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? 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.
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]
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]
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. 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.  With a new round of funding recently raised by the startup, one can only hope that One Medical spreads.
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.