Primary care model brings docs, specialists to the workplace, improves patient experience

Scott Shreeve, M.D., aims to transform primary care delivery with a streamlined approach that brings healthcare to the workplace.

Shreeve (pictured left), a board-certified emergency medicine physician, set out to redesign the patient experience five years ago by hosting doctors and specialists in one facility within the campus of a large, self-insured employer in order to engage employees, bringing the focus of healthcare back to patients' needs, not just their ailments. The result is Aliso Viejo, California-based Crossover Health, which has locations in Silicon Valley and throughout the United States. 

This "next generation care" model has already caught the attention of large companies like Facebook and Applied Materials, which have Crossover Health Centers that offer employees onsite primary, urgent and online care, as well as a host of other services, including but not limited to sports medicine, chiropractor care, physical therapy, acupuncture, behavioral health and chronic disease management. It aims to create a culture of wellness for healthier employees.

"We are bringing the physician practice to large self-insured employers and looking holistically at the patient," Shreeve, who serves as the CEO of the healthcare company, told FiercePracticeManagement during an exclusive interview.

Shreeve says Crossover centers provide "white glove service" to patients by coordinating care and scheduling same-day appointments. "Employers like what we do, providing urgent, primary and preventive care, and helping steer patients in secondary networks to get the best providers," he says.

Crossover's first health center opened in Orange County in 2010 and since then has launched seven more on-site clinics. "We are just part of a big wave and movement on how U.S. based employers are responding to cost pressures and the healthcare crisis," he says. "And this solution brings clinics on campus and provides effective, comprehensive primary care."

Shreeve describes it as "concierge medicine for employers" that keeps their employees healthy. "When you have a $200 an hour engineer and he has to take four hours off campus to go to a doctor's appointment to be taken care of, it's much more effective if they can go on campus and stop in and be back to their office in 45 minutes," he says.

Unlike traditional models that seek reimbursement from health insurers, Crossover physicians receive payment from the employer. "We are getting paid directly by the entity. The model that we use allows us to create and innovate with care delivery and how we are paid," he says.

And unlike traditional models that only allow for short visits, doctors have more face time with patients. "They value us having time with the patient," he says. "In our setting, we say we want to spend time with the patients and take the time to address long-term health needs."

The health centers are also designed to create a better workflow, according to Shreeve. Providers sit together in order to collaborate. A physical therapy office might be next to a physician's office, for example, so clinicians can do warm hand offs to ancillary services. These providers may never have interacted in normal settings, but in this environment, they work together to create patient care plans.

Shreeve believes the model, which is based on five pillars of service delivery, will catch on as large employers seek to reduce healthcare costs. The pillars offer large employers and their employees a brand experience, unique space design, physician leaders, a lifestyle model, and a delivery platform with technology that enables patients to schedule appointments online, receive test results online and send secure messages to physicians.

It is also a model of efficiency, according to Shreeve. One of the health center sites, he says, sees 300 patients a day, 95 percent of them within five minutes of arrival.

"It's the model of the future," he says. "The end result is we do three things. We lower the cost of healthcare, improve the quality of care, and create a different experience and level of engagement for physicians."