Privia Health ($PRVA) went public a few weeks ago and the stock not only popped when it hit the market, but has continued to rise. When you look at the numbers – and hear about the business model from CEO Shawn Morris – it’s easy to get excited and see why. Privia calls itself a “physician enablement” business, which is the two-word marketing way of saying that they bring together different docs in a region and give them the systems to become part of a value-based care network while also maintaining their private practices. They’re more or less building accountable care organizations (ACOs) in a hub-and-spoke fashion, uniting docs around Privia’s common tech systems, workflow processes, value-based care strategies, and contracting power with commercial and government payers. The model is appealing to docs who want to make the switch to value-based care, but still want the autonomy of their own practices. The value prop has already attracted more than 2,700 providers in 650 different locations netting the biz $817 million in revenue in 2020 – and Shawn says they’ll only expand from here. What’s the growth plan? Value-based care models are often criticized as “un-scalable” – what does Shawn say to combat that? A great, detailed chat that pitches a hopeful end to fee-for-service healthcare and a promising future for a newly public healthcare co.
Today on Health in 2 Point 00, Jess claims to be blameless for the drama between Jonathan Bush and Glen Tullman. On Episode 198, we talk about Microsoft buying Nuance for $16 billion and $3 billion in debt – is Microsoft taking over healthcare, and is this going to slow Nuance down? Cohere Health raises $36 million in a Series B, working on improving prior authorizations between health plans and providers. We wrap up with a lightning round of IPO rumors regarding Privia Health, VillageMD, and Bright Health.—Matthew Holt
Today, primary care is considered the bee’s knees of value-based care delivery. Instead of being viewed as the punter of the football team, the primary care physician (PCP) has become the quarterback of the patient’s care team, calling plays for both clinical and social services. The entire concept of the accountable care organization (ACO) or patient-centered medical home (PCMH) crumbles without financially- and clinically-aligned PCPs. This sea change has resulted in rapid employment or alignment to health systems, as well as a surge in venture capital being invested into the primary care space.
Before we get too far in the weeds, let’s first begin with the definition of primary care. The American Academy of Family Physicians (AAFP) defines a primary care physician as a specialist typically trained in Family Medicine, Internal Medicine, or Pediatrics. Some women do use their OB/GYN as their PCP, but these specialists are not traditionally considered PCPs. Now if you’ve gone to your local PCP and noticed that your care provider is not wearing a white coat with the “MD” or “DO” credentials, you are either receiving treatment from a hipster physician, nurse practitioner (NP), or physician assistant (PA). Two of the three professionals are trained in family medicine and can provide primary care services under the responsibility of an associated PCP. At least one of the three has a beard.
The crazy thing is, despite the industries heightened focus on the importance of PCPs, we’re still expecting a shortage of primary care providers. In April 2019, the Association of American Medical Colleges (AAMC) released a report estimating a shortage of between 21,100 and 55,200 PCPs by 2032. Given we just passed 2020, this not that far off. The primary reason for the shortage is the growing and aging population. Thanks mom and dad. Digging into the numbers will really knock your socks off, with the U.S. Census estimating that individuals over the age of 65 will increase 48% over that same time period. Like a double-edged sword, the issue is not just on the patient demand side though. One-third of all currently active doctors will be older than 65 in the next decade and could begin to retire. Many of these individuals are independent PCPs who have resisted employment by large health systems.