times. Katie Hafner. 31 January 2011. http://www.nytimes.com/2011/02/01/health/01medical.html Accessed 9 December 2015.

7. ” One Medical health care is the hot new perk for tech startups (exclusive)” Venture Beat. Christina Farr. 10 February 2014. One Medical health care is the hot new perk for tech startups (exclusive). Accessed 9 December 2015.

8. “One Medical Expands Primary Care to Employers.” One Medical Blog. February 10 2014. http://www.onemedical.com/blog/newsworthy/enterprise/. Accessed 9 December 2015.

9. “One Medical Raises $20 Million For The Modern Doctor’s Office.” Tech Crunch. Erik Schonfeld. 5 September 2011. http://techcrunch.com/2011/09/05/one-medical-raises-20-million/. Accessed 9 December 2015.

10. “CREATING TRANSFORMATIVE CONSUMER EXPERIENCES: MAKE IT MAGNETIC.” Oliver Wyman: Transforming Healthcare. Helen Leis. 10 December 2014. http://blogs.oliverwyman.com/healthcare/2014/12/10/creating-transformative-consumer-experiences-make-it-magnetic/. Accessed 9 December 2015.

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7 thoughts on “One Medical Group: Curing the process of healthcare delivery

  1. OneMedical is such a great concept, and I’ve had very good experiences with them overall. I hope more doctor’s offices take up their approach, but wonder how challenging it will be to maintain their current level of service as they expand to more cities. The alignment between the operating and business models makes a big difference to all their patients.

  2. I have been a member of OneMedical for 3 years and I’m a big fan. One of their draws is that you know what service you’re getting from city to city, so as I’ve moved, I feel comfortable knowing that OneMedical has already vetted my doctor and provides the same healthcare services. A few things come to mind as potential obstacles for OneMedical as they try to expand offerings to keep up with growing demand:

    1. How large is their ultimate market? Are they only looking to expand within the US, or is this scalable outside of the states? Given different healthcare systems, I suspect it would be very challenging to move beyond the United States, but that also limits their business prospects.

    2. How do they plan to compete with services like Pager and Doctors On Demand, that send trained physicians to your home to do the same thing. It would be a logistically tough thing to operate, but they might face competition from services like that, even for primary care.

    3. Would they ever plan to tier pricing to cater to people with different needs (or packages for multi-city use), etc. The membership fee has gone up every year since I’ve used the service and while I find it valuable, for most people who access doctors once per year, the $200 fee is relatively steep.

    Just a few thoughts – I really liked reading about how they optimize patient throughput through organized systems and teleconferencing!

  3. I am THE biggest fan of One Medical group. It is shocking to me that they’re able to provide 10x better service with a $200/yr flat fee. I’d be very curious to look at their margins and understand how sustainable this is – I assume they couldn’t have charged much more than this $200 to draw patients in to this novel business model, but having experienced their premium service, my willingness to pay would certainly be higher.

  4. Great post – thank you for writing! I am a fan of One Medical and have been a client for a few years. However, I have two worries about their model:

    First, I worry that their success in building a good UX for online appointment booking leads patients to prioritize how soon they see a provider and how close that provider’s office is over who the provider actually is. I’ve probably visited a One Medical facility a half dozen times over the past 4 years, and I’ve never seen the same provider twice – I think this lack of continuity of care, or development of any relationship between provider and patient, could hinder care in the long term

    Second, I worry that One Medical fails to restrict rising healthcare costs and may actually be contributing to their growth. I think the typical One Medical client is an urban, well-paid professional who has decent insurance coverage, but who is willing to pay the One Medical membership fee out of pocket solely for the convenience of seeing a provider in <24 hours vs. having to wait a few days. So the care One Medical provides is care that would already be provided if One Medical was not around, and all of the fancy amenities like the spa atmosphere may just mean that care is being provided at a higher cost.

  5. This is super interesting! There was a One Medical office right across the street from my apartment in Manhattan and I used to receive flyers in my building for membership. I unfortunately never joined, but I have always been curious about their business and their model. It seems to me that One Medical’s business model is one that centers around convenience and service – this value proposition is well suited to big cities (with a big population of urban professionals) like New York where you can wait for months for a doctor’s appointment (especially with a well rated/reviewed doctor). My only query would be regarding their growth strategy – I would love to understand to what extent they plan to scale their business, in the future. Is this a model that will only work in big cities or can they tweak it a little bit to be able to adapt to less urban areas?

  6. I am a One Medical convert and particularly appreciate the ease with which you can book an appointment and the limited wait time. However, I am curious to better understand how their model makes my healthcare costs cheaper (per the post)? For someone like me who maybe only visited the doctor 3-4 times in a year (assuming a $20 co-pay *4 = $80 / year), I am now paying $200 instead of the $80 I would have with another doctor. How does OneMedical value my aggravation and wait time and would they consider a tiered pricing model for less frequent visitors (like another comment mentions above)? Also, is this a family friendly business? More often than not, these young professionals that One Medical is capitalizing on now will eventually have families in the near future. I never noticed any kids in the offices I visited in the last four years, and wonder if this is a missed opportunity for them as they might lose customers once they have families and want a “one stop shop.”

  7. I disagree with the post’s thesis that this model is designed to provide ‘affordable care for mass customers’. I do think there is alignment but for a relatively affluent customer: for a $200 entry fee and a $125-175 visit fee (higher than regular primary care visits which are usually $70-100) you get accelerated access to a premium service. It is this which enables the lower level of operational efficiency in terms of patients seen which is reflected in the 35% drop in patient visits per doctor – exactly the opposite of what an efficient, mass customer player would be aiming for! Thus you are creating value through a higher quality service aimed at customers who have a higher willingness to pay, a great alignment.

    However, one opportunity which I think exists for One Medical is to capture the value it creates through lowering overall medical costs to its patients through its higher quality primary care. By avoiding complications, good quality primary care should be something that pays for itself, but is hard to prove to an insurer or employer. If One Medical can start proving that its model is cost effective to insurers than it should be able to get better reimbursement rates and payments from insurers and then it really could become be a well-aligned model for less affluent consumers.

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