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Could Uberizing Healthcare Drive Better Care for the Underserved?

uberization.jpgEven if you’ve never used Uber, you probably know people who have. The convenient, mobile-empowered ride service turned the taxi industry on its head. So great is the influence of Uber on modern life that the word “uberize” is now featured in the Cambridge Dictionary,  which defines it as “to change the market for a service by introducing a different way of buying or using it, especially using mobile technology.”

And change is coming to healthcare in the form of an Uber-like model: direct primary care. Could it be a solution to the doctor shortage problem for medically underserved populations?   


The Pros and Cons of Direct Primary Care

Uber isn’t alone in taking advantage of mobile tech and consumer demand to innovate new ways of doing business. A wide variety of companies are transforming how they interface with people—and connect them with products or services they need. Uber connects people with drivers, but it doesn’t own the cars. Airbnb connects travelers with vacation homes, but it doesn’t own the properties.

In a Tech Crunch article, Tom Goodwin writes, “It’s a great business model because the best interface companies own valuable customer relationships at very low operating costs.” And they win over these customers by providing greater efficiency and flexibility. It’s a direction healthcare providers are exploring as they search for alternatives to the traditional fee-for-service business model.  

“It’s a great business model because the best interface companies own valuable customer relationships
at very low operating costs.”

Direct primary care (DPC) represents an Uber-like approach to healthcare delivery. According to the American Association of Family Physicians (AAFP), direct primary care offers a “meaningful alternative to fee-for-service insurance billing.”

How does it work? Practices charge a retainer—usually as a monthly or quarterly fee—that cover most primary care services. Customers can then opt for a low-premium, high-deductible health insurance policy to address non-covered services and emergencies. What are the direct primary care pros and cons?


For Physicians:

  • PRO: Lower Overhead Costs. DPC reduces staff hours spent on time-consuming third-party payer billing and collections.
  • PRO: Volume Matters Less. Practice sustainability improves, even with fewer patients, which makes starting a practice in a medically underserved community more feasible.
  • PRO: Clinician Burnout Declines. The decrease in volume allows doctors and nurses to focus on providing the best possible care without sacrificing their own personal life to meet quotas.
  • CON: Challenging to Implement. Completely transforming how a practice operates is not easy. Physicians must create a DPC business plan that meets regulatory and legal standards and establishes a sustainable membership fee structure for both the practice and the patients. In addition, practices need to develop an ongoing marketing plan to attract healthcare consumers because they can’t rely on patients coming to them through referrals from insurers.


For Patients:

  • PRO: Manageable Monthly Fees. DPC eliminates the “sticker shock” that comes from not knowing what a doctor’s visit will cost until after it has taken place. In addition, monthly retainers are more budget-friendly since physicians can pass savings on to patients.
  • PRO: Better Chronic Disease Management. Affordable, consistent access to a family physician strengthens the patient-physician relationship, boosting the patient’s ability to proactively manage chronic health conditions.
  • PRO: Improved Accessibility. Patients enjoy greater access to, and time with, their physician—in person and via email or text—because the emphasis at the practice moves away from volume.
  • PRO: Uncomplicates Healthcare. In contrast to complex and often difficult to decipher insurance plans, DPC retainers offer a straightforward approach to healthcare delivery. Retainers cover office visits and associated in-office labs, as well as telehealth, email or text in one fee.
  • CON: High-Density, Medically Underserved Populations Lose Access. For medically underserved patients with limited incomes, a monthly retainer may be out of reach. Moreover, in urban, medically underserved areas, the shift to a lower volume approach to healthcare may exacerbate access issues.


Offering an example of the advantages for both patients and physicians, one DPC physician, Dr. Chad Savage, told that he made the shift to the DPC model because he was frustrated by the bureaucracy of a traditional practice. He now sets his own rates—rather than insurance companies or government regulators—which has reduced patient costs by as much as 50 percent.

Savage explains: “I wanted to work in a system that facilitated being a quality physician, instead of one in which you had to fight against the system to be a quality physician. Direct primary care allows me to do this.”


Consumer-Focused Healthcare

uberization_blog.jpgDirect Primary Care isn’t the only way that healthcare providers can “uberize” to meet healthcare consumer expectations. A few years ago, product innovation consultant Stuart Kurten shared his thoughts on the “Uberization of Healthcare” in HIT Consultant.

“As health companies create products for the modern consumer, they will have to shift their focus toward how these products fit into the larger context of people’s lives,” he said. “Understanding and meeting patients’ needs and desires will become a bigger differentiator, and more crucial to adoption than ever before.”

Gaining that type of insight into healthcare consumers requires that you see them as more than a demographic—be it age, race, ethnicity or a medically underserved population. Psychographic segmentation allows you to understand patients on a deeper level, based on their attitudes and beliefs about health and wellness, what motivates engagement in their own health and more. Customizing communications — face-to-face, printed/digital education, marketing — by the unique preferences of each psychographic segment will enhance engagement efforts and increase the likelihood of success.

As Karten noted in his article, “Like modern healthcare systems, the taxicab model was inefficient, not mobile, and often unpleasant for the consumer.” Karten went on to say that traditional taxi service “was a model built around the needs of taxi drivers and their companies, rather than their consumer.”  

With healthcare consumerism on the rise and a shortage of healthcare professionals looming, direct primary care could be just what the doctor ordered—especially for medically underserved populations—to develop stronger, more engaging relationships with patients.

Psychographic Segmentation and its Practical Application in Patient Engagement and Behavior Change


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