House-Call Business Knocked by Some Doctors

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Heal – a kind of Uber for doctors – has seen rapid growth over the last few months. The Santa Monica startup now claims 3,500 subscribers for its doctors-on-demand urgent-care app-based service, which offers home visits at a flat rate of $99.

“We have grown 400 percent since November,” said Dr. Renee Dua, who co-founded the company with her husband, Nick Desai, early last year.

She attributes much of the popularity to the convenience of old-fashioned home visits rather than driving through traffic to sit in a waiting room to see a doctor.

Several major insurance plans already include Heal in their networks.

“We are now in network with Aetna, Cigna, United HealthCare, and Anthem, and 80 percent of our patients use their health insurance to pay for Heal,” added Dua. “For people with those insurance plans, a Heal visit is typically only the same cost as their co-pay to go to a doctor’s office.”

But on-demand house visits are no substitute for walking into an urgent care practice, according to Dr. Vladimir Manuel, medical director of urgent care at UCLA.

“For startups, there are always ways to make money on the margins. However, these businesses are capitalizing on trends of access and convenience, and that is not always appropriate medicine,” he said. “When people self-manage, some patients need to be hospitalized later to manage problems that could have been managed more cost-effectively if a physician was looking at the bigger picture.”

Meanwhile, the profitability of the Heal business model continues to baffle other on-demand health care providers.

“A primary care doctor charging hourly makes about $120 per hour,” said Dr. Nalini Mattai, owner and family practitioner at Pasadena’s Huntington Family Medicine. “As a business owner I can’t see how you can be profitable charging the patient $99, despite insurance margins. In my private practice, our overhead costs alone account for 80 percent.”

“Big groups like (Kaiser Permanente) and UCLA are growing rapidly and buying out practices in their neighborhoods” said Mattai. “As a small-business owner, it is getting harder for us to attract physicians when the bigger businesses can pay them so much more. My concern is that the big groups will keep getting bigger and the smaller ones will be wiped out.”

The Santa Monica startup raised a $5 million seed round last year from investors including singer Lionel Richie, United Talent Agency Managing Director Jay Sures, and Qualcomm Executive Chairman Paul Jacobs.

Heal doctors, most of whom have jobs at clinics and sign on to work with Heal when they are available, arrive at patient’s doors with a host of supplies and typically deal with nonemergency issues such as sore throats and standard checkups.

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