Recently released by the New York-based Commonwealth Fund health policy foundation is a case study of a new model for extending medical care in Mexico and with a variant in the US for the Spanish-speaking population. In Mexico, MedicallHome (not a typo) connects subscribers by phone and mobile app to a 24/7 national network of physicians and discounted health resources such as clinics, labs, pharmacies, in-person medical services, and hospitals. The 60-person Healthcare Contact Center, staffed by primary care doctors, psychologists, and nutritionists, triage emergencies (press 1) to medical advice (press 2) to referrals (press 3). They also arrange in-person visits and emergency services.
MedicallHome’s model is targeted to low and middle-income Mexicans. It is primarily a direct-to-consumer offering, with subscriptions from $2 to $5/month, including travel health (60 cents for a bus trip) and low-cost insurance for students, but they also partner with private insurance, companies, and employers. With an average of 500,000 calls per year, MedicallHome staff resolve 62 percent of cases by phone and refer the remaining cases for in-person treatment. Prescribing medications without an in-person consult is illegal in Mexico.
The profitable MedicallHome complements the free (but overwhelmed and with long waits) national health service Seguro Popular. It also benefits from the oversupply of primary care physicians who work at multiple hospitals, clinics and private practices, and find the shift work in a call center convenient. Their parent, Salud Interactiva, built the infrastructure, IT, EHR, and worked with Telmex, the largest phone company in Mexico. They have also extended it to the Philippines as of July 2015 as Konsulta MD, a joint venture between Salud Interactiva and Globe Telecom, the Philippines’ primary telecommunications provider.
Salud’s joint venture in the US, ConsejoSano (healthy advice) is also profiled in the case study. Since ConsejoSano connects to the Mexico-based call center and not to US doctors, it is designed as a health navigation service for US Hispanics to integrate primary Spanish-speaking users better with the US healthcare system, whether corporate benefits or community-based. It partners with benefits companies (Mercer), LaSalle Medical Associates and Unite Here Health, but also sells direct to consumer. The US service provides advice related to general health, emotional health, or nutrition with a focus on diabetes and obesity. It has developed a clinic locator in California and Texas, refers to FQHCs and free clinics, and is piloting text messaging. This model is developing as another type of triage model to direct its subscribers to the most appropriate and efficient use of care, but as this Editor had previously pointed out, there is still no ‘warm transfer’ capability to US-based assistance to refer the user to either local in-network doctors, a telehealth doctor in their employee insurance network or other assistive services. In February, they raised $4.9 million in a Series A round led by 7wire Ventures (release). Bridging the Health Care Gap Through Telehealth (Commonwealth Fund). Hat tip to Susanne Woodman