Dr. Jay Parkinson @jayparkinsonmd - Tumblr Blog

Posts

Most people think going to the doctor costs a $25 co-pay. But then a few weeks later, you'll get a bill for the rest of the cost of the visit. So, a PCP visit is typically $175, an urgent care visit is $350, and an ER visit is $2,000. Sherpaa is like having your own primary care doctor. You get unlimited visits with us and it costs less than an urgent care center visit. Next time you think you need a doctor or an urgent care center, give Sherpaa a try. We're pretty awesome: https://sherpaa.com

This morning, Sherpaa launched an entirely new offering for small and medium-sized businesses.

#1: Companies can now pay for Sherpaa based on actual usage. This means each time an employee creates a medical case within Sherpaa’s app, companies are charged a flat fee. No matter how complex and long a case goes or how simple it is, it’s a flat fee. Prior to this, we were charging companies a per employee per month fee and this led to all kinds of headaches. Companies had to trust us that their employees would use Sherpaa. Then we had to spend all kinds of time and effort justifying our value. A flat rate per case eliminates this dilemma. Paying for Sherpaa based on actual usage de-risks the company. Companies can simply sign up and see what happens!

#2: It now takes less than a minute for a company to sign up for Sherpaa. You can do so here. Prior to this, selling Sherpaa was a complicated sales process. We found that companies, especially small companies, were interested in Sherpaa, yet we were not working with companies smaller than 100. Now, any company can sign up and get started implementing Sherpaa within their company in 5 minutes.

A Sherpaa case costs a company $150. Compare this to the average cost of care in traditional settings:

PCP visit: $175

Urgent Care: $350

ER visit: $2,000

When employees don't have an access point before they get in-person care, they're on their own trying to get their problems solved. This often results in piecemeal, expensive, paid for out of their own pocket care from urgent care centers, ERs, and random doctors. When employees have accessible doctors who can nip an issue in the bud before they spend on in-person care or direct their in-person care to exactly who and what they need, they spend their money wisely. Seventy percent of all cases created by your employees are diagnosed and treated without in-person care. Out of 100 cases diagnosed and treated by our doctors without an in-person referral, each $150 Sherpaa case prevents:

35 PCP visits at $175 each

50 urgent care visits at $350 each

15 ER visits at $2,000 each

Just considering those 15 Sherpaa visits that prevent 15 ER visits, for a $2,250 investment, you're saving those employees $30,000. That is an unprecedented gift questionably more valuable than unlimited coffee in the office.

Here's what this means for your company:

Based on Sherpaa’s 5 years of data, 50% of employees will use Sherpaa as their PCPs and they will create, on average, 2.5 cases per year. So, here is what you can expect per month:

10 employees = ~$150 per month 50 employees = $750 per month 100 employees = ~$1,500 per month

What does “Can I use my health insurance for x?” actually mean?

To “use” your insurance to most people means “will my insurance cover this in-full?” Here are the conditions that must be met for your health insurance to cover things in full:

You must have spent your entire deductible

You have a plan without co-pays (very, very rare)

You have a plan without co-insurance (increasingly rare)

The expense happened during a routine annual physical and was a recommended screening test for your age/gender/risk factors (thanks Obama!)

Certain forms of contraceptives (thanks Obama!)

The real questions are:

What will it cost me to see a doctor or visit an urgent care center or ER?

What will it cost me to get tests?

What will it cost me to get procedures?

The answer to these 3 questions is, before you’ve spent your entire deductible, you are responsible for paying for the entire cost of these things.

So, now the question becomes “will my health insurance cover this in-full after I’ve spent my deductible?”

The increasingly likely answer is no. In decades past, when we as adults were introduced to the concept of health insurance, insurance used to cover all visits. Then they started introducing co-pays (to visit the doctor, you have to pay $25 at the time of the visit). Then they introduced co-insurance (your health insurance pays, say 80%, of the bill and then you pay the rest after you’ve met your deductible). The real reason people are confused about this is because deductibles, co-pays, and co-insurance are relatively new concepts that were introduced gradually over time. As you can see, these are measures to offload costs from health insurance companies and employers onto you. The days of insurance fronting the costs of all things are over.

To clear things up, until you’ve spent your entire deductible, co-pays and co-insurance do not yet apply. After you’ve spent your entire deductible, you start sharing the cost through co-pays and co-insurance.

So, before you’ve spent your deductible, the smartest thing to do is to be a super savvy healthcare consumer. If you have to spend $4,000 out of your own pocket before insurance even kicks in, it’s important to spend that money wisely in partnership with a doctor who’s looking out for your spend. And that’s what we do at Sherpaa.

An Employer’s Guide: Comparing Sherpaa with One Medical

What is Sherpaa and what is One Medical?

One Medical is a traditional brick and mortar primary care practice located primarily in San Francisco and NYC that offers online scheduling and same or next day appointments. There’s a significant membership fee for individuals ($149 per year) or companies (~$40,000 for 250 employees) to join and each visit then costs employees market prices for a traditional primary care visit. Their main sources of revenue are a membership fee to individuals or companies plus traditional reimbursements from insurance companies. The more visits they do, the more revenue they generate from your employees.

Sherpaa is an online medical practice powered by our full-time physicians who diagnose and treat 70% of primary care issues virtually and, for the rest, personally arrange care with local specialists or facilities. It is traditional, relationship-based primary care, just online and available 24/7 from anywhere. Our mission is to prevent the unnecessary 70% of traditional office visits, like those that happen at One Medical, to make healthcare convenient and less expensive. There’s no membership fee to join Sherpaa and our only source of revenue is a per employee per month fee only for the employees that regularly use Sherpaa. That fee covers the cost of primary care for those employees and prevents unnecessary claims.

How much does One Medical charge employers per year?

For a company of 250, it costs the employer ~$40,000 in annual fees. For a company of 150 employees, it costs ~$24,000.

What does $40,000 a year get an employer with Sherpaa?

Roughly 275 primary care visits with Sherpaa’s doctors at no cost to employees. This is enough to cover 2 visits for the 60% of employees who use Sherpaa as their primary care doctors. These 275 online primary care visits prevent ~$68,000 in costs for primary care, urgent care, and ER visits.

What does One Medical’s $40,000 a year fees get an employer?

The ability for employees to walk through One Medical’s door. It does not cover the cost of doctor visits and their add-ons. Employees must pay their own medical bills.

Should One Medical pay companies for lead generation? Yes.

One Medical has deals with brokerages and HR platforms like Sequoia and Justworks that give One Medical away for free to employees of companies that use those services. One Medical pays those companies for patient lead generation. An employer is no different. One Medical should be paying employers for their employees’ healthcare dollars. A company has employees who spend money on healthcare. One Medical wants their money. It's old-fashioned lead generation.

How much will your employees spend on traditional healthcare per year?

50% of employees spend $0 to $100

40% of employees spend $100 to $5000 or less

10% of employees spend more than $5,000 a year

Half of employees will not need a doctor in a given year. And half of your employees will use a reasonable amount of healthcare. But do they already have a primary care doctor? And are they willing to switch their care to One Medical’s doctors?

Say you have a company of 250 employees. In reality, 10-20% of them will use One Medical.

What does a $40,000 One Medical membership fee cover?

These are from the actual line items in a One Medical $40,000 proposal for a 250 person company.

#1: One Medical Membership for each eligible employee

One Medical charges employers an $11-$13 PEPM fee for all eligible employees, whether or not they use it. Companies can choose to include dependents age 14 and over. If 20% of employees use One Medical (this number is probably quite realistic), this costs you $800 per employee per year and the employee pays for each visit out of their own pocket. Compare this to the often waived $149 fee each employee would have paid if they signed up as an individual.

If x% of employees use One Medical, this is the membership cost to employers per user:

10% = $1600

20% = $800

30% = $533

40% = $400

50% = $320

60% = $266

70% = $228

80% = $200

90% = $178

100% = $160

#2: Access to high-touch primary care

Annual membership fees simply pay for access or an affiliation, not care. But in-person office care is where One Medical does a good job. It’s a well-designed traditional doctor office that offers online scheduling and same or next day appointments. That’s surely an upgrade to traditional primary care. ZocDoc also offers same and next day appointments with primary care doctors at no cost to you or your employees. One Medical also bills like a traditional doctor’s office. The more diagnoses they make, the more tests they do, the more your employees pay them. When doctors charge you more for doing more, your doctor’s economic interests are competing against yours.

#3: 24/7/365 Telehealth

This service is powered via phone or video by non-doctors for limited, simple conditions for 24/7 real-time nurseline-like care. One Medical does not charge your employees for each use of this service.

#4: Access to all offices nationally

One Medical is operating in 6 cities: 26 offices in the San Francisco area, 9 offices in NYC, 2 offices in Boston, 3 offices in LA, 3 offices in Chicago, 4 in Phoenix, and 6 in DC. If employees who use One Medical regularly travel to these cities and need medical care during normal operating hours, this could be valuable if they are within a convenient distance from one of their practices in another city. But for those remote employees who don't live or work near a One Medical practice, One Medical is irrelevant to them.

#5: Access to Women’s Health Services

These are services provided by a family practitioner or physician assistant. They are not gynecologists nor obstetricians so they will not offer services for pregnancies. Most working-age women already have a gynecologist.

#6: Travel Health Consultation

This service costs an employee $50 plus the few hundred dollars for the cost of a limited range of vaccines. Anyone can enter their itinerary here and the CDC will offer recommended vaccines to be administered in any doctor’s office.

#7: Patient Financial Navigation

There are no details to be found on any of One Medical’s materials that describe this service.

#8: Open Enrollment Communication and Support

This is an opportunity for One Medical to explain their services and attempt to drive engagement and employee revenue toward One Medical. This isn’t really a benefit to be included in an employer’s annual fees.

#9: Rise Nutritional Coaching

Rise is an app One Medical acquired that anyone can download. Your employees will need to pay a $15 to $90 a month, non-insurance reimburseable in-app purchase to use in-app nutritionist services.

And for an extra cost:

Annual on-site flu vaccination program ($18 per employee per year. Others can also visit your office to administer flu vaccines)

Annual on-site biometric screening ($60 per employee per year)

11 On site care days per year: ($25,000 per year)

Virtual-only telehealth care (an additional cost to the employer and available by request...see above for a description of their telehealth service)

Building an on-site center: Custom pricing

What is not included in your One Medical fees?

Free 24/7 physician care for your employees that prevents 70% of in-office primary care, urgent care, and ER visits from happening.

Real-time insights from a dashboard an employer can log into that shows how many employees were using One Medical services with anonymous details about actual usage. You should know at all times the value you’re getting from your investment.

How does Sherpaa add value to employers and employees?

All fees paid to Sherpaa covers the cost of our full-time, dedicated doctors’ care and expertise so it costs employees nothing to get primary care. Sixty to 70% of employees use Sherpaa each year and we prevent 70% of in-person primary care, urgent care, and ER visits your employees would have previously had to pay for out of their own pocket. And employers get a real-time dashboard to see how many of their employees are currently using Sherpaa, how many cases were created, and what types of cases.

9 Reasons to Choose Sherpaa over One Medical

You pay for each and every One Medical visit out of your own pocket and there’s no way to know how much you’ll be billed. It’s traditional healthcare.

Sherpaa is a flat rate for unlimited care. We keep things simple and transparent. When other doctors charge you more for doing more, their economic interests are competing against yours. One Medical, and other traditional doctors, bill you more for doing more.

Sherpaa believes accessibility is a doctor’s ethical duty. You, nor your employer, should pay a meaningless access fee to doctors and then pay for each visit. The money you pay doctors should be for their time and expertise. See how much employers pay for One Medical here.

Sherpaa turns multiple visits into one. When you need more than primary care expertise, Sherpaa doesn’t make you come in to then refer you to what you actually need. We get your story via our app, understand your needs without an appointment, and then personally arrange specialist or urgent care for you. That way, Sherpaa skips the traditional primary care visit and sends you directly to the specialist with the expertise needed to solve your problem.

When you're sick or hurt you shouldn't have to go visit a doctor unless absolutely necessary. Sherpaa diagnoses and treats the majority of primary care without in-person visits. One Medical overwhelmingly requires in-person office visits, with occasional virtual care handled by doctor assistants. One Medical restricts their telehealth service to a few “common” things to drive more office visits, and, therefore, more revenue from you.

Sherpaa can be your primary care doctors for life. You don’t have to live or work near our physical office. When you move neighborhoods, change jobs, switch insurance, or travel, you should have the same doctors.

Sherpaa uses full-time, dedicated doctors, not nurse practitioners or physician assistants. When your health is on the line, do you want extensive physician expertise or a “physician extender” employed to cut costs?

Sherpaa will not send you medical bills that cause confusion and waste your time. One Medical traditionally bills you with the same line items full of medical codes and things that look like bills but say “this is not a bill.” In fact, One Medical online reviews suggest billing disputes are a primary complaint.

Sherpaa is an independent, mission-driven, self-funded company. One Medical’s last two rounds of funding came from a hedge fund and a private equity firm. Support Sherpaa. Or support Wall Street.

Yesterday, one of Sherpaa’s members reached out and asked if we could help them find a health insurance plan. We said, “have you seen Stride Health? Go there and let them do that for you. They nail it.” The patient’s response was a simple “Wow! Thank you.” Over the last 5 years, there’s been an onslaught of new digital health companies, some good, some bad, and some absolutely great. Healthcare is one big complicated, messy process. It wasn’t designed around real, everyday people’s needs. While it’s gotten more complex, digital health companies have been working passionately on real solutions to transform healthcare and the patient experience.

My company, Sherpaa, tries to solve one real problem for our members: delivering the right care to each patient as accurately, easily, and affordably as possible. Sherpaa is “primary care in the cloud.” But we view ourselves as not only doctors but curators and partners in making our patients lives easier and healthcare more affordable for them. When members communicate with Sherpaa’s doctors, they get diagnosed and treated and/or guidance through online and local services available to them. We’re effectively a funnel that can point our members to a curated set of services that make healthcare easier, less confusing, and more affordable for them. From Sherpaa’s and the patient’s perspective, there are so many other steps involved in healthcare. Things like:

Choosing health insurance (Stride)

Purchasing health insurance

Understanding how to use your health insurance

Analyzing your healthcare spending

Ensuring medical bills are accurate (Remedy)

Financing large medical expenses

Understanding costs of care (Healthcare Bluebook and ClearHealthCosts, FairHealth or NewChoiceHealth)

Getting an FSA or HSA

Finding a PCP (ZocDoc, Amino)

Finding the most appropriate and effective specialist (ProPublica, Amino)

Treating chronic medical issues

Treating mental health issues (Lantern)

Planning a predictable procedure

Getting a second opinion (GrandRounds)

Getting in-person acute care (Concentra, CityMD)

Getting care at home (Honor)

Procuring medication at the lowest cost (GoodRx)

Receiving daily medications consistently and reliably (Pillpack)

Getting a lab test and results (STDCheck.com)

Getting an imaging test and results

Learning about your health conditions (SmartPatients)

Learning about your medication (Iodine)

Learning about the value of procedures

Learning about actions/therapies you can do at home to improve your health

Daily health coaching (Vida)

While Sherpaa is a healthcare service and communications and problem-solving platform between doctors and patients, we can’t solve every problem. Best-in-class, forward-thinking digital health companies, like the ones linked to above, must band together to offer a seamless solution that solves real problems that real patients have on a regular basis. And when you effectively solve a real need, people see value and businesses flourish. Most digital health companies have chosen one problem to solve. But that problem is just one of over 20 complicated problems that real patients have. We can’t leave it up to the patients to find these services. It’s too confusing and it’s too hard for them to vet the services. We must identify one another, treat each other as partners, and effectively solve these problems together. We shouldn’t be acting in silos. We should be partnering, using and recommending each other’s services, and coming together to define and design the optimal healthcare experience that puts the patient first. Luckily, we have a built-in test market...our own employees. Between all of us, we have thousands of engaged, super passionate employees, who are patients themselves, working hard to make healthcare great.

If this resonates with you, send me an email or tweet at me. From there, we can start the process of getting us all together and delivering an elegant experience as one comprehensive solution that solves real problems for real people.

Ideal criteria for inclusion:

The service must be accessible to consumers directly

The service must have elegant design at its core

The service must be scalable across America

The service must deliver a delightful experience

The company must have a mission to put the patient first

The company wants to collaborate for the good of the patient

Who should pay for primary care?

Today’s primary care is a series of one night stands from fractured silos of random providers. There’s a 22 day wait to see an experienced primary care doctor in NYC, but the future looks more like Boston’s 45 day wait. So folks turned to ERs because they were accessible. As insurance companies tried to get expensive ER overuse under control, this led to the rise of urgent care centers that were just as accessible but a bit less expensive. As every business executive knows, the more inefficient, the more expensive. Letting insurance companies pay for primary care created today’s sad state of primary care. But an accessible primary care system is the backbone of efficiency and, therefore, affordability.

So who could pay for primary care?

Insurance companies. See above.

Individuals/employees.

Employers.

Employers should pay for primary care. Here’s why.

Health insurance is a benefit meant to protect employees from financial ruin when an expensive medical issue arises. However, health insurance paying for day-to-day care, often makes employees lives harder. They’re confused by what may or may not be covered. They’re frustrated with wait times for appointments. As employers offload more of the monthly premiums to employees, they’re increasingly paying for care out of their own pocket. They hope their conditions improve on their own so they delay care until things get worse and more expensive. Meanwhile, their ability to be a good worker suffers.

Up until now, employers had no way to easily pay for scalable primary care across their workforce.

Companies have offices and remote employees scattered all over America, but healthcare systems are local. Signing deals with the best healthcare systems in each city and state is untenable. Some companies have invested in brick and mortar primary care on corporate campuses. This is fine for those employees on those campuses but irrelevant to other offices and remote employees. Also, companies shouldn’t be in the healthcare delivery business.

How much should primary care cost?

$150 per problem. Easy and crystal clear. Problems can be simple, moderate, or complex. A simple problem is a UTI treatment that takes a few minutes. A moderate problem is tweaking asthma medications throughout a person’s springtime flareup. A complex problem is arranging and organizing a team of local doctors to perform surgery on a cancer case that’s ongoing for 6 months. There will be lots of simple problems, less moderate problems, and even less complex problems. No matter what, each problem should cost the same $150 and, over the course of a year, they average out.

Why $150? Let’s look at the competition. It’s $49 for a 10 minute Doctor on Demand video visit for the very simple things like pink eye, $200 for a typical PCP visit, $300 for a typical urgent care visit, and $1,233 for a typical ER visit. Averaging all of these out in a population of normal users and each case is ~$150.

Leaving it up to insurance companies to attempt to manage your employees’ care is markedly contributing to your 12% or 20% annual cost increases.

How can new models of primary care be delivered much cheaper than traditional primary care?

Seventy percent of primary care can be delivered virtually without the cost of in-person visits the overhead from managing brick and mortar clinics. Last year, more than half of Kaiser’s patient visits were done virtually. While this is wonderful for the 7 million folks in California who have Kaiser insurance, what about the other 323 million Americans?

Primary care should be accessible anytime from anywhere, consistently acquired from the same service, and affordable. That’s where Sherpaa comes in. Sherpaa is an online primary care practice available anytime and anywhere. It’s primary care in the cloud available to all of your employees, whether on campus or remote. We charge $150 a case, no matter how simple or complex and ongoing that case is. And we make your employees happier, healthier, and more productive.

How to Spend Your Money On Healthcare

Spending thousands of dollars a year on health insurance and healthcare needs a careful strategy. You wouldn’t buy a new car or a new house without doing your best to spend wisely.

Also, having insurance doesn’t mean you have doctors when you need them. In efforts to save money, insurance companies are limiting the number of doctors available to you. And without a doctor you can easily turn to at all times who can help you figure out exactly what you need, you’ll probably overspend. Many people go to the ER because they have nowhere else to turn to. Just one unnecessary $5,000 ER visit pays for 10 years of Sherpaa’s services. Healthcare is expensive but mistakes are avoidable. Having Sherpaa helps you figure out:

Can you get diagnosed and treated online or do you need in-person care?

Can you just get a blood or imaging test and get diagnosed instead of an in-person visit?

Do you need a specialist, an internist, an ER, or an urgent care visit?

Where can I get this medication for the lowest cost?

Can I get a refill on a medication without the cost of an office visit?

How to get the most out of your insurance

Step 1: Get a high deductible plan

Step 2: Get a Health Savings Account

Step 3: Get Sherpaa

Step 4: Spend on in-person healthcare strategically and only when necessary

$1,130: Typical Savings Per Year as an Individual with Sherpaa

The Details

Sherpaa wants to ensure you spend as little of your deductible as possible. Our unlimited care membership covers the costs of treating 70% of typical primary and urgent care health issues, avoiding out-of-pocket spending on expensive in-person visits and tests. For the 30% of the time that you need in-person care, Sherpaa doctors organize in-network care for you helping you spend effectively. Most insurance plans make you spend thousands before insurance starts picking up the bills. Sherpaa is a smart layer that sits on top of any health insurance plan and helps you spend your money wisely.

Here’s how to do it:

Step 1: Choose a high deductible plan.

Use your employer, healthcare.gov, or Stride.

A higher deductible means a lower monthly premium (the typical difference is ~$50 less per month for an individual).

We recommend choosing the insurance plan with lowest monthly premium. This works best for most people.

Step 2: Get an FSA or HSA account

As an individual, you can invest $3400 pre-tax dollars per year into the FSA or HSA account (What is an HSA account?) that can be spent on healthcare, including Sherpaa. This means Sherpaa’s $40 a month fees are discounted by ~20% (pre-tax money) turning that $480 a year into ~$380 for unlimited 24/7 care.

You can get these accounts through your employer or as an individual through your bank (Bank of America, Wells Fargo, UMB, etc).

You can also invest the money in your HSA account in a service like Betterment and likely earn a return on your investment. The average return on Sherpaa’s employees’ Betterment accounts was 8% for the past year.

Step 3: Join Sherpaa: Get 24/7 doctors + financial guidance

Figuring out what you need and how much to spend is almost impossible. We’re doctors who know how to look after your health and wallet.

If you switch insurance companies, you often switch your traditional PCP. Instead, use Sherpaa as your PCP and don’t ever worry about which plan you have.

Just remember

Sherpaa never bills you for anything but our monthly membership fee. It’s unlimited 24/7 care.

If any doctor, including a Sherpaa doctor, orders tests or medications before you’ve spent your deductible, you cover the costs. If you’ve spent your entire deductible, insurance picks up the costs.

Assumptions

Average 18-65 year old has 2.8 doctor, ER, and urgent care visits per year

Sherpaa prevents 2 out of 3 in-person visits

Working age population gets, on average, 8 prescriptions a year at an average cost of $70 a month. Sherpaa doctors prescribe medications through the app and direct you to the most cost-effective way of getting these medications.

There are two healthcare systems in America, I call them The Last 5% and The First 95%.

The Last 5%

It’s characterized by expensive daily drugs, highly specific tests, detailed imaging, super-specialized specialists, robots, massive hospital campuses, and every expensive thing but the kitchen sink. It’s the world’s best. It’s powered by specialists and big hospital buildings. And when people talk about the US healthcare system being the world’s best, it’s because of this “Last 5%” System. It’s life-changing when everything goes right. It’ll cost you an arm and a leg, but it can sometimes work miracles, if your definition of miracle is maintaining a beating heart. It’s also highly unsafe, risky, and prone to complications, hospital-acquired infections, and disconnected care. But that’s not something The Last 5% likes to think about. I call it The Last 5% because it’s solving the last 5% of human health problems. Remember, 80% of your lifetime medical costs are spent in the last 6 months of your life. It’s treating people, mostly adults, at the end of their life, after an unhealthy lifestyle from an unhealthy culture and environment has done a number on their bodies. Any problem where you’re trying to solve the last 5% of the problem is ungodly expensive and can only get more expensive.

The First 95%

It’s vaccines, clean water, short-term antibiotics, quick fixes, healthy food, exercise, education, and environments. It’s powered by neighborhood primary care doctors in small practices, farmers markets, bike paths, relationships with family and friends, and anything else that helps you get to the last 5% of your life. Health insurance companies are terrible at impacting this System for the better. But for an idea of how they could, see how the largest health insurance “company” in America has agreed to pay for removing lead in Flint. Compared to The Last 5%, there’s not a lot of money to be made here. That’s why the medical component of this sort of looks and feels like the DMV. It’s also not really connected to the Last 5% System. But it’s 95% of the solution. It helps you live a wonderful life throughout your life. And that's what matters. That's why all I want to do with my life is fix 95% of the problem.

Sherpaa’s Not-So-Secret Master Plan.

In August 2006, Elon Musk wrote a blog post outlining Tesla’s vision for the next 10 years, The Secret Tesla Motors Master Plan. I think it’s important for every company to articulate their long-term strategy and vision. So, with a whole bunch of self-awareness that I’m not Elon Musk, here’s Sherpaa’s not-so-secret Master Plan for the next 10 years. Keep in mind, healthcare moves glacially and the problems healthcare fought 10 years ago are essentially the same as today. With that in mind, here’s what we want to accomplish:

1/ Sherpaa will be a new specialty for young and middle-age adults that focuses on our unique issues.

2/ Sherpaa will be the cloud-based healthcare service funnel accessible anytime and anywhere. We will be the primary go-to service for accessing healthcare and solving health problems, arranging in-person care when necessary, curating and connecting patients to the right online or local healthcare service, and managing ongoing health issues.

3/ Diagnosis will be data-driven. Because 98% of everything that happens within Sherpaa’s platform is asynchronous text-based structured messaging, Sherpaa is the only place in healthcare where the entire conversation, questions asked, tests ordered, treatment plan prescribed, and outcome are meaningful, easily analyzable data points. Since the EMR we built was built to solve communication and health problems, not bill insurance companies, the data we have is extremely real-world and accurate. We will leverage this data to make diagnosis and treatment more accurate and cost-effective. Sherpaa will use a data-driven evidence-based strategy to ensure your diagnosis is efficient and consistently accurate. These diagnostic protocols will be made open-source to benefit anyone and everyone. Think “If This Then That” but for diagnosis. We do not want to focus on diagnosing long-tail diseases. Let Watson do that. We want to ensure that diagnosis for non-long-tail diseases are accurate 99.9% of the time. (Example: “If a patient answered our series of questions in the following way, and the recommended tests ordered showed these results, there’s a 99.9% chance the patient has x diagnosis.”)

4/ Treatment will be data-driven. Sherpaa will ensure all your treatment plans are custom-tailored to your unique body, genetics, and lifestyle and correlated with outcome to benefit you and the entire patient population. These treatment protocols will also be open-source.

5/ Care will be Increasingly cost-effective. Sherpaa will deliver care increasingly cost-effectively for you while also continuing to operate profitably. All virtual care should get less expensive over time with improving automation and artificial intelligence that augment our professionals’ expertise.

6/ Sherpaa will work with professionals from all the specialties that can effectively diagnose and treat virtually (dermatology, allergy, nutrition for example).

7/ Sherpaa will ensure price transparency. Every order for tests, medications, and referrals show an associated cost to you with a description of benefit and value to you and your unique situation.

8/ Sherpaa will curate and drive patients to virtual and local services that fulfill real medical/financial needs that make our patients’ lives easier throughout each step of the patient experience.

9/ Sherpaa will deliver virtual care and coordinate in-person care in all 50 states and be insurance company and employer agnostic. Your care shouldn’t be tied to your insurance company, employer, or neighborhood. These change in our mobile world. Your care should be cloud-based, accessible anytime and anywhere, and layered on top of any insurance plan to make care more and more cost-effective for you.

If healthcare was designed around you, it’d be Sherpaa.

You graduated from your pediatrician, so you’re sitting next to a 90-year old in an internist’s office. For the past few years, your relationships with random doctors have felt more like one night stands. Healthcare’s broken and backwards. It’s had decades to fix itself, but it still looks and feels too much like the DMV. And it’s out of control expensive. Your insurance premiums are $450 a month and you have to spend $5,000 out of your own pocket before insurance even kicks in. Even worse, your doctor’s ordering tests for you left and right and you’re not even told how much they’re going to cost. There goes vacation this year. It’s completely out of your control and your bank account is at their mercy.

All of you occasionally get sick or hurt. Thirty to 40% of you have ongoing problems and you need regular doctors. Things like asthma, anxiety, migraines, allergies, depression, arthritis, high blood pressure, sex issues, family, friend, and romantic relationship issues, and job stress issues. So why isn’t there a healthcare specialty that specializes in your unique issues?

And it'd be nice to have some consistency. You change jobs, move cities, change insurance companies, travel. Every time, you’re scrambling for new doctors.

If healthcare was designed around your needs, you’d see that most things don’t need to be done in person. Healthcare is just communication and problem-solving. If office visits and procedures weren’t the only way doctors got paid, you’d quickly see that 70% of healthcare communication and problem-solving could be handled virtually. You’d do everything you possibly could within an app, before you stepped it up to the inconvenient and expensive in-person visit. And when you need to spend your money, you want to know how much it’s going to cost you.

This is the vision Sherpaa has for you. We’ve had almost 5 years of a head start working with the employees of ~150 forward-thinking companies like Blue Apron, Casper, Tumblr, and Foursquare. Here’s what we’ve accomplished so far:

We’ve built primary-care-in-the-cloud powered by our team of full-time doctors and our patient-facing web, iOS, and Android apps that enable you to create cases; message with our doctors; approve or deny prescriptions, labs, and referrals; view the details of referrals to specialists and facilities; and view lab results, imaging results, and reports from specialist visits.

We’ve built a robust technological platform for our doctors allowing them to manage an entire online population of people; message with you; ask you a series of questions about your issues unique to your situation; treat you with evidence-based treatment plans; easily share with you the profiles of local specialists, urgent care centers, radiology centers, ERs, and ambulatory care centers from the proprietary network of Sherpaa-friendly resources we’ve built over the years; e-prescribe; order lab and imaging tests; receive those results; and ensure all of these online and real-world actions are accounted for and acted upon.

We’re delivering online care in 37 of the most populated states.

We’ve created a new genre of healthcare and redesigned how doctors and patients problem solve and get things done.

It’s important to have a vision. It keeps you laser-focused. But for now, purchase a high deductible plan, sign up for Sherpaa today, use Sherpaa doctors as your primary care, and join our mission to make healthcare accessible, appropriate, and affordable.

Trending Blogs

Recently Viewed Blogs

Dr. Jay Parkinson