Tennessee: Medicaid, Medicare, and Dual Enrollment

Chen Medical

Attracting clients/members

• One of the main differentiation factors of the business is its founding story. According to the official website, in 2003, Dr. Jen-Ling James Chen was diagnosed with cancer and told that he had only two months to live.
• As medical professionals, Dr.Chen and his family decided to fight for his life. But the family experienced the "complicated and largely unsympathetic healthcare system" where only profit, not the patient's life is valued.
• After Dr. Chen defeated his cancer, he was "determined to revolutionize the healthcare delivery system" and "offer affordable, human-centered care to medically underserved communities."
• Additionally, ChenMed's current CEO Dr.Chris Chen is also an exceptional leader and storyteller, which was highlighted on the company's 2020 review report. In alignment with the company's messaging theme, Dr.Chris Chen opened the report by sharing his personal experience when he was diagnosed with Covid-19 and his struggle against it in the intensive care unit.
• By curating and sharing those personal and intimate experiences, the company able to reach the clients and appear more personable and humane.
• Secondly, ChenMed appears to be much more agile when it comes to embracing change and adapting to the business environment. For instance, in March 2020, ChenMed rolled out telemedicine service and, within the first week, made virtual visits to 90% of the clients.
• Moreover, in 2020, ChenMed made a major investment in IT/propriety software and solutions.

Clients/members retention

• One of the main strategies ChenMed employed toward client retention was the "Reach out with love" campaign. During the early days of the pandemics, ChenMed recognized that many vulnerable elders were suffering from loneliness and isolation. To combat the issue, the company started the campaign and called the clients, and simply checked on them and said hello.
• Although this campaign or retention strategy could appear less significant, but according to the clients' testimonies those calls had an immeasurable impact on them.
• One client said, "You saved my life, I don't know what would I have done without your help."

 

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• According to the report, during those calls, ChenMed staff found out people without food or low on medicine.
• Another factor for the high client retention is its unique primary care method developed in-house. According to a recent study in the American journal of preventive cardiology, ChenMed patients had 40% better Covid-19 outcomes than those who did not receive its high-touch preventive primary care.

Staffing model

• In 2020, ChenMed aggressively expanded its operation and opened 15 new centers in 20 weeks, and hired 1,700 team members.
• For the long-term staffing, ChenMed offers two alternative career progressions for its physicians.

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• As shown in the figure above, the physicians can choose between the partnership track and the leadership track 
• ChenMed operates and measures its performance based on so-called "Value-Based Care", instead of the traditional Fee-For-Service. According to the company, under this model "patients have 33% fewer hospitalizations and ER visits" and it's more focused on prevention.

Staff attraction

• In regard to staff attraction, the company employs a strategy consistent with the company's value and goal. The company highlights that it serves those who in need the most and emphasizes "Passion with a purpose".
• Besides promising fulfilling jobs and competitive compensation, the company curates its messages toward those who are more ambitious and promises fast-track career development.
• To deliver the latter promise, ChenMed operates its corporate training program, Accelerate leadership academy. In order to attract new professionals, the company's founder Dr. Jen Ling James Chen himself coaches and guides the participants.
• ChenMed describes its culture as "a culture of giving". According to the official website, in 2019, the company donated $500,000 and contributed 9,000 volunteer hours across 14 cities.
• ChenMed's employee benefit plan includes medical, vision, dental, accident insurance; 401K, life insurance, short and long-term disability insurance.

Partnerships

• ChenMed has a partnership with OhioHealth, Blue Cross Blue Shield of Michigan, and COLAB.
• In 2020, ChenMed partnered with the University of Miami to conduct a peer-reviewed study on the efficacy of its high-touch primary care.
• In 2019, in a partnership with Propeller Health, ChenMed conducted research on the efficacy of Propeller’s digital health tool for patients with chronic obstructive pulmonary disease.

Attracting clients

• Cityblock promises to be there on a 24-hour basis, ready to listen and help the client with whatever they need. In addition, the company's services are available wherever the client feels safe, in an office, via phone, video or anywhere the client is comfortable.

• Cityblock utilizes a persuasive tone in their language when delivering the messages, a known strategy to attract readers. Here are some messages: "care that meets you where you are," "whatever is going on, we’re here," "designed just for you," and "works with your existing care." In addition, the pages incorporate a call to action. "Call us now".

• According to the company's blog, Cityblock has a custom technology known as "Commons" that reinforces the care model that the company offers, thereby allowing Cityblock to serve more members while ensuring empathetic, high quality and effective care.

• Cityblock attracts more clients by providing additional services besides medical care such as social needs like childcare, transportation and housing. Up to March 2021, the company had attracted up to 75,000 members.

• According to Forbes, Cityblock's model prioritizes spending more time with the patient rather than rushing through appointments in order to generate more revenues, which is common with the traditional model where physicians are paid per visit.

•  According to Scott Shleifer, of Tiger Global, Cityblock is at the forefront of shifting healthcare trends towards "new and powerful delivery models" such as, value based payments, virtual care and care in-home.

• Cityblock is actively speaking about social injustices and equity issues in America. The company has added its signature among the list of companies in America that are opposing the effort to limit the right to vote. The company has also tweeted in support of gender equity and equality with the hashtag; #TransWomenAreWomen. According to the Entrepreneur, "Consumers want to support entrepreneurs and businesses that take a clear stand on today's issues.
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Client retention

• Cityblock's model is member-oriented and grounded on earning the trust of client members by keeping promises and providing better care.

• CityBlock has designed a mobile app as part of a health plan that ease communication with clients. This helps new and ongoing clients to save time while connecting to the provider and getting the care they need right away. The company also claims that this benefit is at no added cost.

• New investments into the company have enabled the company to venture into providing new solutions. Cityblock services have seen success in the number of emergency reductions (15% reduction of emergency room visits) and in-patient hospital stays (20% reduction).
• Cityblock has also seen a 70% member engagement, compared to the average engagement of 5-7% experienced by other health plans. The company has also reportedly received a high NPS score of 85 compared to 15, given to the average provider. The fact that few providers can duplicate these statistics, favor the company with regard to retaining client members.

Staffing model

• Cityblock's workforce is hired from the communities that the company serves.

• Cityblock staff include "Community Health Partners, nurses, physicians, advanced care practitioners, social workers, and more."

• Care teams including doctors, paramedics, nurses and mental health practitioners are available for home visits and online appointments on a 24-hour basis 

Staff attraction

• According to the company's website; diversity and equity in hiring is a core value within Cityblock. The company also claims to bring together a diverse group of providers including physicians, nurses, community health partners, advanced care practitioners etc. This statement encourages providers from minority groups to apply for positions within the company.

• Cityblock promises technology that will support care teams in providing care to client members. In addition, the company brags of working with technologists who have experience working for giant tech companies like Google, Uber and Oscar. One of the custom technologies that has been developed specifically for Cityblock is "Commons," a technology that allows care teams including pharmacists, doctors, virtual care teams and social workers to be on the same page and in real time, therefore "simplifying logistical nightmares" and making work easier.

• Cityblock promotes its job openings through its website and platforms such as Glassdoor, Indeed, SimplyHired, Angel.co and Zip Recruiter 

Staff retention

• Besides enhancing diversity and inclusivity in the company, Cityblock "values creativity, collaboration and mutual learning." These principles ensure everyone is "respected and celebrated as part of the community."

• Some benefits employees at Cityblock enjoy include;
• Great health insurance benefits that include a comprehensive health, dental and vision care coverage for all employees and their families.
• A paid parental leave of 12 weeks for new moms and dads and a flexible work culture.
•  Four weeks paid time off in a year, options to work from home and paid holidays.
•  401 k plans

Partnerships

• The company has partnered with the following healthcare providers:
• New York partners: EmblemHealth.
• Connecticut partners: ConnectiCare.
• Massachusetts: Tufts Health.
• Washington DC: Carefirst.
• Ohio: Molina Healthcare.

• The company provides an open invite for others to apply and become partners.

Attracting Clients

• VillageMD positions its brand as a "national leader in value-based primary care."
• The company proposes a business model that is centered around its clients. According to the co-founder and chief medical officer, Clive Fields, "the best interest for our patients is to have a physician's voice at the center of the table, wherever decisions are made."
• VillageMD utilizes a care model that anchors on the physician-patient relationship. This model is physician-led, team-based, data-informed, and tech-enabled.
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• VillageMD promises to deliver "primary care everywhere." The company provides care while prioritizing the convenience and comfortability of its clients at the clinic and homes of the client. Virtual visits are also available to those who need them.
• In addition to adequate care for its clients, VillageMD "delivers an exceptional patient experience, while lowering the total cost of care." VillageMD identified a problem with patient care in the US, with an annual spend of over $4 trillion. The company moved to provide better ways to deliver professional care by "partnering with physicians to provide tools, technology, and industry support to deliver high-quality care and better patient outcomes."
• The general tone for messaging across all platforms can be termed strong, persuasive, and caring. Some tag lines include "primary care: it's our passion" and "primary care everywhere."

Client Retention

• One of the several ways VillageMD uses to retain its members is quality, utilization, cost, and experience. The company reports an 85% quality in medication adherence rate and 39% lower rate of acute admission than the market average.
• According to the company's care model, there is a focus on post-visit follow-up. Additionally, with the aid of technology and an operating system known as "docOS," VillageMD connects and integrates thousands of clinical source systems with ongoing patient-generated data. Furthermore, hundreds of millions of messages are analyzed through its artificial intelligence engine to enable patient self-care.
• VillageMD utilizes a "continuum-of-care model" that delivers better outcomes in a clinic setting.

Staffing Model

• VillageMD is hiring professionals who are "tired of the same traditional thinking and want to collaborate on new and innovative solutions for better healthcare." Some job openings can be found here.
• The company's staffing model includes associate physicians, independent primary care providers, and pharmacy integration.
• Care teams include the nursing team, dieticians, physicians, behavioral health counselors, pharmacists, lab technicians, and the care management team.

Staff Attraction

• According to the company's website, the company is looking to hire "professionals who see something wrong with the system and are working to change it." The company's staff structure hinges on three central pillars, "get stuff done," building trust, and innovation.
• There are different opportunities to attract different levels of staff for various positions, including analytics and technology, clinical, operations, analytics, market growth, market launch, and corporate services.
• Furthermore, VillageMD offers its employees broad experiences while "delivering the most effective, accessible, and efficient healthcare in the world."
• VillageMD promotes its job openings through its website, emails, social media platforms, and other job-seeking platforms, including Glassdoor, SimplyHired, and Angel.co.

Staff Retention

• The company operates through partnerships. There are so many benefits that are in place to retain the company employees, including,
•  Independence and a level of autonomy over your practice.
•  Market-leading risk-based contracts.
• Fair and transparent compensation model with a compelling and comprehensive benefits offering.
• Physician-driven community, where the "voice of the physician" matters.
• Ongoing education and physician leadership development.

Partnerships

• According to the company's website, they partner with primary care organizations in Atlanta, Chicago, Houston, Indianapolis, Kentucky, Michigan, New Hampshire, Northern Indiana, and Phoenix.

• Additionally, the company has partnered with the following healthcare providers:
• Walgreens: VillageMD partnered with Walgreens to "open the next 40 full-service primary care clinics."
• CMS: The partnership with CMS is aimed at "reducing expenditures and preserving or enhancing the quality of care for Medicare beneficiaries with a focus on those with complex, chronic conditions."

Research Strategy

Members/Clients Strategy

Attracting Members/Clients

• In 2018, Iora Health closed $100 million in Series E financing, reaching total funding of $223.5 million that is focused on growing its number of patients.
• The CEO and co-founder of Iora, Rushika Fernandopulle, stated that in 2017 the company doubled the number of members, and they expected to do the same in 2018 by bringing high-quality care to new markets and existing ones.
• The company is focused on attracting the senior Medicare population, unions, and self-insured large employers who can pay a monthly fee of $50-$60 per patient.
• To attract new clients to use their Iora Primary Care service, Iora Health works with the Merge World marketing agency to develop a marketing strategy that included creative development; brand strategy; and generation, production, and measurement of leads.
• Its marketing campaign focused on idealizing the relationship that people over 64 wish to have with their doctors and promote their specialization with people on Medicare without adding extra cost to their Medicare.
• The campaign managed to increase the company's converted website traffic by 172% and a 2.15% conversion rate only from its landing page.
• Its marketing message included "Are you getting the primary care you deserve?" "Premium care for people on Medicare at no additional cost," "Act Now and get the primary care you deserve."
• They promoted their message through digital advertising, videos, flyers, informative events, geo-targeting, traditional and mobile billboards, etc.
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Members/Clients Retention

• The company's retention and business model is service-oriented primary care that combines patient satisfaction, improved health cost-saving, a flat monthly fee service model, good patient service, and high-quality care.
• Their payment model reduces the cost of billing paperwork, allowing more doctor-patient time, extended staffing, and a same-day scheduling system, creating a better doctor-patient relationship which ultimately increases primary care follow-ups and reduces hospital and ER visits.
• To retain its clients, Iora Health ensures that each patient receives a care team of a health coach, nurse, behavioral health specialist, operations assistant, and clinical team manager. They also offer special private practices at physical locations and phone calls, email, and text messages support outside of the office.
• Additionally, they've created Chirp, a collaborative care IT mobile platform so the patients, their families, and the care teams can have open communication, access to medical records, and share information.
• Their members have a 20% decreased rate in ER visits, a 40% reduced rate of hospitalizations, a substantial cost-saving.
• According to Iora's records, thanks to what they offer, their patient satisfaction levels are high at 93.4% and 87.5% from hospital administrators.
• The company's patient retention rate is 98% and its Net Promoter Score among customers is above 90.
•  Michael Greeley, a board member of Iora Health, said "What sets Iora Health apart is a combination of a laser focus on the consumer, the ability to scale, and a very compelling economic value that dramatically lowers the cost of care. The Iora care model is built on relationships and endorsed with positive patient satisfaction ratings at levels rarely found in health care. We see Iora Health as the clear leader in this space, and believe it is poised to scale rapidly."

Staffing Model and Strategy

Staffing Model

• Iora's "put people first" business model organizes its staff to provide each patient with a team of care providers, which includes a nurse, a behavioral health specialist, social workers, a physician, and their innovation, a health coach.
• Their staff includes physicians, care teams, business & operations members, sales & marketing members, talent & culture, and technology teams.
• The staff is selected from the same community and population of the patient to build better cultural understanding, trust, detect possible health impacts surrounding the patient, and eliminate racial imparities.
• Health coaches and physicians are scheduled to visit their patients and address any non-medical barrier in the customer's health journey and medical issues.
• Their model focuses on providing dynamic solutions for patients and is composed of 1) a care team, 2) a forum for patients, 3) a caring atmosphere, and 4) a Health Coach per patient.
• Their staff is required to participate in a daily morning huddle where they discuss the patient's health status, assign priority of visits, and schedule the visits of the day. The huddle is led by a different staff member every time to focus on the patient's situation and not on a hierarchy, involving everyone from the physician to the operations assistant.
• Health coaches are hired based on their capacity to work and empathize with patients.
• Iora Health worked with Gates Associates to develop a staff attraction and retention business model by developing strategic management solutions and identify organizational behavior problems including decreased productivity and misalignment with company goals.

Attracting Staff

• Staff feels attracted to join Iora as they feel connected with the company's value and calling to help people.
• They attract employees through their culture, mission, and benefits.
• Iora Health also promotes its job openings through its website; employee referral; mailing lists; job platforms like Indeed, SimplyHired, Sulekha, Glassdoor, Venture Loop, and Zip Recruiter; and through social media

Staff Retention

• Iora Health has received high scores for staff retention.
• Physicians and staff find the capitated payment offered by Iora Health more convenient than the fee-for-service offered by others.
• To keep its staff happy, Iora offers a mission-driven culture, competitive compensation, 401k match, generous PTO and holidays, medical coverage, life coverage, employee referral program, ad long-term disability insurance coverage, among other benefits.

Partnerships

• Iora has a partnership with Humana, Darthmouth, TUFTS Health Plan, Massachusetts, King Arthur Baking Company, Boeing, Devoted, Aetna Medicare Solution, BlueCross BlueShield of North Carolina, Allwell from Arizona Complete Health, Cigna, and United Healthcare, among others.
• In April, they partnered with the Colorado Department of Public Health to get its local patients vaccinated for COVID-19.
• They also have an open form to apply and become partners.

Dr. Faisel Syed

•  Dr. Faisel Syed is with ChenMed since 2017 and he is currently its National Director of Primary Care.

• He has a personal mission to improve America's underserved seniors' access to primary care.

• Dr. Syed is the primary care podcast host of "Faisel & Friends: A ChenMed Podcast" which streams live on a weekly basis on ChenMed's social media platforms like Facebook, YouTube, and Twitter.

• The podcast subjects were focused on "how value-based care addresses the challenges of America’s healthcare system".

• He firmly believes that "everyone deserves access to primary care" regardless of their ability to pay.

 

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• He also conducts virtual events. Some of the topics are learning how to shape the future of primary care and another one is discussing the unemployment crisis amongst healthcare workers in primary care, cardiology, and other fields due to the "Fee-For-Service" system.

• In one of his articles published on LinkedIn in 2020, Dr. Syed talked about the fee-for-service system and how this system (1) allows sick people to suffer if they are not capable to afford healthcare; (2) rewards inefficient management and complications rather than prevention; and (3) prioritizes profits over the trust between patients and doctors.

Dr. Daniel McCarter

•  Dr. Daniel McCarter is with ChenMed for three years and he is currently its National Director of Primary Care Advancement.

• His specializations are family medicine and population health.

• In some of ChenMed's virtual events, Dr. McCarter works with Dr. Faisel Syed in discussing the importance of primary care.

• Some other topics on their virtual events include producing better and stronger patient outcomes through value-based care and the upcoming event "Unearthing the Value in Patient-Centered Care".

 

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• In the recent live podcasts of Faisel & Friends, he was the event's moderator as they discuss "how people are gaming the system for better health and building better habits".

• He also co-authors recent publications that discuss how prior screening can predict the severity of the coronavirus infection among the seniors and how a certain drug can lower the hospitalization, mortality and coronavirus infection among this group.

Dr. Gordon Chen

•  Dr. Gordon Chen is the Chief Medical Officer at ChenMed.

• He leads ChenMed's clinical model and is responsible for managing its clinical leaders, training, physician culture, outcomes, and medical costs.

• Dr. Chen was part of a podcast episode of The ACO Show discussing how to "provide seniors with coordinated and patient-centered care".

• In his published articles on LinkedIn, Dr. Chen talks about the importance of vaccination programs, how to effectively educate people about these programs, coaching as the best tool to promote better health, and the importance of having physician-led and patient-centered models to give the kind of health care that patients deserve.

• He also co-authors recent publications that discuss how high-touch care leads to a better outcome and lower costs in the senior population, a systematic review of 3D printing in orthopedic preoperative planning, and the role of echocardiography in screening to predict the severity of coronavirus infection among elderly patients.

• Toyin Ajayi is the chief health officer and one of the co-founders of City Block Health. 
• She mentioned that she helped establish the company when she realized that the U.S. healthcare system is not effective in meeting the needs of patients.
• Together with her other co-founders, CEO Iyah Romm and head of product Bay Gross, Ms. Ajayi mentioned that they formed City Block to transform the incentive structure for administering care to "low-income patients with complex healthcare needs."
• The founders established a model that focuses on putting in more time with patients instead of speeding up through sessions to increase the number as with the typical model where physicians are compensated per visit.
• Ms. Ajayi also mentioned that they have established the idea that there is a promising business case for financing systems that can significantly improve the care experience of the neediest patients.
• Mr. Romm further added that their "big Aha" moment came when they realized that this new model will only be effective if the paradigm of how players are paid will be overhauled.
• Ms. AJayi also said that trust in the healthcare system is significantly lower among disadvantaged groups such as low-income families, communities of color, people with mental health issues, and those who experienced bad systems in the past. She realized that they have to begin by establishing trust as this is the only way to influence people to change their mindsets.
• Ms. Ajayi also mentioned that she and her co-founders have a shared aspiration for addressing difficult issues and for enhancing on-time premium care to marginalized communities.
• The co-founders also envisioned a more expansive and "personalized, high-touch, value-based healthcare delivery model" that could be scaled.
• Mr. Romm also added that he is willing to dedicate his effort to prove that the program is essential, affordable, and can operate for a long time.
• The co-founders strongly believe that by integrating "primary care, behavioral health care, and social services" into one value-based care system, the team can deal with various factors of a patient's condition at once, enhancing results while making the service more affordable.
• Mr. Gross further mentioned that utilization is more expensive than providing care for someone from a social point of view.
• Mr. Gross also highlighted that their new system is capable of enabling care providers to provide a "home-based intensive primary care model with integrated behavioral health, substance abuse counseling, and social benefits coordination."
• He further added that their business model is operationally complex so they are continuously strengthening the capabilities of their in-house engineering division.
• The co-founders are also aware that all the available advanced technology is useless if there is no skilled workforce to command it. Hence, they are hiring people with the passion to reach the same vision.
• The co-founders also said that the COVID-19 pandemic crosses with the need to undo systemic racism and go with value-based models as these are the future determinants of health care. They also mentioned that they are "committed to building an anti-racist company," hence they are focused on dealing with healthcare gaps.
• They also mentioned that traditional basic care is not robust enough to address the healthcare demands of marginalized groups in these trying times. Given this, the company worked hard in doubling its weekly member sessions in certain areas, helped by "new analytics models" to enable care providers to determine those with higher disease risks.
• According to Ms. Ajayi and Mr. Romm, they are aware that there is plenty of unknown factors in our future. However, they are aware that better models should be chosen to undo root causes of disparities to establish a more fair and equal environment where all communities were given a fair chance to enhance their health conditions.

Publications

• Ms. Ajayi co-authored an observational study about early experiences with the acute community care program in Eastern Massachusetts.
• Mr. Romm has authored several articles and policy papers that tackle topics such as "medical and undergraduate education, culturally appropriate care, end-of-life care, health care financing, community-based education, humanitarian response, and post-disaster recovery."
• Mr. Gross is one of the authors of a research study on computers in human behavior where Facebook friendships were analyzed.

Findings

Written Publications

• The only publicly available written publication by VillageMD from the last two years is a "Pharmacy Integration: Crossing the Chasm between Pharmacy and Clinic Operations" whitepaper.
• It was published in May 2020.
• The whitepaper focuses on improving patient outcomes through the integration of the pharmacy and the clinic. It advises integrating them in a three-step process, which includes shared electronic medical records, setting up a communication platform, and executing a collaborative practice agreement.
• It also provides a comprehensive list of benefits of such integration and includes rich data on medication adherence issues when pharmacy and clinic operations aren't integrated.
• An example of a visual from the whitepaper can be seen below.
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• It is worth noting that there are several job postings for directors of content development at VillageMD. One of the job responsibilities is "producing a high-volume of creative marketing assets." Two of the examples of those assets are research-based reports and infographics. However, such materials appear not to be available yet.

A Vodcast

• The company also has a vodcast. It is called "Working Smarter" and provides easy-to-understand guidance on legal issues for value-based healthcare practitioners.
• The vodcast's description says, "VillageMD’s Working Smarter vodcasts distill the avalanche of legal information down to the key points that matter most to you and your practice. Short, engaging, and directly relevant to daily work, these episodes give you the information you need to navigate and succeed in value-based care."
• It is published irregularly. So far, 47 episodes are available.
• Some recent episodes focused on CMS Quality Payments, the future of healthcare policy, hospital price transparency, and the summary of recent regulatory changes in healthcare.
• Each episode features a deck, which includes rich written and visual content. A deck from the "Lessons from COVID-19" episode is the only one that is available online outside of the podcast.
• The screenshot that shows the visual style of the decks can be seen below.
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• It is worth noting that the "VillageMD Working Smarter" website includes several brochures with guidance for physicians in the "News Alert" page. They focus on carcinogens found in Zantac and the outbreak of severe pulmonary disease from vaping products. However, they are not branded.

Events, Conferences, and Interviews

• The company also shares its thought leadership by participating in industry events and conferences, including in-person and online ones.
• Its executives mostly speak about topics such as challenges for the healthcare industry, the future of healthcare (specifically primary care), and how the value-based model fits into the current and future landscape.
• Examples of events they spoke at are Forbes Healthcare Summit and J.P. Morgan Healthcare Conference.
• The company's executives also regularly moderate podcasts by Matter, a healthcare incubator. They usually talk with innovative healthcare entrepreneurs.
• They also appear in the industry media. Some of their recent interviews focused on integrating pharmacy and clinic operations, providing details on their innovative healthcare delivery model and issues with the US primary care.
• The company frequently emphasizes that the pandemic uncovered the need for changes in the primary care model. It is a common topic in the most up-to-date media appearances.

Research Strategy

Relationship-Based Clinical Model

• Iora Health believes that primary care clinical models should be “centered around relationships rather than transactions.”
• As the company is not using the fee-for-service model, 90% of its revenue is fully at risk.
• By adopting the relationship-based model, Iora Health is paid for keeping people healthy in a value-based way.
• According to Iora Health, the relationship-based approach has resulted in a better experience for patients and physicians, better clinical outcomes, and lower total healthcare costs.
• The model has allowed the company to easily shift to providing mostly non-visit-based care through the use of email, phone call, and video call during the COVID-19 pandemic.

Consumer-Centric Patient Care

• Iora Health has adopted a consumer-centric approach for patient care with a focus on patient engagement.
• Instead of physical offices, the company’s care teams, which include doctors, health coaches, and operation assistants, are organized around patient populations.
• The care team will develop a “shared care plan” with the patient during their first meeting.
• The main responsibility of the health coach, “a trained layperson from the community who is tasked with removing any barriers the patient has to achieving their goals,” is to help patients execute the care plan.
• While a typical primary care practice interacts with a patient only three to four times per year, Iora Health usually interacts with their patients 19 times a year via email, text messages, video visits, phone calls, and in-person visits.
• Unlike many primary care practices, Iora Health has committed to keeping all offices open during the pandemic for patients who required in-person visits.

From-The-Ground-Up Technology

• Iora Health has built its own technology (from-the-ground-up technology) as the company needed “technology solutions that do what we want to do, not make it harder for us to do the right thing.”
• By developing its own solutions, Iora Health is able to build its own culture, which the company described as “a culture of service, a culture of high-impact relationship-based care.”
• As traditional electronic health record platforms are primarily designed to record and bill patients, Iora Health developed a care collaboration platform called Chirp to “engage patients and manage populations.”
• The company has also built an IT platform to collect data from patients such as hospitalization records, medication filling behavior, and others.
• In response to the new COVID era, Iora Health has made plans to create a new set of tools to optimize care and “help patients and care teams improve self-efficacy.”

Culture Book

• Iora Health has published culture books in 2014, 2016, and 2020 to celebrate the company’s mission and culture through stories from employees and patients.
• The third culture book “Celebrating 10 Years of Impact” covered topics such as overcoming obstacles during the pandemic, company values, memorable patients, and others.
• Alexander Packard, the president of Iora Health, has noted that this book is special as it contains stories from “over 400 employees across the company, across all markets and teams” and former employees.

Chen Medical Marketing Strategy and Content

Website

• Chen Medical uses its website to market itself. On its main website, Chen Medical has labeled itself as 'America's Leading Primary Care Provider.'
• To separate itself from its competitors, Chen Medical has highlighted its USPs on its main website. These include 33% "fewer ER visits and hospitalizations," 10x in-person time for patients and doctors, and 100% board certified doctors on its panel.
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• Other than its main website, Chen Medical has three separate websites for its three subsidiary members, namely Chen Senior Medical Center, Dedicated Senior Medical Center, and JenCare Senior Medical Center. The messaging used by Chen Medical is consistent across all these websites.

Content Marketing

• The 'Patient Services' webpage on its website lists the various medical services offered by the company.
• Chen Medical has a dedicated blog section on its main website where it publishes articles on medical health, company updates, and interviews of doctors in its staff.
• Chen Medical also has a dedicated news section on its website where it showcases press releases highlighting the new developments of the company and all the media coverage received by it over the years.
• There is a dedicated 'Resources' webpage on Chen Medical's website that has ebooks, infographics, and podcasts that can be accessed to know more about the marketing efforts being undertaken by the company.
• Chen Medical has a dedicated 2020 Review webpage called Impact where the company has highlighted the differences it has made to the society during the COVID-19 pandemic in 2020 and the positive strides it has taken during the year. The webpage also has a video featuring the CEO Dr. Chris Chen who talks about the hardships faced by the world during the COVID-19 pandemic and Chen Medical's renewed commitment to make the world a better place through its world-class services.

Social Media

• Chen Medical uses social media platforms like Facebook (1,019 followers), Twitter (1,286 followers), Instagram (645 followers), LinkedIn (32,391 followers), and YouTube (532 subscribers) to market itself and reach out to the public.
• The company posts professional and user-friendly content across its Facebook, Twitter, and Instagram handles. It uses images, articles, podcasts, and video content across these channels to connect with its clients. The company has 147 videos on its YouTube channel that showcase the services provided by it, patient testimonials, interviews of doctors, and other educational content.

How Chen Medical Approaches Marketing

• Chen Medical has marketed itself as a brand that deeply cares for its patients. On its main website, it clearly states that each patient gets VIP care that includes a personal doctor, a care team, free transportation to appointments, and 24/7 access to doctors and on-site medications.
• On the websites of its subsidiary members, Chen Medical uses the tagline "You are the reason we are here" and the sentence "Your coordinated healthcare and well-being are our focus. Like a member of our family, we will take care of you in good times and in times of need" to further reinforce its commitment to its patients.
• Chen Medical markets itself using a friendly, warm, and caring tone in its messaging across its webpages and social media channels. Even the 'Patient Services' webpage begins with the sentence "You are our first priority."
• On its biography across its social media webpages on Facebook, Twitter, and Instagram, Chen Medical has written the following sentence: "ChenMed is a family-owned, value-based care organization committed to providing superior, affordable VIP health care to seniors with Medicare Advantage." On its Instagram page, Chen Medical has highlighted its three core principles of accountability, love, and passion. This further enhances Chen Medical's marketing strategy of using friendly and warm language that appeals to its clients.

Examples From Actual Marketing Materials

• Chen Medical uses storytelling as a means of marketing its services. The company has a dedicated webpage that features video testimonials of its patients who have been satisfied with its services.
• Besides the marketing strategies of content marketing on its website and social media marketing, the company relies on the word-of-mouth referrals of its patients to market its services and provide the senior citizens of the community greater access to quality healthcare.
• On its social media channels, Chen Medical makes use of positive and proactive messages to engage with its client base. An example of such a Twitter post is shown below.
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• Chen Medical has also used TV advertisements to market itself. These TV advertisements are available on its YouTube channel. A few such advertisements can be watched by clicking here, here, and here.
• Chen Medical has also taken steps to educate people about the importance of health and fitness with a series of exercises, activities, educational material, and videos. The company has also focused on promoting "social justice and racial equality" within the society and encouraging the next generation of leaders through its 'Accelerated Leadership Academy.'
• By listing out all the memorable moments and achievements during the pandemic-stricken year 2020 on its Impact webpage, Chen Medical has marketed itself as a medical care provider that cares about the communities it serves.
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Key Metrics

• While there is an investor pitch desk created by Chen Medical that is available in the public domain, it dates back to the year 2014 and does not cover the recent developments of the company.
• However, the company's 2020 Review webpage called Impact provides a few recent metrics and developments of the company. In 2020, Chen Medical was the only healthcare delivery company to be named in Fortune Magazine's "Change the World" list.
• In 2020, Chen Medical hired 1,700 new employees, thereby bringing the total employee count to almost 3,300. The company currently has over 75 centers in 20 cities across 10 states in the US.
• In 2020, Chen Medical offered a virtual consultation option to its clients for the first time owing to the COVID-19 pandemic. Within the very first week, 90% of its clients had availed of this feature from their homes. Chen Medical also invested over $840,000 to "produce a series of 176 'Ask the Doctors' telephone town hall meetings to educate seniors about COVID-19." Through this initiative, the company managed to educate a total audience of more than 630,000 seniors.
• Chen Medical has highlighted that it has an average Net Promoter Score (NPS) of 90. In comparison, the average NPS among health insurance providers is 12, with the highest being 31.
• According to G2 Stack, "ChenMed uses 24 technology products and services including HTML5, Google Analytics, and jQuery."
• According to BuiltWith, "ChenMed is actively using 48 technologies for its website" which includes iPhone / Mobile Compatible, Viewport Meta, and SPF.
• According to Aberdeen, it is projected that Chen Medical will spend $207.5k on IT infrastructure in 2021.
• According to SEMrush, Chen Medical has about 26,363 monthly visitors on average to its website. Based on its monthly web visitor activity, Chen Medical is ranked 698,359 among all websites globally. However, the monthly visitor growth has declined by 30.65%.

Cityblock Health Marketing Strategy & Content

• Cityblock primarily leverages its website, blog, and various social media platforms like Twitter, Facebook, Instagram, and LinkedIn for marketing purposes.
• The company does not seem to be extremely active in paid advertising. We did not come across any TV advertisements or paid marketing campaigns from Cityblock Health in the public domain.
• The company has a dedicated blog with around 870 followers where it publishes various company updates, health education articles, content highlighting company culture, its viewpoints on various social and political subjects like racial oppression in the US, and its efforts to undo systemic racism during the current pandemic.
• Cityblock Health also has a dedicated media section on its website where it highlights all the press coverage received by the company over the years in various reputed and leading media publications like Forbes, Bloomberg, Business Insider, Fierce Healthcare, and CB Insights, among others. This serves as a forum to highlight and market the growth and reputation that the company has built since its inception in 2017.
• The company has also launched a dedicated app to connect with and market its offering to clients and Cityblock members. The messaging used in the app highlights that it can be used by members to manage their healthcare needs all in one place, connect with Cityblock customer support executives 24/7, and easily schedule a video call for doctor visits and follow-up appointments.
• Cityblock uses a friendly, emotional, connecting, informative, and persuasive tone in its marketing messages used on the website and various social media platforms. Some messages used by the company on its website that corroborate the above include: "Care built on trust," "Care that meets you where you are," "Whatever is going on, we’re here," "Designed just for you," and "A partner for on-call support," and "Works with your existing care."
• Additionally, to underline its competitive advantage and unique market positioning, the company highlights on its home page that it offers "radically different care for a healthier life," provides a "care team that’s got your back," and offers "comprehensive care for you, at no extra cost."
• Regarding social media advertising, the company has a presence on Twitter, Facebook, Instagram, and LinkedIn. It has 3,639 followers on Twitter, 665 followers on Facebook, 12,809 followers on LinkedIn, and 831 followers on Instagram. The company makes use of images, articles, and video content across these platforms to connect with its clients and community members. Cityblock uses various social platforms to highlight key corporate developments, voice its opinion against various social injustice and equity issues in the US, share season greetings with its community members, provide financing updates, and enumerate various healthcare industry developments.
• The company's management executives also feature in various forums, discussions, and interviews to share company updates and best solutions for addressing the healthcare needs of underserved urban populations. Cityblock also employs a Network Strategy Lead to help it market itself and develop relationships with healthcare providers, institutions, social services organizations, and third-party vendors. The attached document has a compilation of images and other marketing materials used by Cityblock across the various marketing channels highlighted above to market its offerings.

Key Metrics

• While we were unable to find a pitch deck for the company in the public domain, we were able to compile a few key statistics/metrics about the company. Cityblock Health has raised a total of $491.3 million in funding over 6 rounds. Their latest funding was raised on March 29, 2021, from a Series C round. The company has made it a point to highlight its financing success across the various marketing channels.
• As per Forbes, the company currently has 75,000 members, and its 2020 revenue run rate was around $400 million. It is experiencing a 3x YoY revenue growth.
• Additionally, the company has highlighted on its blog that it has been successful in reducing emergency room visits by 15% and in-patient hospital stays associated with Cityblock services by 20%. Further, the company has a 70% member engagement rate compared to a health plan average of 5–7% member engagement.
• The company has also highlighted that it has an average NPS score of 85 as compared to the provider average of 15. As per Crunchbase, Cityblock has 8,275 monthly visits on its website. The same has declined by 25.51%.

Marketing Materials/Overview of Marketing Strategy

• Village MD uses content on its website and tweets and posts on its social media sites like Facebook and Twitter to market its products and services.

Website

• Village MD markets itself using its website. The company markets its services and products on its 'solutions' web page.
• One marketing strategy used on Village MD's website is internet marketing. The company states that its "entire care model is anchored around the physician-patient relationship."
• Village MD also uses storytelling on its website to market its services. Patient testimonials and physician testimonials are used to engage consumers and inform them of what the company is doing and how it is helping different patients with care.

 

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Social Media

• Village MD uses its social media sites for marketing its services. The company markets its products and services on Twitter and Facebook.
• The social media marketing strategy provides users with valuable content to read, watch, and share content, images, and videos across their social networks to help increase visibility and traffic.

How Village MD Approaches Marketing

• Village MD approaches marketing as a way of informing consumers about the products and services that the company offers and how they can benefit from them. This is evident in the content, posts, and tweets that the company uses.
• The company offers solutions across different geographies and does not take a "one-size-fits-all" approach. It recognizes that every physician, practice, or market is unique, and it customizes its approach based on the unique needs of its customers and partners.

Examples From Actual Marketing Materials

• The company has an "our solutions" web page, where it markets the three ways it delivers care to patients. These are clinic where it provides care in a clinic setting, virtual visit where it offers care remotely, and home solutions, where the company provides care in patient's homes.
•  Video testimonials by patients who have used the care services provided by Village MD and physicians who are offering services through Village MD.
• On Twitter, the company uses tweets for marketing itself and its products. For example, this tweet highlights the benefits of patients receiving care from a Village MD primary care physician.
• An example of a Facebook page post by Village MD markets the company's virtual visits during the Covid-19 pandemic and informs consumers that it also offered in-person visits following after adopting safety protocols. Another example of a Facebook page post by the company marketing its services can be found here.

Key Metrics Related to Content

• After searching the Village MD's website, social media sites, marketing databases, and reports like Adage and emarketer, no key metrics or what the company is tracking in terms of content were found. Most of the metrics we found were about the number of 40 new clinics opened by the company.
• The metrics provided by Village MD on its website were those of the net promoter score of 93 in experience, a 39% acute admissions utilization rate, and $200 PMPM saved on Medicare Advantage contracts.

Marketing Strategy and Materials

Website

• Iora Health uses its website to market itself. The company uses the website to inform potential customers about its value proposition and key brand messages.
• For instance, on its website, Iora Health highlights its value proposition of putting the patient first and its commitment to focusing more on people rather than the process. According to its website, "everyone at Iora is committed to helping people live their happiest, healthiest lives."

Content Marketing

• Iora Health creates and distributes information relevant to its potential customers' needs on its blog, website, and social media pages such as Facebook.
• The content is in formats such as videos, web pages, and podcasts. 
• An example of Iora Health's content marketing efforts is a podcast by the company's CEO that provides information about the "transformation of the healthcare delivery model." 

Social Media Marketing

• Iora Health is present on Facebook, LinkedIn, and Twitter. It has 1,727 followers on Facebook, 4,009 followers on Twitter, and 10,304 followers on LinkedIn.
• The company uses its social media pages to share valuable content with users. It shares videos, photos, links to articles that have proven to increase conversions. 

Brand Storytelling

• On Iora Health's blog, it uses storytelling to engage potential customers and business partners at an emotional level.
•  Testimonials from patients and physicians provide information about the company, what it does, its model, and its values.
•  Here is a link to testimonials of Iora Health employees.

Co-branding and Cause Marketing

• Iora Health works with employers, health systems, insurers, and unions. According to its website, each practice shares the company's "patient-centric model and collaborative care technology platform."
• In this arrangement, these brands lend collective credibility that increases the perception of the value of services offered by Iora Health. An example of this is a recent partnership with the Colorado Department of Public Health to vaccinate Iora patients.

How Iora Health Approaches Marketing

• Iora Health uses a friendly, optimistic, and informative tone in its marketing messages on its website and social media pages.
• Messages used by the company include "We're restoring humanity to health care," "our team is passionate about making a difference," and "...more than a friendly face."
• Additionally, the company highlights its commitment to put the patient first and focusing more on people rather than the process. It highlights this with statements such as "payment focused on outcomes," "patients at the center," and "technology that enables care."

Iora Health Metrics

• According to G2 Stack, Iora Health uses Mailgun and Yet Another Mail Merge (YAMM) to track emails, and Segment to manage customer analytics data.
• According to SEMrush, Iora Health has about 15,728 monthly visitors to its website. It is ranked 953,910 globally.

New Technologies To Help Senior Citizens

Innovation#1: Hero digital pill dispenser

 

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•  Hero ensures that a senior's medication is dispensed on time each day. This senior-friendly technology can store up to 10 different pills of various shapes and sizes and customize them to fit any medication schedule.
• Depending on the pill size, Hero can store up to a 90-day supply of medication. The device syncs with the Hero app, which keeps track of pill doses and usage. The downside is that the dispenser does not work with gummies, half pills, or sticky dissoluble pills due to the risk of contamination.
• For some people, pillboxes or PillPack are excellent options. However, they aren't the best options for people who have trouble remembering to take their medications or have a medication regimen that frequently changes. Hero helps those who may require (or desire) a little extra help with their medication management.
• In case one frequently leaves the house for work or travels, the Future Dose feature in Hero allows one to pre-dispense the pills you'll need. Hero's Vacation Mode lets you plan your trip ahead of time, dispense the pills you'll need ahead of time, and store them in their original containers for travel. The app also reminds you to take your medication and tracks your adherence data to stay on track no matter where you are.

Relevance to Senior Citizens

• One study found that nearly 60% of US seniors do not take their medications as prescribed. Many factors influence medical adherence, including culture, personal beliefs, and medication side effects. It's made even more difficult by aging issues like mobility and memory problems, poor eyesight, and a general inability to understand instructions.
• As the number of scripts, doctors, and prescription lengths grows, proper adherence suffers even more. 10%of hospital admissions are due to failure to follow prescription instructions. Among seniors, the rate is even higher. It's no surprise that adherence is a problem for over 40% of seniors who regularly take at least five different medications.
• Compared to hiring in-home care, the machine's advantage is that you'll save a lot of money, provide peace of mind for caregivers and family members, improve script adherence, and push notifications of missed doses as soon as possible.

Innovation#2: Toi Labs (TrueLoo)

 

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• According to the International Foundation for Functional Gastrointestinal Disorders, fecal incontinence (FI) affects 17 million people in the United States. Unfortunately, it frequently goes unnoticed. It is also the second most common reason for seniors to choose assisted living or long-term care. Although fecal incontinence is common, it can be embarrassing or upsetting to talk about.
•  Vik Kashyap, founder and CEO of Toi Labs, wants to turn the toilet into a valuable source of health data. Kashyap created the TrueLoo toilet seat after realizing that what is flushed away can actually indicate potential health problems.
• TrueLoo has sensors that can determine who the user is and can be installed on any toilet. It then examines the excreta in the toilet bowl to determine their size, color, consistency, frequency, and shape.
• The data is given to senior living managers to keep track of their residents' health. It's not a particularly pleasant dinner table conversation. Still, the information revealed, such as dehydration, urinary tract infections, and diseases like Clostridium difficile (also known as C. diff) and norovirus, which are major concerns among seniors and frequently result in hospitalization, can be detected early.

Relevance to Senior Citizens

• In individuals 65 years of age or older in the community, the prevalence of constipation is 26% for women and 16% for men. This rate increases to 34% for women and 26% for men in those 84 years of age and older. For long-term care residents, the prevalence is as high as 80%.
• With this technological innovation, the idea is that by catching these issues early on, they can be addressed, avoiding hospitalizations and other more serious health issues, such as the spread of infectious diseases among senior living communities.
• In the U.S., Carlton Senior Living uses the TrueLoo in four of their communities in northern California, with 70 units installed. Following the completion of a clinical study with the senior living community, Kashyap says it will soon be made available to the public. The price has yet to be determined, but senior-living operators will almost certainly pay a monthly fee.