The Reverse Mullet Healthcare Podcast
Ellen Brown, Justin Politi, and Dave Pavlik bring their 90 collective years of healthcare experience to BP2 Health where they're on a mission to effect real change in the industry. Connect with BP2 Health Here: https://bp2health.com/contact/
The Reverse Mullet Healthcare Podcast
Tapping into TeleHealth 2.0 with Dr. Geoffrey Rutledge and Craig Hittle
On the Road Edition - Live at ViVE, Episode 4
Prepare to unlock the secrets to a healthier life as we bring you an intimate conversation with Dr. Jeffrey Rutledge and Craig Hiddle from HealthTap. Their pioneering virtual-first approach is reshaping the landscape of primary care—tune in to discover why a strong doctor-patient bond could be your ticket to longevity and lower health costs. We're tearing down traditional healthcare barriers and opening up a world where your primary care doctor is just a text away, thanks to the innovative blend of healthcare and technology.
Join us for a thought-provoking journey with our esteemed guests, as we navigate the economic maelstrom of the healthcare industry and pinpoint how consumer-driven changes are poised to turn the tide within the next decade. We're not just talking about the future of medicine; we're actively shaping it by addressing the quarterback shortage in primary care and tackling the food system that's at the heart of our well-being. Don't miss this episode—it's a heartfelt pledge to continue this vital conversation with a future in-depth feature that could revolutionize your approach to health.
And we're back again at five with the Reverse Mullet Health Care Podcast from PP2. I'm Dave Pavlik.
Speaker 3:And I'm Ellen Brown, and we are the two of the three co-hosts. Our third is at home having serious FOMO now. Shout out to Justin Exactly.
Speaker 1:And now, today we have the pleasure of speaking with Dr Jeffrey Rutledge and Craig Hiddle of.
Speaker 2:HealthTap. Yes, great to have you guys.
Speaker 3:We know Craig from past ventures and so when I reached out I thought I bet Craig's going to be at Vive and I wanted to connect anyways. And we still haven't had time to connect offline. But I'm glad that we got to connect.
Speaker 2:Likewise Pleasure to be here.
Speaker 3:Thanks for having us Tell us about what you're doing and why you're here at Vive, and then we'll ask you the fun question we get to ask.
Speaker 2:Yeah, amazing. So I'm the Chief Commercial Officer at HealthTap and our goal, our mission as a company, is to put affordable, accessible, high-quality healthcare at the fingertips of every American, right. I mean, everyone knows the challenges of affordability and just lack of you know, pcps and the economics are out of control and we've set out to change all that and we firmly believe that one of the keys of providing the right kind of, and really the only sustainable kind of, economics long-term is by virtual first primary care and empowering members to actually partner with their provider in a longitudinal way to really take control of their own healthcare and then obviously rely on the expertise of doctors to help them in that journey. So it's an exciting journey. We've been around for about 14 years. Dr Rutledge is one of our co-founders, so we have a little fun.
Speaker 1:You said that really well. Thank you, good job. Did you miss anything? Well, we started the company 14 years ago with the vision of bringing healthcare to mobile devices, and it's been a delight and an amazing journey to build this platform that, over the past more than a decade, has been refined to the point that it actually works incredibly smoothly now. At the same time, we discovered that it's not just health care but primary care which is, by the way. People are beginning to recognize how important primary care is and there isn't enough of it, and it's also a problem for primary care doctors, who cannot practice the kind of medicine they want in the system that we have. Absolutely, and the amazing thing about the virtual platform is that it gives the doctors time and ability to connect with patients in a way that they don't actually do in the office.
Speaker 3:Well, the word connection is just missing.
Speaker 1:And how many people have a good, solid relationship with a primary care doctor. They trust someone that they would turn to when they have a question or concern or don't know what to do. And we're enabling that because on our platform you get to pick your own doctor. You see them, you can look at the video, you can see where they trained, how long they've been in practice, where do they live? What they'd like to do? Is that the kind of person you want to be?
Speaker 1:you know, have as your doctor that you trust and different people choose different kinds of doctors.
Speaker 2:Yeah, and it's so different from the typical transactional virtual care that's out there, right? Telemedicine's not a new thing, obviously Virtual care is not a new thing, we would argue. Well, we were around before COVID, right?
Speaker 2:It didn't take a pandemic for us to really say, hey, this virtual first primary care model, that's where it's at. We were purpose-built around that whole function to begin with, and so I think what Dr Rutledge is talking about in terms of that longevity, that longitudinal relationship, that's really the key. And I think one of the things hopefully we get to talk about in this podcast is some real change in terms of the rise of consumerism, the rise of the patient to be able to make better and more informed decisions on who they partner with for their clinical care, how they pay for their clinical care. Everyone just has kind of plugged into the system for so long. I get my insurance from Medicare or my employer and I mean everyone sees the cost curve continues to spiral out of control.
Speaker 1:We gotta do something about that, yeah, yeah yeah, and what's been shown is that people that have a primary care doctor get better healthcare. They have higher level of preventive health services. They live longer. When you have a primary care doctor, you live longer.
Speaker 2:It's really quite astonishing, but what percentage of people have a primary care doctor and you spend less on health care?
Speaker 1:And you spend less on health care.
Speaker 3:But again you're defining the transition we need to make, which is from sick care to health care, so you're defining a core component of health care.
Speaker 1:In order to be healthy, you need a guide. You do need a guide and a good doctor who knows you, understands your preferences and your approach to life, can give you guidance about how you can lead a healthier life and is willing to connect with you and guide you.
Speaker 3:And is set in a system for success.
Speaker 1:And they can steer you away from things that are expensive and don't work. Yeah, and toward the common simple things you can do.
Speaker 3:Dave's ready to sign up.
Speaker 2:You can do to have a healthier life? I want to know the answer to craig's question.
Speaker 1:You started to ask what, what, what percentage of people have?
Speaker 2:primary care.
Speaker 2:Yeah, I mean, actually most people think they have a primary care doctor but they really don't and in fact, my wife personal story she doesn't have a primary care doctor anymore because her primary care doctor fired her because she hadn't seen her in the last 24 months, right? So so providers are? I mean, they're under such a time crunch and they've got to, like you know, continue to turn the wheel that if you don't come back and see them, they'll actually fire you from their practice. Like what kind of law? So it's a low percentage? Yeah, it's probably. I would say 30, 35%. That blows me away. That blows me away.
Speaker 1:I thought everybody had a primary care, but people will have a doctor that they've seen, and some people will see a specialist for a specialty problem. And they'll say well, that's my doctor, but the doctor's not paying attention to their entire spectrum of health issues. Yeah, good point, because they're necessarily, as a specialist, they're not the primary care.
Speaker 1:Really good ones will do some good primary care, but a lot of people are missing out on the things that are needed to maintain a healthy life. And the amazing thing is the virtual technology enables people to get this no matter where they are, and if the doctor is available more conveniently then it's easier to get to them, so people use it more. You're lowering the barrier for access.
Speaker 3:It's friction right, However much friction you can take out of the system.
Speaker 1:The other really cool thing we do is, once you meet your doctor, we let you text your doctor and it goes not to a nurse practitioner or a customer support representative, it goes to the doctor. When you text your doctor, it's a message that appears on their machine. They look at them, respond to you directly and the person who's responding to your text is someone who knows you, and that is a wonderful glue for gaining access.
Speaker 3:I, and that is a wonderful glue for gaining access to a good cure. I might get fired from my doctor though, if I could.
Speaker 1:So are your customers.
Speaker 2:The practices the health systems. Yeah, so we are a medical practice right? So we are licensed in all 50 states, Health plans, self-insured employers, accountable core at-risk provider organizations. So we can be considered like a subcontractor of an ACO, for example.
Speaker 3:That's like you know. They've got a cap. That's a question. Anybody would have asked no, no, it's fair.
Speaker 1:Also, don't forget, we have a direct-to-consumer offering. We're the least expensive for people that don't have or are underinsured.
Speaker 3:If you have a high deductible, which is, I think, like half of the commercial population now, if not more so you're paying all of your routine care unless something goes really bad. Yeah, that's me.
Speaker 1:We are the most efficient and effective way for someone who's paying for their health care to actually get access to a wonderful doctor. One of the challenges primary care doctors have in the corporate world is they're often pressured to spend less time with each patient and to quickly make a referral Absolutely or to order a test Right, and they're pressured and incentivized to do that. Our doctors we've selected as ones that want to build relationships with their patients and we give them enough time to do so. The first visit with a doctor in LTAP is always a half an hour if you schedule the visit Not if you want to do an urgent care right off and you get a doctor who's the next first doctor in one. We're very proud of the fact urgent care clinic has doctors that answer within one minute. Our median answer time is like 45 seconds. It's great, wow. So you can date that. That's a shorter visit and that's available. But if you have a doctor that you know, then schedule a visit. Usually it's available same day, almost always same week.
Speaker 3:That's amazing, absolutely amazing. Okay, so let's ask the question. So we will start with Craig. What do you think could affect real all caps change in healthcare with Craig? What do you think could affect?
Speaker 2:real, all caps. Change in healthcare All caps, all caps.
Speaker 3:Real yeah, and I know we all have we all have to do the incremental work Like I get it, but what like? So you know me crazy. And so food and fixing the food system is one of my biggest things because I feel like unless we fix our broken food system, people are never going to be able to get healthy because they don't have access or knowledge or any of that. So I say that for context that you can really go far here and not be considered crazy.
Speaker 2:No, food is medicine is a real thing. I think it's a great place to start. Food is health. Food is health Health and medicine.
Speaker 3:Sorry, I'm in such a pain.
Speaker 2:No, I love it, I know Okay.
Speaker 3:You know me, though you know me.
Speaker 2:All good. So I think the rise I mentioned it earlier, but I think the rise of consumerism.
Speaker 3:And if you just look at the trends, I'm an economics guy. I went to business school and I'm like and economics Okay, so actually I'm not really an economics guy, I'm a finance guy. Yeah, but this is close enough. Love the numbers right.
Speaker 2:So anyone, we all know that the cost curve is unsustainable and if you look at employer-sponsored coverage, which I think is about 100, I mean half the country, about 150 million people get their health insurance through employers. And employers are having to deal with this premium increase every single year. This year, I think it tripled in 2024 from where it was in 2022. I mean, it's always been that way and at some point there's going to be a bubble.
Speaker 3:Like something's going to have to happen where the employer is going to say we can't deal with this. We had Mike Barrett who used to be at Centene from CHS, so we had him on for an episode as a guest and his hypothesis, his answer to the change question was he called it Consumer Direct 2.0. Answer to the change question was he called it consumer direct 2.0 and he is convinced that employers at like any moment now employers are going to be- like I'm done, I'm not doing this anymore.
Speaker 3:You will go get your own health insurance. Mike stole my answer because that's amazing. Oh darn it.
Speaker 2:Sorry, no, but a different take on it, though, is I mean I do think that, yes, eventually, employers are going to say look, it's going to be more of a defined benefit plan type thing right, we're going to give you $1,000 a month, We'll underwrite a catastrophic plan for you for that type of stuff.
Speaker 2:But as consumers become more savvy and there's more digital access and more savviness in terms of how to shop for health care the right way and to talk to doctors that they really can build that relationship with, that helps keep them healthy over the long term, I really think that has to happen and will happen. I would suggest I don't know the timeframe I would think the next 10 to 15 years.
Speaker 3:So you're, you're, I'm very aligned with you, as I always when people you know, this is, I call it the plane conversation. You're on the plane and what do you do? What do you do? Right, I'm, I'm in healthcare. Oh my gosh, it's so broken. Is it ever going to get fixed?
Speaker 3:And I'm like well and then the question is how are we going to fix it? What would you do to fix it? This is when I get asked. You know like people ask me this and I always say it's complicated, because the person consuming the health care doesn't even make their own choice about what they're getting. Their employer is doing that. So I always say until you remove that middleman, right.
Speaker 2:And there's no other industry. I challenge anyone. I mean what other industry can you think of where, as a consumer, you literally have no idea what the cost of that product or service is?
Speaker 3:And you don't have the cost, are you?
Speaker 2:related, Because that's you say that all the time.
Speaker 3:Yeah, Not only that. Not only do you not have an idea of the cost of the benefit plan, you also can't even get a frigging quote for what you're having done.
Speaker 1:Right, this drives me crazy. Right, it's even worse than that because you don't know what it is that you need. Very true. So how do you evaluate the cost of the thing which you're trying to figure out? The cost of it? Yeah, if you don't even know if you need it, let alone want it.
Speaker 3:But I'll challenge you and say there's been many times when I know what I need, sure, where somebody has said to me this is what you have to go get done and I happen to have a high deductible plan and and I call and say what is this going to cost me?
Speaker 3:because this is me, I'm paying for this, right, I don't know. I. What do you mean? You don't know. Well, we have to see what your insurance will pay. Well, if I tell you what my insurance is, can't you tell no, I can't. We have to process the claim. I'm like what auto body shop do you go into and say I need a new carburetor? Well, that's great, we'll do that for you and let you know at the end.
Speaker 2:Right, I'm sorry I'm stealing your thought, dr and it's still 20% of our GDP, right? We wonder why we spend so much on healthcare, dr.
Speaker 1:I have to kind of suggest there's really two sides. It's really two questions, not one, okay, dr, because there's the how do you fix the sick care system and how do you generate a society in which people are behaving in a way that they're healthier? Oh yeah, dr, food is. Medicine is one element of that, but there's a whole variety of things we know. If people did, we would all be healthy.
Speaker 3:Oh, I don't get me started. The look at the crisis.
Speaker 1:The obesity is sort of a manifestation a symptom of how severe the issue is, and it's a bigger societal issue about education and focus on health and well-being Separately. We also need to fix our health care sick, able to deliver the things that are known to work. We have a whole set of things that we know, if done consistently, will actually help people a lot.
Speaker 3:That's why people that have a primary care doctor live longer, absolutely. But I would say, if we had a sick care system, that was, yeah, well, we could talk. Okay, I'm going to stop.
Speaker 1:So I would suggest that virtual technology and integration of intelligent systems is going to be a huge component in delivering better and more efficient and more accessible care. If you look at what we're doing right now, we're leading the way, showing what can be done. So, for example, when you schedule a visit on HealthTap, we ask you to do a pre-visit interview and we have an AI conduct a dynamic, interactive interview with you to collect all the routine information the doctor would do in the first 10 minutes of the visit, and then it writes the note for the doctor when your visit starts. The doctor reads the note and you just save 10 minutes of time, but the doctor can now give you talking about things like impediments to care, other issues that are going on in your life, the things the doctors wish they had the time to get to, that they often don't, because they spend all the allocated time just figuring out what the problem is is there good adoption for that?
Speaker 2:the patients are doing that. It's wonderful to see.
Speaker 1:And when they do it, like 95 of the time, the information is helpful to the doctor. And when the doctor sees it, more than half the time they just copy paste the note in as a foundation for the note they actually write. And when I did the analysis to show that actually this ai is so smart that, based on its interview, it can figure out what the patient has, the differential diagnosis that the AI generates matches what the doctors actually put on the chart. Wow, impressive 88% of the time.
Speaker 3:Yeah, I definitely hear at Vive we've gone to some talks and I have definitely been swayed a little bit further that AI isn't just a shiny object. What?
Speaker 1:we're going to see is intelligent integration to improve workflow. We're going to see intelligent the things that can't be done in an automated way should be. The doctor should be relegated to the role of integrating and understanding and evaluating the preferences and assessing how the patient will respond and what's the right thing for them to do, with a foundation of accuracy and diagnosis and decision making and removing a lot of the administrative friction that they face and just the stress and pressure that's put on them and yeah, so we appreciate you guys coming in and bringing the I mean we had we just had a health system CIO come in and she was talking about the importance of virtual.
Speaker 3:So I appreciate you all bringing a delivery model that is solving a problem in the industry of a shortage of a very important and needed part Really it is the quarterback of our health care system and creating a solution. So I commend you, dr Rutledge, for what you have accomplished and I appreciate you guys taking some time to talk to us.
Speaker 2:This is also to get you to come back for a full episode. Yes, I think we have a full episode. Sign us up. Thank you Ellen, thanks guys. Beautiful music, pleasure, appreciate it.