Embracing AI in healthcare: A balance of innovation and compliance
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Today Accolade announced its intent to acquire PlushCare, a leading virtual primary care and mental healthcare provider. By delivering virtual primary care, we will create a powerful way to further support improved health outcomes and cost savings within our personalized healthcare advocacy model.
Accolade's primary care service is differentiated from the start: a 360-degree focus on the member and longitudinal, integrated relationships. For over a decade, we’ve provided a seamless, caring and empathetic experience to our members every step of the way. In fact, we’re often the number on the back of each member’s healthcare ID card, often making Accolade the first number they call when they have a health need. With this acquisition, we can leverage that relationship and the trust we’ve earned to do even more for our members.
The pandemic has forced us to rethink many things about our healthcare system, including how we address increased demand for virtual services that allow for easier access to care. Many people are touting virtual care as the wave of the future. They are only partially right.
We believe that the most effective way forward is a combination of virtual care and in-person visits. By combining with PlushCare, we can supplement existing, in-person visits with virtual visits to primary care physicians (PCP) and other types of providers, to make sure members get to the right care. For members who have a relationship with a brick-and-mortar doctor, we can seamlessly keep that provider in the loop. For members who do not yet have a primary care doctor, we can connect them to the PlushCare physician who is right for them.
For example, let’s say Joe, an Accolade member, is having issues breathing. He messages Accolade and is soon on a phone call with a nurse. The nurse asks him several questions, with his answers indicating he should see his doctor again. The nurse also notes that Joe has seasonal allergies. However, when we call to schedule his appointment, Joe’s doctor is booked until the next week. This is where PlushCare comes in. Within 15 minutes, our nurse has informed PlushCare of Joe’s medical history and Joe has met with a virtual primary care physician. It turns out Joe also has asthma, which his allergies have exacerbated. He’s prescribed an inhaler and his records are updated. A week later, the nurse messages Joe and learns that his symptoms have cleared—he’s back to playing basketball with his children.
Our data combined with our team of experts enables our ability to leverage both virtual and in-person care. We have a member’s medical history and other important facts at hand to inform their journey and provide coordinated across our team of primary care physicians, specialist physicians (through 2nd.MD, an Accolade company), behavioral health specialists, Accolade care advocates, expert and generalist nurses, medical record collections experts, and claims and benefits experts.
How does that impact example member Joe’s ongoing care? When his inhaler prescription is almost gone, he visits his doctor in-person. His doctor sees that he was prescribed Albuterol and that it’s helping him when he uses it before exercise. However, Joe mentions that he’s having trouble breathing at other times too. His doctor recommends a different prescription that Joe discovers will cost him almost $100 out of pocket. So he connects with Accolade, where one of our benefits experts lets him know that he can use his Health Savings Account to cover the cost.
Our data encompasses benefits like medical, prescriptions and point solutions; insurance claims, utilization management, and verification of benefits; and provider electronic medical records, specialist network for complex treatments and provider quality insights. By coordinating all these resources, our care team could easily help Joe figure out a way to afford an item outside his budget and ensure he can access the healthcare he needs.
We are also intentional about removing barriers to care. PlushCare will be supplementary for most of our members but occasionally, depending on a member’s circumstances and needs, a PlushCare physician may become their primary care doctor. Because PlushCare is a consumer-driven company with NPS scores of 90 and top-tier doctors with an average of 15 years of experience, this is a great option.
Bottom line: we have the information we need to best help each and every member at our fingertips. And we do not work in silos.
We couldn’t be more excited to welcome PlushCare to the Accolade family.
To learn more about how we’re transforming healthcare as we know it, read our CEO’s blog post.