The City of Jacksonville, Florida is addressing access to care for the uninsured (roughly 100,000 people) through a virtual service that’s connecting them to local providers. In its first three months of operation, the program, called HealthlinkJAX, has saved taxpayers nearly $1 million in potential ER visits. HealthlinkJAX is addressing a major issue for the community—as it is a major issue for communities around the nation: ED overcrowding. Many uninsured individuals see the emergency department as their only reliable care delivery resource. But the HealthlinkJAX program is working to guide uninsured individuals to virtual care providers, in order to both improve their outcomes and relieve overburdened emergency departments.
Matthew Thompson, M.D., a board-certified emergency physician who has been in clinical practice for 14 years, is the CEO and co-founder of the Jacksonville-based Telescope Health, which describes itself on its website as “a physician-led health care solutions company focused on reducing barriers to care through innovation, human connection, and technology”; and it is Telescope Health that is providing the clinical workforce behind HealthlinkJAX’s success. As the company notes, “Since 2018, our mission has been to improve outcomes and provide unmatched value-based care solutions in partnership with health care organizations. Dr. Rill and Dr. Thompson, both emergency physicians, founded Telescope Health after seeing countless emergency department patients without timely access to a primary care physician or care navigation services. Over the past several years, our passionate leadership team has grown to include experts with years of experience in technology, patient experience, provider training, and value-based care.”
Dr. Thompson spoke recently with Healthcare Innovation Editor-in-Chief Mark Hagland regarding the creation of Telescope Health, the set of needs that the organization is addressing in Jacksonville and elsewhere, and the opportunity to meet the needs of uninsured Americans for care delivery. Below are excerpts from that interview.
How would you describe Telescope Health’s scope and range of services?
We are a national company with contracts and clients all across the U.S. We really are a value-based care, tech-enabled organization. We are delivering the same suite of services on the payer, employer, ACO [accountable care organization], sides. Delivering the same services.
We provide data-driven virtual care. We have our own analytics software. On the ACO side, we do preventive outreach for ACOs’ physician groups, provide 24/7 coverage to avert ED visits, and do it all in an invisible way. We don’t want to steal patients. We do it white-labeled under the ACO or physician group, in order not to confuse patients.
Tell me about the founding of the company?
We founded the company in 2018; Telescope started as a service line for a still-existing ED staffing group, Emergency Resources Group. In 2018-2019, we established Telescope Health as a separate entity. And Baptist Health in Jacksonville, our first client, is still one of our biggest clients. I’m an emergency physician, and, as Emergency Resources Group, we began working with our partners to bring down ED and hospital admission rates. We started in a very different way from consumer-facing organizations. We’re built our infrastructure to receive real-time referrals, etc. It’s a different kind of approach. At our core, we are a physician organization.
We have our own proprietary telemedicine software, etc. We cover their employees for virtual care services and navigation, and telehealth services, and do targeted transitional care follow-up for congestive heart failure, among other clinical service lines. And we quickly branched out to the employer side—Ameriflex, a benefits administrator with over 55,000 employees, and so we’re providing services to their clients. For example, they provide for the Consolidated Appropriations Act requirements [around pricing transparency]. Employers are being sued because employees are spending too much on healthcare. And Ameriflex is helping brokers, employer administrators, and others, to address those concerns. A lot of employers are now becoming self-funded, and are looking for ways to reduce expenditures, and frankly, urgent care telemedicine doesn’t help manage the 2 percent with high levels of chronic disease. So we will proactively outreach to those patients. And that’s value-based care. So we fill that gap, because we can provide the providers.
What is your physician corps like?
We have a large pool that takes care of patients nationally. In fact, Blue Cross Blue Shield of Nebraska, with 400,000 members in the state, is one of our clients. And we take care of over 100,000 patients in Jacksonville. Per all that, we have a group of several hundred physicians involved with us; some are employees, some are on contract. It’s like an Uber-driver model. We also have therapists and psychiatrists nationally also, in all 50 states.
Because we work with employers and health plans, everywhere from Alaska to New York to Florida, by state law, you have to be able to treat patients wherever they are, including if they’re traveling. So that’s a standard, to have providers in all states, to provide telehealth.
Can you say how many visits per year you log altogether?
It’s in the tens of thousands of visits.
What have been the biggest challenges in architecting this and making it work?
Providing an urgent care visit in telehealth and treating someone’s runny nose is the easiest element; and utilization sometimes is low. The most challenging aspect is the workflows and the partnerships that are involved. But we’re the first in the country to develop a program fully funded by a municipality—in this case, the City of Jacksonville, through HealthLinkJAX, which provides virtual care for residents in Jacksonville. I’ve delivered a TEDTalk on the subject. And every municipality has a budget for EMS, telephone service, etc. And the uninsured population often uses the ED as their primary care; but value-based care means addressing those needs early on. And if you’re a Medicaid patient, you’ll have incentives to get into value-based care. The uninsured population does not have that.
So this program is pretty simple from a public health perspective. Call 925-CARE if you’re uninsured; a nursing team will address your need. If you need a doctor, you’re immediately sent a link, and you’re seen by a doctor. And if you’re a diabetic, I’ll connect you to care management. In Jacksonville, we have seven safety-net clinics, two federally qualified health centers, and five independent health systems, some for-profit and some non-profit. Jacksonville is a huge medical hub. We’ve got a ton of hospital beds and a smaller population here in Jacksonville, including a branch of Mayo Clinic, as well as UF Health, Baptist Health, and HCA Healthcare.
And in this program, because we integrate services with health systems, we have a real-time feed from health systems so that we can outreach to patients. The health systems love it because we’re freeing up ERs and beds. And I can immediately help the patient, including through follow-up. We provide that transitional care service. It’s very comprehensive from a data integration perspective, clinical workflow perspective, and providing comprehensive care perspective. We’re in talks with ten municipalities. And we’re successful because we’re white-labeled. We’re unique.
As of last month, over 3,000 calls have gone through this program, and over 1,000 people have used us instead of the ED. In Duvall County, if you’re uninsured, $4,800 is the average cost of an ED visit. The average charge, you’ll get a bill for $4,800, and that could have been averted.
How do you see the next few years for your company?
We have payer clients, health insurance clients who want us to reach their members; we have municipalities and we have self-funded employers, and health systems. It doesn’t matter who comes to us; it’s the data integration, the navigation outreach, and the care. For us, it’s heavily on the engineering side, so we can stitch all those pieces together. And if we can integrate with your data, we can provide targeted services and achieve financial ROI. So we’ll replicate this in other large cities, and we’ll see results.
Is there anything else you’d like to add?
At the center of all of this, it does not work unless you partner and collaborate. Where things fail is when a single vendor or entity wants to control everything. You can’t push out the stakeholders. We’re the glue in the middle. When you provide 24/7 access to a physician, you can be the glue.
