Iora Primary Care's unconventional relationship to payments

Iora Primary Care has a unique approach toward fee-for-service payments: It does not accept them at all.

As a result, the Massachusetts-based medical group, which operates in six states on both the Eastern Seaboard and the Western U.S., has been able to refocus how it delivers care to patients as opposed to focusing purely on the financial aspects of the transaction, according to Value-Based Care News.

"We've turned healthcare in the U.S. into a series of checkboxes," Iora CEO Rushika Fernandopulle, M.D., told the publication."Checkboxes have never healed anyone. The only thing that really works is relationships. Get rid of all the garbage--the coding and billing, the meaningful use--and focus on relationships."

Instead of sending patients directly to physicians for every facet of their care, the provider assigns patients, many who have chronic conditions such as diabetes, "life coaches" who prod them to change their behaviors. Iora has three to four health coaches on staff for every doctor. "For those patients with diabetes, we take them shopping. We walk with them. We help them make a plan, hold their hand when it's the right thing to do and kick them in the behind when it's the right thing to do," Fernandopulle said.

Such value-based care is taking hold in the U.S., particularly with the expansion of accountable care organizations, although the payment approach tends to be much more straightforward. Iora also pushes the envelope in other areas, including offering patient amenities such as wi-fi and iPads. And Iora also likes to focus on making its medical staff happy as well.

Fernandopulle founded Iora four years ago as a way to practice healthcare in a unique manner without being held back by bureacracy. It  has raised a total of $42 million in venture capital and has built a proprietary healthcare IT system from scratch. Fernandopulle told the Boston Globe earlier this year that the system will use the money to continue the expand the number of medical practices it manages nationwide.

Iora receives global payments under a contract with health plan Humana for the practices it operates in Seattle. But in New York City, it asks a patient population of mostly immigrants to pay $1 a day or $360 a year for their primary care.

To learn more:
- read the Value-Based Care News article (registration required)
- check out the Boston Globe article (subscription may be required)