There’s an old saying that there are only two certainties in life – death and taxes. In modern America, there’s a strong case to be made for a third: Frustration with the health care system.
Tackling some of the key problems driving that frustration is the mission of Integral Leaders in Health, a Greenville-based startup created by seasoned health care leaders to bring about meaningful change.
Primary care philosophy at Integral Leaders in Health
ILH founder and CEO Spence Taylor was formerly president of Prisma Health’s Greenville Health System and is a longtime professor at USC School of Medicine Greenville. His decades as a practicing physician and health care leader convinced him that one of the underlying problems with modern health care in South Carolina and across the country is the increasing lack of physician autonomy, particularly for primary care doctors.
Broadly speaking, he said the consolidation and corporatization of health care systems has created conditions that have eroded a physician’s ability to prioritize patient care. He said this has led to circumstances patients find all too common during doctor visits – long wait times, followed by frustratingly brief interactions with their primary care physician.
This leads to patients feeling underserved and puts doctors on a burnout trajectory.
With that as background, Taylor launched ILH as a public benefit corporation with an eye toward bolstering the number of independent physicians in South Carolina, which is currently about 2,000, in maintaining their autonomy to provide the highest quality of care.
That focus led to the creation of The Physicians Collaborative (TPC), centered on the core value of “by doctors, for doctors.”
Taylor said organizing TPC was the necessary first step on the path to tackling broader challenges. By creating a support system, particularly for primary care doctors, it helps them with resources and tools to maintain their independence.
TPC is also working to address another critical health care problem – cost.
Direct primary care
Taylor said in working with the 1,000 or so independent, primary care physicians across South Carolina, he discovered a group of about 100 or so who follow a “direct primary care” model. In a nutshell, that means they provide care for cash.
As crass as that may sound to some, this model cuts out the confusion and complications of dealing with health insurance companies.
Seeing this in action was a “eureka” moment for Taylor, who then began contemplating how the model could be replicated at scale to solve one of the most vexing problems for employers – how to control ever-increasing health care coverage costs.
With companies large and small facing on average a 10% to 15% annual increase in health care coverage costs, the issue is a significant contributor to the perception that the health care system is not what it should be, Taylor said.
“And so it’s just the wild, wild west out there,” he said.
To bring order to that chaos, Taylor and his team asked a simple question: What if we empowered primary care physicians, who know their patients best, to offer appropriate care at the right time and cut out the middle men?
This led to TPC Direct Care, a physician-owned, physician-led public benefit corporation that aims to deliver primary care to patients, while providing cost savings and employee wellbeing to employers.
Jason Crumpler saw the consequences of inadequate primary care during his years as an emergency medical physician. Too many times, he said he saw people in a medical crisis who could have avoided a stressful, expensive ER visit if they’d had regular, affordable access to a quality primary-care physician.
As chief medical officer for Integral Leaders in Health and chief clinical officer for The Physicians Collaborative, Crumpler said bridging the gap between patient outcomes and employer health care spending was an area where meaningful improvement could benefit everyone involved.
Taylor said MUSC has been an important partner in helping develop the TPC Direct Care model. Not only did the medical university provide important early capital, but it has also provided access to its network of specialists at direct cash pay rates.
Taylor said the model is not a replacement for traditional health care insurance plans, but provides an additional tool businesses can use to help lower costs.
“This is a solution that helps our community, helps the people we know,” he said.
For more information, visit tpcdirectcare.com.
Direct primary care by the numbers
The logic of using the direct primary care model is it can improve employee health and wellness and thus help lower employers’ health care spending in key areas, including:
- An average 30% reduction in hospital admissions
- About a 60% average reduction in specialty referrals
- About 85% fewer radiology and imaging exams
Source: TPC Direct Care
