Episode 14: Going old school with your doctor - Exploring Direct Primary Care with Beth Holmes of Hint Health

Justin Steinman:
Definitively Speaking is a Definitive Healthcare Podcast series recorded and produced in Framingham, Massachusetts. To learn more about healthcare commercial intelligence, please visit us at DefinitiveHC.com.

Justin Steinman:
Hello, and welcome to the latest episode of Definitively Speaking, the podcast where we have data driven conversations on the current state of healthcare. I'm Justin Steinman, Chief Marketing Officer at Definitive Healthcare, and your host for this podcast. I'm joined today by my colleague Todd Bellemare, and our guest Beth Holmes, Head of Network Development at Hint Health.
Hint Health is a technology company that enables direct primary care. I've personally been fascinated with DPC for years from my days back in GE Healthcare, when I was marketing electronic medical record software, to my time at Aetna and CVS where we were exploring all sorts of new models to deliver better care a lower cost. So, I think we have a lot to talk about today.
Todd, great as always to have you here.

Todd Bellemare:
Thank you for having me. Always happy to be here.

Justin Steinman:
Good to see you come all the way down the hall. Thank you. We're actually in office again today. And Beth, thanks for joining us. We're so excited to learn more about direct primary care.

Beth Holmes:
Yeah, I'm really excited to talk to you guys today.

Justin Steinman:
Okay, so let's get this started and keep it simple for our audience. There are a lot of people out there who've never heard of direct primary care. What is it?

Beth Holmes:
Direct primary care is a model in which doctors are working with their patients on a subscription basis instead of on a fee-for-service basis. What that means is, typically either a patient or their employer pays the doctor a monthly fee for all services that doctor would provide. The feeling that it kind of feels like when a patient works with a direct primary care doctor, is like having and old-timey family doctor. It's like having someone who will know you and answer your calls, and really be there for you instead of having to interact with a doctor inside of a system that's really hard to get in touch with.

Justin Steinman:
[inaudible 00:02:05] my doctor to be doing all that for me, and it was like, full disclosure, I'm not part of a direct primary care practice today. I see my own doctor part of a fee-for-service. He's part of a big facility network here in the Greater Boston area. Shouldn't he just be doing everything that you just said for me as part of that?

Beth Holmes:
I think he should be, and he probably wants to be, but the reality is that most doctors working in the fee-for-service system have a huge patient panel so it's really hard to get in to access them. Sometimes you're waiting weeks or months even to get in to see them. Then when you do go in, visits are really short.
Doctors and other clinicians have a really, really short amount of time that they have to see their patients. They don't have time to really get into knowing you, who you are, and working with you proactively on their health. That's something that DPCs do have. They carry smaller patient panels, and because they're not paid on a fee-for-service basis, they can manage their time in around the way that patients need their care.

Todd Bellemare:
I think when I was looking into this and thinking about this, what it made me think of is the amount of extra stuff that a fee-for-service physician has to go through just to work in their practice, whether it's the rules about referrals, or working through a schedule of different charges that they have to look through, and even just the incentivization of that physician on how they make money.
I think that's the thing that clicked for me when I was trying to think of why it might may be better in a DPC model. It made me think more of the value-based care type settings, where it's a set fee and the physicians are paid a set fee no matter what happens. So, they are then incentivized to maybe not order a bunch of tests that are needed as opposed to someone who is incentivized to do so. I think maybe that comes into play early.
When you think about all the things that come along with being in a fee-for-service model, that sort of thing is something that makes me think, "Oh, maybe we should think more about DPC," but then it starts thinking about, "Well, what are the fees associated?" For me, when I first read about it I was like, "Oh, this is concierge care." I was curious, do you make a distinction between DPC directly or in concierge care?

Beth Holmes:
Going back to your initial point, I think you're absolutely right. We've been trying to figure out how to pay particularly primary care doctors outside of the fee-for-service system for a long time. From capitation in the 90s to value-based care today, it's like how can we pay them to take care of people and work with them through health issues in a way that doesn't involve seven minute in office visits?" Direct primary care absolutely aligns with that kind of long line of thinking. To your question about how much it typically costs, there is a really important distinction between concierge care and direct primary care.
Concierge care typically is a fee on top of fee-for-service payments, so that your doctors are able to maybe deliver a more high end experience, or take on fewer patients. But they're still billing your insurance, and typically billing a pretty hefty fee on top of that. Direct primary care kind of averages a monthly price in the 70s. So, it's changed but it's usually $70.00-$75.00 a month, which is a lot more affordable than something that might be a couple of hundred or a couple thousand in the concierge model.

Justin Steinman:
Is that cost-per-person, per family? I've got four kids and it's my wife, so as a family of six I'm clearly more expensive than someone in their 20s whose not married, right? How does that 70s cost work out?

Beth Holmes:
Usually, it's per person, but that's an adult price. A lot of DPCs will have a family price, and say the first adult is $70.00, the next one is at maybe $65.00, and kids are $30.00, or do a family bundle. If you are setting up as a family, it can be accessible if you're all with the same doctor who can offer discounts. Yeah, it is typically more than people are used to spending for primary care. I think that's a function of us really defunding primary care over the years, and a lot more healthcare dollars going into specialty care and hospital care.
If you look at what America spends for primary care versus other OECDE countries, we're spending a lot less on primary care. If you look at the overall dollar we're spending, we're spending a lot more and our outcomes are a lot worse. I think those are just obviously tied together. We need to think about how we can reinvest in primary care to influence everything that happens downstream.

Justin Steinman:
Got it. That makes sense. How does... My apologies for getting into the weeds, but it's interesting to me here to understand it. Hopefully, I'll only have to see my primary care physician, but I never want to actually have to go see a specialist, or God forbid go to a hospital. So, even if I'm okay paying this additional money for direct primary care, because that's outside of my insurance if I understand you correctly, do I also need to carry health insurance in addition for all that other stuff?

Beth Holmes:
Yeah, absolutely. Most people year to year are going to be healthy. They're only going to need to see their primary care doctor. They might need an annual physical, or they might have small things that come up. You do absolutely need coverage for unexpected events, whether it's accidents or more serious diseases, when you need to see specialists, or go to a facility.
You said direct primary care might not be part of your insurance. That's not true for everyone. When we look at our data, about half of the lives that direct primary care practices who use our technology are employer-sponsored lives. Employers are finding ways to pair together direct primary care and the rest of the benefits that they're offering their employees.

Justin Steinman:
That's good. I think maybe we should take a quick pause here and have you clarify just for everybody who Hint Health is, because I don't want people to think that Hint Health is providing direct primary care. What's Hint Health, and how do you play in this broader ecosystem?

Beth Holmes:
Hint Health is a direct primary care company. We have technology that helps direct primary care practices manage their eligibility and enrollment, because they're just on a completely different membership and billing basis than doctors who are working in the fee-for-service system and have to process claims. DPCs don't typically submit claims. They don't need a technology that can help them do that, but they do need technology that helps them manage their memberships.

Justin Steinman:
So, you're basically like a back office provider for a direct primary care?

Beth Holmes:
That's right. That's right. We also have a network of direct primary care practices that large employers can work with so that they can have that health insurance network experience rather than having to work directly with the many different direct primary care practices in their communities, especially when they're larger and more spread out. That's called Hint Connect.

Todd Bellemare:
I think that's... It's almost like you guys are the analog to the revenue cycle management programs like a fee-for-service provider might use that generates the claims, sends it to a clearing house, and so on. That really gets into the things that I do here, is work through medical claims data to understand outcomes and behaviors, and trends, and things like that. That's super interesting.
In terms of working with, you had mentioned, 51% of the programs for DPC is sponsored by employers, and you mentioned it, can you talk a little bit more about that network? So, you guys partner with employers to build out what that might look like? I forget the percentage, forgive me, but there was a certain percentage, or most of the employers have less than 10 employees or more.

Beth Holmes:
Yeah. DPC started more as a retail movement, so doctors working directly with patients. Kind of like a direct-to-consumer model. As more people found out about DPC, and employers learned about DPC, they wanted to start offering it to their employees because it's a really differentiated benefit. It's a really strong front door into the healthcare system. Yes, we're seeing 51% of the lives that flow through Hint Health Technology are employer-sponsored in the DPC model. You're right, a lot of those are coming from really, really small employers.
We think part of that is because it's easier for small employers to make really big benefit changes. Changing people's primary care is huge. For people who do have primary care doctors, they typically really like them. Making this change is big for employers. It's been confusing for employers about how to fit direct primary care into the rest of their benefit structure, because it's not part of... People are used to being like, "I work with this one health insurer, and they do everything. They do my network and my plan design, and the administration, and the claims payment, and reporting." It's all-in-one.
DPC right now is standalone, so it's taken employers who are really willing to go outside the mold and do something else. Usually, it's employers who really have longterm employees and really care about their health, and want to see changes in longterm health outcomes that are really interested in DPC. I don't know if I answered your question, so you can tell me if you have follow up there.

Todd Bellemare:
No, I think it was much more along the lines of how those employers get involved with it. First, I was thinking it's probably, I don't want to say an easier way, but it is a way for them to comply with laws that in some states say employers over a certain size have to offer some kind of insurance plan. It's just super interesting, and it's something that I had not really thought through before when looking at volumes of patients by insurance providers.
There's a gap there, whether it be a couple hundred thousand or a million patients. So, that still can be significant especially when you're looking at where patients start their healthcare journey, which typically would be in the primary care space.

Beth Holmes:
Yeah, another reason that employers really love direct primary care is the access of it. A typical member journey in direct primary care is you sign up with a DPC, and you go in and you have your first in person appointment with the doctor. Whereas, an initial visit for a fee-for-service doctor might be max 35 minutes. I think that's the maximum you can bill for. With a DPC, you're typically looking at about an hour. So, they're really getting to know you, and they're getting to know not only your health problems, but also who you are, because your health problems don't exist in a vacuum.
It's about where you live, who your family is, what your job is, the things that worry you, your mental health as well as your physical health. They're really getting to know you. Then once they know you, it's a lot easier to provide virtual care. So much of DPC is done virtually, and that's not just video visits, it's phone calls, texts, emails just like, "Hey Doc, I had this happen. Can you help?" Those are the types of encounters that fee-for-service doctors don't get paid for, so they're not doing them because nobody wants to work for free, but with DPCs that's covered in the membership fee.
For employers, that means people can stay at work. It means they have access after hours, so they're consulting with their PCP instead of going to the ER or going to an urgent care. That becomes really good for both employee's health and the employer's bottom line.

Justin Steinman:
You said earlier that 51% of the lives passing through the Hint OS or your Hint Health system comes from employers. How do the other 49% of people who aren't getting it through their employers get into direct primary care?

Beth Holmes:
Well, they're meeting direct primary cares in their community and they're paying for it themselves out of their pockets. They're saying, "This is the service that I need, and it's worth it to me to have this out-of-pocket payment."

Justin Steinman:
Okay, so it's really just individuals regular consumer shopping. It's like, "Instead of going off and buying a new microwave, I'm going to go off and I'm going to find myself a direct primary care, and I'm going to subscribe on my own."

Beth Holmes:
Yeah, that's right.

Justin Steinman:
That's actually a lot higher than I would have expected you to say. When I think about getting my primary care, my medical, I always think my employer. I think most people think about their employer. To think about that, almost half of yours is coming directly from consumer shopping is really interesting commentary on healthcare and how it fits in.

Beth Holmes:
I have worked in the Massachusetts market before. I'm in California now. I think that the way we experience healthcare in Massachusetts, which has really, really high insurance coverage, is not the way that everybody else in the United States is experiencing their healthcare. I think there are people in a lot of different buckets. I think over 10% of Americans now are uninsured, so there are a lot of people out there who don't have insurance, and they're figure out, "How do I get the most bang for my buck when engaging with the healthcare system?" And having an affordable primary care doctor who can help you both with your healthcare problems, but also help you navigate the rest of the healthcare system is something that's very valuable for a lot of people.
Another bucket of people are those who have very high deductibles, or even PPO plans that are technically not [inaudible 00:16:22] plans, but have really, really big out-of-pocket costs. Medical debt is the number one cause of bankruptcy as even people who are getting an employer-sponsored coverage who are paying tens of thousands of dollars a year for their premiums have out-of-pocket costs that can be really unaffordable if you're minimum wage or have really a lot of other expenses, especially in times of inflation. People are figuring out, "If I go to the primary care doctor in the fee-for-service system and I have a high deductible, I might be paying $200.00-$300.00 anyway for the exam and the tests, and everything that's going to happen there. I don't know what that's going to be."
So, that discourages people from engaging with maybe the benefits they do have. With a direct primary care doctor, you know how much you pay monthly. So, it's a transparent upfront fee. It's not going to be a surprise, and you get this really great service and great experience.

Justin Steinman:
That's really interesting, Beth, because I actually hadn't thought about that. Thanks for shining a light on my blind spot there. I've lived in Massachusetts for my entire adult life, and I've only experienced it. Are there certain areas of the country or certain parts... area's probably the right thing I'm looking for, where the direct primary care is more popular? Is it in more rural areas? Is in the center of the country? How do I think about that?

Beth Holmes:
There's not direct primary care in every state in America, but we do see it in areas where historically there hasn't been as much insurance coverage. So, where there are more market solutions for people without insurance coverage in the healthcare space in the South, in the Midwest, in Central areas of the country. But we see it exploding in a lot of different places. In fact, there's a great community of DPCs around Boston. That was really shocking to me coming from the Boston healthcare system, and then starting to work at Hint, to know that and they're popping up all the time.
We're also seeing it become popular in states that do have really good insurance coverage. I think that's because the model is so strong, because ultimately yes this is a payment model, but from a healthcare delivery standpoint this is a care model. This is a different experience than people have been having, having a really hard time getting in to see doctors, having short appointments, not being able to get all their stuff taken care of, being referred to as specialists right away, and having to go through a PCP first. People like the model, and they think that somewhat the payment side is secondary to the experience.

Justin Steinman:
That's interesting. You keep coming back to this point around uninsured, which I think is a really interesting point. According to the Congressional Research Service, there are roughly 28 million people in this country who are uninsured. That's about 8.6% of the US population according to this lovely data sheet I have in front of me from the Congress. One of the problems I'm having, I worked in insurance for four years at Aetna, and I know you worked at Humana I believe?

Beth Holmes:
I worked at Humana and Tufts Health Plan as well.

Justin Steinman:
Right, so you also have the insurance background. I remember back in my days at Aetna, it was like how do we help address the uninsured market? How do we tap that in? You've mentioned several times here that really direct primary care might be a way to get coverage for those people who are uninsured. Is that a core part you think of the DPC model?

Beth Holmes:
I think like we talked about before, DPC is not a substitute for insurance. It is really focused on the primary care services. I think it's a compliment to maybe policies that can be cheaper for people, but have higher out-of-pocket costs. So, something that can pair with those so that it doesn't feel like you don't have any coverage when you have these very high out-of-pocket cost plans. I think it's better than nothing if you have nothing, but it's not a substitute for insurance. You have to have something to cover those really big expenses as well.

Justin Steinman:
All right, but it definitely has to be better than nothing at all, because I think we all know an ounce of prevention is worth a pound of cure. As you read all the healthcare studies, people who are engaged in primary care are over a long period of time healthier, because you catch something before it comes chronic. You catch something before it becomes critical. It's always cheap and less expensive to treat that less [inaudible 00:21:18] catch earlier.
Direct primary care potentially is an opportunity to keep some of those people who are uninsured from winding up in a hospital where ultimately they're going to get taken care of because we have that obligation as a society here in the United States. Then we simply absorb that cost somewhere into the healthcare system. This could theoretically be a way to cut some of that cost out of the healthcare system.

Beth Holmes:
Yeah, I think it's a really interesting point. I think it's a great point.

Todd Bellemare:
I was thinking that when you're talking to or pitching, or maybe not you directly, but the providers that are providing DPC when they pitch these services to employers, that could be a big part of the message. When you look at how that network is growing, and you said you guys have your provider network, when they are going out to work with employers to try to convince them, "Hey, this is a good add on," are there ways that you have tracked outcomes, whether it be economic or health outcomes for the patients that go through DPC care to prove out, "Hey, this is the proof in the pudding of why you should move, or add this as one of your benefits."

Beth Holmes:
Yeah, absolutely. The cost piece is so important, especially because like we talked about, employers may be used to spending $20.00 or $30.00 per member/per month on primary care. With direct primary care, you're talking about an expensive, maybe $60.00-$80.00 PM/PM. So, you're doubling or tripling what you're spending in primary care. Overall as a percent of the total healthcare dollar, it's still pretty small.
What we've seen, there was actually a study that came out a couple of years ago that was an independent study between Milliman and the Society of Actuaries that showed that at a certain price point, the average price point, DPC is pretty cost neutral because it does reduce even in the very short term ER visits, urgent care visits, and unnecessary specialist visits. I think one of the really cool things about DPC is that it gives primary care doctors time to practice in the full scope of their practice so they can take care of more things that otherwise they'd be sending to specialists just because they don't have time to care for it.
I think what you're talking about in the longer term of having really strong primary care and working on healthcare outcomes, helping reduce those hospitalizations because of acute episodes of chronic diseases is absolutely on point. Those can be harder to measure because you're always trying to measure what isn't happening. So, you need really strong claims datasets over multiple years and pre-post or a matched group to detect those.

Todd Bellemare:
Yeah, absolutely. That was kind of where I was thinking in terms of outcomes, how to track and really look at what the outcomes for patients that are within a DPC model, because if there are no claims being generated, that data is... There's a ton of that data out there, tons of claims data to go map out what patients are getting diagnosed, what tests are then included, and then what the overall cost model might be.
So, not having that for patients that go through DPC, I think it does give a big blind spot to the research side of things to try to figure out what might be happening. It might be an absence of evidence situation where you're trying to reverse engineer what might be coming out of the claims model if you do get information on where DPC may be growing in a certain area.

Beth Holmes:
Yeah, I think that typically there's only so much that happens in the primary care office. If you have the rest of the claims dataset, you can absolutely see what's happening, how is specialty trending, are you seeing decreases in utilization there, how is your ER usage, your urgent care, your hospitalization trending. The overall claims data will paint a picture, and then what several of our larger clients, and what Hint Connect is doing, is taking data from the EMR as encounter data instead of claims data.
If you think about what claims data is, it's a report on what happened during an encounter. You can get most of that, minus exactly a CPT code, from the encounter data through the back end of the EMR. You can see when people were seen, what they were seen for, what the diagnosis codes are, what medications were prescribed. That paints a really robust picture that otherwise you'd be looking at through claims data.

Todd Bellemare:
For sure. In terms of the methods of extracting data from EHR is definitely a little tougher. Point taken, no question. In terms of Hint OS, are the data that's recorded within your system, is it more like an EMR or EHR system that a hospital would have? That it does have patient histories, and details like that, and the encounter data. Or is it much more along the lines of the eligibility and management of the payment systems?

Beth Holmes:
It's more along the lines of the eligibility and financial data. We do integrate with EMRs, so we are not recording that ourselves. But we have those integrations there to pass data back and forth.

Justin Steinman:
Beth, I want to pivot a little bit and talk about something you said earlier. You said that doctors seemed to have smaller patient panels. Is that right?

Beth Holmes:
That's right. Typically, you're seeing DPC's target patient panel at about 600 patients.

Justin Steinman:
What's a typical patient panel for someone who has fee-for-service?

Beth Holmes:
They say 2,000-3,000.

Justin Steinman:
So you're almost 25% of that total population, right?

Beth Holmes:
That's right, yeah.

Justin Steinman:
Not to put you on the spot or anything here, but we have a physician shortage in this country. Even in some of your own data, I think I saw anywhere between 18,000-48,000 in primary care physician shortage by 2034.

Beth Holmes:
Yeah.

Justin Steinman:
Would you say that DPC has taken physicians out of circulation?

Beth Holmes:
No. I love this question. I'm so glad that you asked it, because what I saw when I was working on health plans, and what I see today talking to doctors practicing in the fee-for-service system, is that we are losing doctors to other careers, to technology companies, to administrative positions because the current system is totally unsustainable. To bring yourself and your expertise, and your empathy, and your problem solving skills every single day all day long, in seven minute chunks to every single patient, is burning doctors out.
I saw so much turnover when I was working with primary care doctors in Massachusetts. I'd go back, it'd be a different doctor every year who was trying to manage the risk systems. I think that what we really need to think about is attracting more people into becoming primary care clinicians. That includes doctors. It includes nurse practitioners and PAs of the whole spectrum. We're not going to do that unless we paint it being a good quality of life. Unless we can show the reason that you get into this, is to take care of people.
You don't become a doctor and spend so much money and time doing it because you're in it for, especially primary doctor, for any other reason than that you really want to help people's lives. We're not giving clinicians the opportunity to do that right now in the system we have that in. If you did the math and you said, "If every primary care doctor took a third of the lives that they're seeing now, or even a quarter of it, is that going to help the shortage?" No, but I think that that's a lens...
Direct primary care isn't the problem. I think it's a solution to that. I think we need to open up the field to license and credential more primary care doctors to attract more people into being NPs and PAs. If we can show them this is sustainable, it will earn you a good living, you like the rest of us... Doctors deserve work/life balance too. Doctors have families too. There's so much data that shows that female doctors put off having families, suffer from infertility, family system structure. Physician suicide is a real problem.
There's so much wrong about the way that we treat the carers in our society. A model that's more humane I think can only help and can only get more people to want to go into the field.

Todd Bellemare:
That really ties in with the staffing episode we did a while back in terms of the burnout doctors are feeling up and down the chain, from NPs all the way up through specialists with primary care included. We were talking about ways in which we could save the physicians to stay in the market. It was a lot about that, like keeping people close, giving them a better quality of life. It's really interesting to hear a solution, because we walked out of that episode feeling a little bit like, "Uh-oh, we've got a problem because everybody is burnt out," and we have a very small number of physicians filling the top of the funnel to be the next 10, 20 years of carers and providers.
To have an option to show that there is something that might be a little bit more work/life balance so to speak is nice to hear definitely. Getting more people to get through college and join in is important too, but at least there's an option out there that is not the same as just work until you're burnt out.

Beth Holmes:
The interesting thing about direct primary care is, people do it differently. I talk to people who have 300 people on their panel, and they like that because if they were working in an office job they might be working 30 hours a week and that's what they want, because they want time with their kids, or they're taking care of an elderly parent. That's just the way they want to live their lives. DPCs can index onto how many or how few patients they want.
We also have really, really advanced direct primary care clinics who are working in doctor mid-level teams, and they're seeing 800 patients per clinician, and they're really more on what you would consider a traditional advanced practice model in the fee-for-service. It runs the gamut, but I completely agree with you. We have to attract people to the field.

Justin Steinman:
Just for our listeners out there to kind of give a framework of reference to this, DPC, I think you said is that somewhere in one of the white papers, just so everybody knows Hint Health did write this great white paper called Trends in Direct Primary Care that Todd and I both read before the show and got up here today. So, we have all of our data-

Beth Holmes:
Thank you. Thank you.

Justin Steinman:
... at our fingertips. You cited a stat that said DPC has grown by about 240% between 2017 and 2021. When I reverse engineered that math, I came up with roughly about 540,000 people in the United States today who have direct primary care subscription, which is roughly 0.2% of the population. That's a still pretty small number, 0.2% of the population. What's it going to take to get DPC to over a million people or even to 1% of the US population?

Beth Holmes:
I think that's a great question. Our data indicates that we might be over a million now. It's really, really hard to tell because we only have the patients who are being managed through our software. There's other software out there. There're doctors who are doing this on paper and in Microsoft Excel, and managing their patients that way. I think that good ideas spread fast, and I think that Americans really love to have the best experience and buy the best thing. If you're sitting there and you're using your Blackberry, and next to you Todd has his iPhone, and you look over and you said, "What? What are you using there? That actually looks really cool. This old thing that I have doesn't work very well. It's kind of falling apart. I'm not happy with it."
And he tells you, "This is an iPhone. You can buy it. It's a little bit more expensive, but it's a great experience," I think good ideas spread. We see DPC really spreading in pockets in communities and in states, because I think that once people are exposed to it they ask, "How can I get that? Why don't I have that? Why isn't that available to me?" We hope that it's been spreading organically. I think it's definitely gotten a lot more press, especially with the One Medical Amazon acquisition, particularly because One Medical had just acquired a DPC company out of Colorado. So, they're actually offering a DPC model.
We think that the more people who hear about DPC the better because I think it makes sense to people having that family doctor, having someone to help you navigate your health and the healthcare system.

Justin Steinman:
You're talking to somebody who still longs for his Blackberry keyboard, but I hear your point nonetheless.

Beth Holmes:
The click is very satisfying.

Justin Steinman:
The click was very satisfying, absolutely. That's why Apple actually tried to mimic it. That's probably a podcast topic for a different day. I am glad that you brought up One Medical, because when Amazon bought One Medical, who had previously bought Iora, which is one of the very first DPC providers for Medicare, it made a lot of news. Amazon spent like $3.1 billion for this. So my question to you here as we get to the end of our podcast is, why?

Beth Holmes:
Well, I'm very flattered that you think I would know the answer to that.

Justin Steinman:
You don't have Jeff on speed dial?

Beth Holmes:
If I did, I probably wouldn't be talking to you guys.

Justin Steinman:
Thanks.

Beth Holmes:
No, so I think Amazon is really... One thing they're really, really good at is understanding what people want. They spend a lot of time and money researching what people want and what they're going to buy. I think they see One Medical, and personal experience, I was the One Medical patient profile, and it was a great experience. It was easy to schedule. I could see my doctor quickly. She had a little bit more time for me than a typical fee-for-service. They had a great virtual care component.
Those are all things that we see in direct primary care and that people love about DPC, and I think people love about One Medical. I hope that Amazon can keep the good parts of One Medical and make that available to more people. But who knows? Who knows what Amazon is thinking?

Justin Steinman:
We'll find out. I have my little theory.

Beth Holmes:
We'll find out.

Justin Steinman:
We are definitely heading towards a discussion of Amazon and healthcare podcast, Todd.

Todd Bellemare:
I can't wait. I can't wait.

Justin Steinman:
It's just coming. I can't wait, it's coming. Beth, thank you. This has been really educational. I feel like I learned so much more about direct primary care. Thanks for teaching us.

Todd Bellemare:
Yeah, thank you.

Beth Holmes:
You're welcome, Justin. It was really great talking to you guys. If you need a DPC, I can let you know who is in your area. Hopefully, I'll be coming back to you in a few years and you could say, "You know, we're over a million now," for sure. It's really catching on, so thanks for the opportunity to talk about it.

Justin Steinman:
Yeah, let's hope it's not a few years before we get two million. I'm looking like six months, right? Come on.

Beth Holmes:
Sure, yeah. February of next year, book it.

Justin Steinman:
There you go.

Beth Holmes:
I'm available.

Justin Steinman:
Awesome. Todd, as always, thanks for joining me, my friend.

Todd Bellemare:
Thank you, absolutely.

Justin Steinman:
For all our listeners out there, thanks for listening to Definitively Speaking, a Definitive Healthcare Podcast. Please join me next time for a conversation with Anthony Gentile from Katon Direct, a recruiting firm focused exclusively on the healthcare industry. Anthony will share his insights on the new ways that hospitals need to brand themselves to attract top talent, everything from nurses to doctors, to executives and staff at all levels. Given the ongoing war for talent in the healthcare industry, I expect this conversation to be full of the proverbial "must do" for everyone hiring out there in healthcare.
If you like what you've heard today, please remember to rate, review and subscribe to the show on Apple Podcast, Google Podcast, Spotify, or wherever you get your podcasts. To learn more about how healthcare commercial intelligence can support your business, please follow us on Twitter @DefinitiveHC or visit us at DefinitiveHC.com. Until next time, take care and please stay healthy.