" Mrs. Smith was elated and so encouraged by her progress in the CCM program. She was feeling better than she had in a long time and could see that her progress report indicated she was much healthier than she had been a few months prior."
What is Precise Telehealth?
Our company, Precise Telehealth, aims to address the health care needs of the highest cost and most complex chronically ill patients in rural and other underserved areas to optimize the delivery of health care and fill the gaps in the existing healthcare system. We aim to optimize patient outcomes by using our decades of expertise while simultaneously generating ROI for our angel investors.
Who is a part of the current management team?
The core of our team has been in this industry since the 1970’s. Our CEO, Mike Kerouac , CTO, George Tremblay and EVP, John Strucke have started and sold 3 prior companies in this space. They have spent the last 10 years as consultants in the telemedicine arena, helping large health care as well as insurance companies. Through this activity, they have identified recent changes in health care reimbursement laws that will allow Precise Telehealth to achieve its primary aim listed above.
How specifically will Precise Telehealth help patients?
Currently, patients with chronic diseases like Diabetes, Heart Disease, and Kidney Disease suffer from multiple medical as well as social co-morbidities. Those that are high functioning can easily access existing health care resources and direct their own care. However, the vast majority of costs are generated by patients who are unable to navigate the healthcare landscape due to behavioral, cognitive and socio-economic barriers . These patients lead to a disproportionate expense for the health care providers, insurance companies and self-funded health care plans/organizations) that manage their care (by CMS estimates, 10% of Medicare patients generate 85% of the costs). PRECISE is focused on these two patient populations: patients with multiple chronic medical disease and those who require a disproportionate proportion of the health care resources.
By offering empathetic, personalized, and multi-disciplinary care using proven care plans (we have pilot data in over 6,000 patients) and low cost videoconference/telemedicine technology, we can effectively manage high-resource utilization patients in the home. As a result, patients reduce the need for inpatient or emergency care and manage their complex conditions effectively.
For providers, payers, and self-insured employers this translates to significantly lowered risk and considerably less cost. This is extremely important, as healthcare is moving towards “value-based” care, where payers will essentially be rewarded for keeping people healthy and away from treatments that are highly expensive.
As such, health IT is being considered as one of the big drivers to create value and decrease costs in healthcare, especially for those with chronic conditions. States are now making it easier to allow telehealth to create the access to these patients.
Payers are willing to pay Precise Telehealth to help them achieve these savings.
Why Precise over any other competitors? Do you have anything proprietary?
We have developed robust care plans for the management of patients with multiple medical co-morbidities. We are actively researching and developing unique content that we can copyright and incorporate into existing care plans.
Though not proprietary, we do have a few other “competitive advantages”
How will Precise generate revenue from these payers?
There are different revenue models that we are employing:
For Large Insurers/High Acuity Centers:
In this model, we can help both the high-risk patients as well as the health centers in ways that are slightly different than working with large insurers/high acuity centers:
1. These FQHC’s submit a yearly budget to the Federal Government, taking into account their total overhead as well as the number of patients treated the prior year. Based on these calculations, the Government gives these centers a flat fee (called “wraparound rate”) for every time a patient uses their service. There is no maximum number of visits per patient or cap on utilization.
2. The fees given to these clinics per visit range from $175 (Southwest Texas) all the way up to $350 in the Tribal Health System.
3. If patients do not utilize the services of the Health Centers, there is no reimbursement given.
Enhanced revenue on existing patients based on above example.
What are the expected costs of generating this revenue?
About $75 per patient. This factors in personnel as well as equipment.
What type of personnel and equipment are you using?
How often do they engage with the patient?
The Precise Team consists of Nurse Case Managers, mid levels, and a supervising Physician. We also subcontract behavioral health specialists as necessary. Typically the patient is seen 4 times per month via telemedicine video consults. The mid level or supervising physician may sit in on or have a call with a patient directly on a monthly basis. A behavioral health call can either supplement the weekly calls or in some cases substitute for it.
Do you have any existing contracts or revenue currently?
What are the projected revenues over the next few years?
2016 2017 2018 2019 2020
Revenue $1,225,000 $ 8,000,000 $17,700,000 $31,000,000
EBITDA -$480,000 $ -890,000 $1,200,000 $ 5,050,000 $ 9,000,000
Patients 2,100 5,500 15,000 26,000
What are the plans for exit, and what type of returns could I expect in a best case scenario?
Who are the likely acquiring entities?
Insurance Companies operating multiple ACO/Advantage/Waiver programs
Device and App companies needing outcomes associated with their products