Technology entrepreneur Nick Desai sees a not-too-distant future where his infant daughter will not have to learn to drive a car, thanks to self-driving cars and ride-hailing services. His children and others in their generation also will likely never need to go to a doctor's office, he predicts.
That's the potential impact of technology innovation and on-demand services powered by mobile apps, Desai, co-founder of on-demand doctor house call app Heal, told FierceHealthcare. Case in point—Desai's 11-month-old daughter and 82-year-old father both receive all their primary care services from Heal house calls, he said.
"Look at the revolution that we're seeing in the retail space. Ten years from now, we will think of going to the doctor’s office as dated and arbitrary as going to the store to buy diapers compared to buying diapers on Amazon," Desai said.
The company is seeing demand for house call services grow and is expanding its services into the New York City market with the acquisition of Doctors on Call. Founded in 1968, Doctors on Call is a medical house call service for the elderly servicing New York City’s five boroughs and surrounding areas. The company averaged 42,000 house calls to seniors in NYC in 2018.
The acquisition was made public Monday morning. Heal acquired the company for $15 million, according to the company.
Los Angeles-based Heal launched five years ago with the aim of reinventing primary care by taking an old model and giving it a modern twist. Heal lets patients call a doctor for a same-day visit in their home using an app and pay less than $150 while allowing doctors to take more time with their patients and have time left over to finish required documentation, according to Desai.
"It turns out house calls are not just more convenient care, it is fundamentally better care. A doctor who comes to your home can see your social determinants of health, such as food insecurity, which can lead to better outcomes," said Desai, who founded Heal with his wife Renee Dua, M.D., the company's chief medical officer.
The acquisition of Doctors on Call marks Heal’s entry into its largest single city, making Heal services available to more than 75 million Americans throughout Atlanta, California, New York, northern Virginia and D.C., according to the company.
With the acquisition, Heal plans to transform an "old-school" people-intensive practice into an omnimodal care solution to lower healthcare operating costs and provide always-on, connected care.
The company has raised $71 million to date, and its key investors are Fidelity, Breyer Capital, Slow Ventures, former Qualcomm CEO Paul Jacobs, Glenview Capital, IRA Capital, TransPacific Technology Fund and Lionel Richie.
The house call app service is on track to perform more than 100,000 house calls this year, representing 310% growth over the last 12 months. Heal estimates its house call services have helped reduce unnecessary emergency room and urgent care visits by up to 71% and also reduced hospitalization by 28%, averaging healthcare cost savings of an estimated $53.7 million per year.
Heal also offers remote patient monitoring services through its Heal Hub, which helps monitor blood pressure, blood oxygen levels and other biometrics in real time. The company's services are available 24/7, 365 days a year.
More flexible Medicare Advantage (MA) policies have helped open up the market for on-demand service providers like Heal. The Centers for Medicare & Medicaid Services (CMS) announced it was broadening the range of supplemental benefits MA plans can offer in 2020 to cover any benefits that “have a reasonable expectation of improving or maintaining the health or overall function” of beneficiaries with chronic conditions.
Previously, CMS restricted Medicare reimbursement for doctor house calls to homebound seniors. "They changed the rule to allow house calls for all Medicare patients. That made us want to aggressively look at the Medicare market," Desai said.
Doctor house calls are ideal for the Medicare population, because it is more convenient than traveling to a doctor's office while also enabling physicians to address social factors contributing to elderly patients' health, Desai noted. According to Feeding America, nearly 8% of Americans 60 and older were “food insecure” in 2017.
"We view every visit as an opportunity to look at the patient as a whole, not just the issue at hand. When the doctor comes to a patient's house, he or she can talk to the patient about their cold but can also see that the patient has had three colds in several months. The doctor can then look to see if there are factors contributing to asthma going on behind the scenes. We can address those care gaps," he said.