All on the Same Team

You won’t see any white doctors’ coats when you walk into an Iora Health clinic.

That doesn’t mean board-certified physicians don’t work there. Iora Health chooses to underscore its team-based approach to care by doing away with this visual cue of traditional medical hierarchy.

Patient-centered, team-based care is receiving a great deal of attention throughout the healthcare industry, and Iora Health is joining the fray if not leading the way in that movement.  The Cambridge-Mass.-based company couples that innovative approach to care delivery with an innovative payment mechanism that properly aligns the financial incentives among providers, payers and patients. 

Iora Health has defined its job to be done as engaging patients in their own care by improving the primary care experience. The end result is better experience and health for patients, lower costs for payers and better business health for Iora Health’s six clinics.

“Our mission is to transform healthcare by demonstrating that a better model of primary care allows you to change everything that follows,” says Zander Packard, chief operating officer of Iora Health. 

Iora Health runs primary care clinics for specific clientele, namely self-insured employers, unions and insurers seeking an improved experience for employees or members and better value per dollar spent on healthcare.  Partners include Dartmouth College, the New England Carpenters Benefits Fund; the Freelancers Union in Brooklyn, N.Y.; and the Culinary Health Fund in Las Vegas. 

The model jettisons traditional billing and coding (fee-for-service medicine) in favor of a flat per-person, per-month fee. There are no copayments for patient visits. This frees up providers to spend the appropriate amount of time with patients under their care — whether in person, over the phone or via email. Same-day access is a priority.  One Iora Health clinic has seen a 12% year-over-year reduction in total net health costs with this model.

“We want to inspire other people to explore a more holistic, proactive, value-based way of delivering primary care,” Packard says.

Iora Health applies a patient-centered model of team-based care, with physicians, nurses, social workers and health coaches all working together to deliver patient care. Like many other patient-centered clinics, Iora Health providers conduct team “huddles” each morning. Iora dedicates 45 minutes to this critical conversation and expects every member of the team to participate equally. During the huddle, the team reviews the appointment schedule and identifies patients who missed their appointments, who are in crisis or who require follow-up after a hospital discharge or for chronic illnesses or other conditions.

Involving Patients at All Levels

Iora Health employs four non-physician caregivers for every one physician. Health coaches work with patients to help them set goals, identify barriers, navigate the system and get the right care when they need it. 

“What patients really need is someone who is a compadre, a health coach, someone who actually cares about them, teaches them to care about themselves and helps them navigate the system,” Packard says. “The only way you can do that is by flipping the model around, putting patients at the center, getting paid differently and building a team that is good at that stuff.”

Iora Health is inclusive with its provider teams and patients, and Packard says this approach keeps leadership open to new ideas.

“We view innovation as something that happens all the time — not just by people who have innovation in their title,” Packard explains.

For example, a health coach in Las Vegas suggested starting a diabetes club, an idea that has since been implemented.

“Our definition of innovation is that people across the organization are learning and sensing what patients need and are empowered,” he says. 

Iora Health has a patient advisory group, where each practice invites patients to give their input on a quarterly basis. Inclusiveness and attentiveness build trust, Packard says.

“Once patients know that we’re all on their team, it creates this incredible opportunity to serve them,” he says.  “Patients start referring to ‘our practice’ and feel a real sense of ownership in how well it serves them and their community.” 

Technology is an important component to meeting patient needs, and Iora Health has developed a proprietary platform that combines claims, administrative and clinical data to better serve patients. It includes disease registries and other identifiers to follow up with and proactively manage relationships with patients who have chronic care needs. This system is also available to patients online to encourage their participation in care and treatment plans. 

Trying new things in healthcare is necessary to drive improvement in an ever more costly system, Packard adds.

“The catalyst is the status quo,” he says. “It’s about time we try things, because staying with the current model of care delivery isn’t going to get us where we need to go.”