Omnichannel primary care chain Carbon Health launched a new partnership ecosystem today to expand its footprint and, when necessary, more easily refer patients to vetted specialists or hospital-based providers.
The company is kicking off its program, called Carbon Health Connect, by naming Walnut Creek, California-based John Muir Health as its flagship partner for the San Francisco Bay Area.
Together, the organizations plan to open 15 to 20 new East Bay clinics that will be owned and operated by Carbon Health while also affiliated with John Muir Health.
But beyond adding to the 60-or-so California urgent and primary care clinics Carbon Health already runs, the company said its inaugural partnership is a means to addressing the entirety of its patients’ care needs with as few bumps along the way as possible.
“Basically, 80% of the care [patients] need could be done with Carbon, so [Carbon Health Connect] really is for the services that we don’t do,” Nita Sommers, chief growth officer at Carbon Health, told Fierce Healthcare.
“For example, let’s say someone really needs to go to a cardiologist or needs to get surgery done. … What we’re doing is creating a curated list of provider partners in each of our markets—both specialty groups and health systems—to really have a seamless care model with them. We work and develop a number of technological and operational integrations to make a streamlined handoff so that we can tackle what I think is one of the biggest problems in healthcare, which is fragmentation.”
After vetting a potential partner, Sommers said that Carbon Health will work with them to integrate electronic health records and other relevant technologies so that patient information can be easily transferred bidirectionally between the two organizations. Alongside giving Carbon Health access to the information it needs to secure a referral, the integration gives partner providers a window into the patient’s medical history and, similarly, ensures Carbon’s primary care providers are still in the loop when a patient returns to their care.
“The other thing we’re doing is working to make the whole process really smooth—how do we know who’s available, what are other specialists that they might have, how do we actually make sure we can do an urgent referral to get people in within 48 hours?” she said. “We’re investing in that operational integration as well to make that referral to the downstream care process as easy as possible, which is usually a huge pain point.”
Much of that referral hurdle for patients has historically come from payments and incongruous insurance networks. Sommers said that although Carbon and its future program partners will “probably have pretty overlapping commercial mixes and insurance mixes,” the company will be working to identify when a patient encounters a coverage issue and direct them toward a preferred alternative.
“Where we can, we do highlight those differences and if someone is out of network we’ll come up with alternatives as well just to help people through this process,” she said. “And we are investing in this particular issue, [building] more and more information into our referral database so we can help guide people as smartly as we can through what is an extremely complicated and confusing area for patients today.”
Sommers and John Muir Health executives described the arrangements as a boon for partner providers who want to expand their reach, reduce strain on their facilities and offer their patients a more modern care experience.
“This affiliation allows John Muir Health to expand into areas with a respected partner that provides an excellent patient experience and allows us to do so in an economically responsible way,” Paul Deeringer, senior vice president of strategy and emerging business at John Muir Health, said in a statement. “It also enables us to grow and augment access to the services we already provide as a health system.”
Rather than put their patients through long wait times and higher cost visits, the Carbon Health Connect program gives John Muir Health and other yet-to-be-named partners additional trusted venues where they can redirect low-acuity patients, Sommers said. Others that Carbon has spoken to have long been interested in employing digital access points and other consumer-facing technologies to reach new patients, she said, but haven’t been able to make the investments on their own.
“That’s attractive to them because times are changing; what people are looking for from ease of access and technology is changing,” Sommers said. “It’s hard for them to keep up and we can actually help with a lot of these things by providing a great, easy entry experience and, for example, being able to integrate with them easier and just faster than others.”
Not to be forgotten are Carbon’s recent investments into remote patient monitoring and disease management. The company and its prospective partners “see a lot of synergy” in leveraging devices and virtual care platforms, which Sommers noted can act as both an onramp and a resource to specialist care.
“That’s definitely an area of focus for us and one of those new avenues for us to work with the provider community,” she said. “Certainly the acquisitions of Steady Health and Alertive [Healthcare] expand our capabilities very quickly in this space and we continue to do a lot of development in this area.”
Carbon Health will begin integrating John Muir Health’s services into its existing Bay Area clinics “in the coming weeks,” although the partnership won’t be fully operational until the start of 2022, according to a representative of the organizations.
Additional Carbon Health Connect partnerships will likely be announced “in the coming months” and will take a region-by-region approach, Sommers said.
Carbon Health currently runs 90 full-service clinics across 14 states, so the initial focus for new program arrangements will remain within its current markets, the executive said.
However, the company has been on an accelerated growth trajectory since the start of the pandemic, recently locking up a $350 million funding round and additional primary clinic acquisitions on the road to CEO Eren Bali’s goal of 1,500 U.S. clinics by 2025.
As Carbon eyes new territory for those clinics, Sommers said that interested parties representing different sectors of the industry are welcoming the partnership program with open arms.
“We are having the conversations where payers are pulling us into certain markets, employers are pulling us into certain markets and even health systems are pulling us into certain markets,” Sommers said.