- Concierge primary care provider One Medical is doubling down on chronic condition management with the launch of a new program to all members and employers.
- One Medical, which went public early last year, has had branded programs in the past for certain segments of chronic care, but never one this comprehensive, according to the San Francisco-based provider. With the launch, the provider enters a crowded market, as a number of programs looking to lower costs and improve outcomes for the high-need chronic disease population already exist.
- The program, called "Impact by One Medical," will be available to One Medical's employer customers or members at no additional cost, beyond regular co-pays and claims.
Chronic diseases are a major stressor on the U.S. medical system, as roughly 60% of adults have at least one chronic condition, while about a tenth have two or more. Meanwhile, an estimated 84% of healthcare costs are attributed to treating chronic conditions alone.
And those figures are expected only to rise as the baby boomer generation ages and due to increased disease prevalence among children and younger adults, experts say, resulting in an even higher strain on the health ecosystem.
Addressing this issue has been a key focus area for many healthcare companies even before COVID-19 as they look to cut costs and improve outcomes for patients with chronic conditions, while yielding a profit. Startups have seen rising investments and deals as they round out their offerings. For example, Livongo, a condition management player, was acquired by virtual care behemoth Teladoc last year for $18.5 billion.
But despite rising activity, chronic care management players have only captured a small slice of the 133 million U.S. adults with chronic diseases. As of August last year, Livongo had only 328,000 members, while another chronic condition management company Lark Health had 2 million between its payer and provider clients.
One Medical has been piloting its chronic care management program throughout 2021. The provider says its program is different than others because it's integrated in the primary care system, which it argues allows for a more holistic care experience.
"Our healthcare system has been more focused on developing point solutions like virtual-only monitoring tools and treating those that become critically ill rather than developing cohesive intervention solutions within a primary care setting," Raj Behal, One Medical's chief quality officer, said in a statement.
In Impact, patients have access to a healthcare team consisting of a primary care provider, care navigators, nurses, a certified health and wellness coach and a clinical pharmacist. A tech platform integrates with devices for remote patient monitoring, including Fitbit, giving the care team access to real-time data on a patient's condition.
One Medical's investment in chronic condition management hints at a newer direction for the company. The rates of patients with chronic conditions are concentrated disproportionately in public health insurance programs like Medicare and Medicaid. Meanwhile, the majority of One Medical's business comes from commercially insured members, and its clientele — captured through direct-to-consumer arrangements and contracts with employers like Google — skews mostly wealthier and healthier.
But in June, One Medical announced it was buying value-based medical chain Iora Health for $2.1 billion. Unlike One Medical, Iora's business stems from steering Medicare patients into full-risk models, allowing it to capture revenue by creating savings with contracting arrangements like Medicare Advantage and the Medicare direct contracting program.
Analysts pointed to the acquisition as evidence One Medical is focusing on capturing its members' care as they age, from pediatrics to privately insured adults to seniors. The launch of its chronic condition management program likely ties in with that strategy, as age brings a higher risk of chronic diseases such as Type 2 diabetes, heart disease, arthritis and cancer.