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The Changing Healthcare Landscape

A conversation with Sanjula Jain, Ph.D., SVP, Market Strategy and Chief Research Officer, and Todd Latz, Chief Executive Officer, GoHealth Urgent Care

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Sanjula Jain, Ph.D.: It’s my pleasure to welcome Todd Latz, CEO of Go Health Urgent Care. Todd, thanks so much for being with us.

Todd Latz: Thanks for having me.

Sanjula Jain, Ph.D.: You have had an extraordinary time during the pandemic in terms of all the things you saw firsthand with healthcare.

Todd Latz: That's right.

Sanjula Jain, Ph.D.: Tell us a little bit about how urgent care behavioral patterns and utilization patterns changed from your perspective.

Todd Latz: What we saw was, we were on the frontline, so we've always sought to be the front door to the health system, the ecosystem, even more broadly than just a singular health system, both brick and mortar and digitally. What we saw was a true triage model with respect to patients. We had to guard the acute facilities; in the pandemic, they saw the toughest cases, the sickest patients from a Covid perspective. Someone had to call balls and strikes on where those patients should go and truly defend against the high acuity facility, so they were only seeing the sickest patients. So that put us way out in front of the community. While everything else was closing down, we were ramping up; primary care wasn't seeing sick patients, and everybody else had difficulty with supplies, PPE, and testing. We were really out on the forefront.

In fact, there's a crazy little piece of data. In March 2020, at Go Health nationally, we did 9% of the Covid testing for the entire nation at one urgent care provider. It’s not like we're in all 50 states, at least not yet. So, from that perspective, we just had an immense wave hit us. It was a pretty interesting experience from there.

Sanjula Jain, Ph.D.: You may not have this data off the top of your head. But I'm wondering, did you see a segment of patients who really interacted with the healthcare system and your services for the first time because of Covid, and then now they are starting to engage in other services?

Todd Latz: We did, for sure. We track all of that; we're very data-oriented. We tracked the first-time Covid visit, and we looked at those patients; how frequently do they come back? What did they come back for? There's no question that for our environment, I think this is true of any on-demand, even retail, we saw a huge bolus of what we call a net new patient, someone who hadn't gotten to trial or didn't understand our environment previously.

We do two things; we track how quickly they come back - how frequently do they come back - to us. Then where else do they go within the system once we are at the front door? Then maybe the third piece of it is we look at win-backs with our healthcare partners, that is a patient who was once loyal to the system, primary care might have had surgery, had been seen somewhere once before within the system, but they've been gone for 24 to 36 months. How often do we win them back into the system through our front door? Then we can track that level of engagement for that patient going forward, which gets to a piece that I know you've been tracking really closely, which is patient loyalty. How much are they splitters, and where do they spend their time across multiple different venues?

Sanjula Jain, Ph.D.: Speaking of loyalty, we've talked a lot about the rule that different access points and patient preferences for access play into that beyond what I'll call traditional urgent care; you're also looking at other types of access points. Tell us a little bit more about how you think about that and what you're doing there.

Todd Latz: We would broadly define ourselves as on-demand care. We think about what we offer to the consumer; they get the first and most important vote in terms of what they want us to be. During the pandemic, we did a lot with employers, so a lot more employer-based care, and we had a different need set in terms of access points because the typical places patients would go were shut down. That has parlayed itself into us offering other things. So we've gone pretty deep on the value-based care side, that's with both our health system partners, that's with payers. But behavioral health is probably a great example of that. We didn't set out saying we're definitely going to be in the on-demand behavioral health space. That was customer driven for us. We often had direct-to-employer in the scholastic or educational space need, and a huge need for behavioral health, especially virtual behavioral health. They would come to us and say you're doing this for us on an on-demand care or virtual basis, urgent and primary care. But what about behavioral? So we looked at ourselves and said, hey, we should be able to do this, as well. We're partnered with health systems that really have the high-end acute piece. So, we're taking that first-level and second-level opportunity, and that's a place where there's just a huge gap, supply-demand inequity. We think we can do a lot to fill it.

Sanjula Jain, Ph.D.: You and I spend a lot of time thinking about data trends and all of that. So given everything you're seeing and what you've been analyzing, as you think about the next three years across the health economy, what's a trend that you're seeing that you don't think enough of us are thinking about?

Todd Latz: I think the first piece is the movement to the ambulatory space. That's been going on for really two decades. I think the home, there's a lot of lip service being given, a lot of talk about what's moving into the home. I think a lot of providers and health systems right now, people in our space that are pretty terrified by that the belief is, well, if the care moves into the home, what role will we have to play, I think you know this about us, we're deep believers in omnichannel care. That means you have to have virtual with brick and mortar, and the patient should be able to move seamlessly between those two channels. You can start virtually, come in and be tested for something, and finish that visit virtually.

We think of the home in the same way. So, whether you're home-based testing, there's going to be a whole lot more of that after Covid. Or if you're doing some other type of service, right, you can now buy equipment as a consumer to be able to test yourself in the home; what happens when you have an inconclusive or a positive result? You don't have anywhere to go today.

So we think there's a great play both virtually and with brick and mortar to be effectively the middleware in that equation. So that more is moving to the home, I don't think that's a trend we'll be able to stop, nor do we want to from a cost perspective; that's actually a good thing for the system overall. I think there's a huge role to play in both how you better deliver care in the home, but when it needs to be seen, when that patient needs to be seen, touched, tested, etc., where can you intercede there at a low-cost point versus test at home and then end up in the hospital or in the ED? I think all of us should be spending a whole lot more time thinking about where care is moving and how we play an important role there versus how we keep everything in the place that it's in today. I think that's a pretty time-limited approach.

Sanjula Jain, Ph.D.: That actually made me think of something else. How do you view this shifting dynamic on the testing side as it relates to markets in traditional diagnostics; whether it's lab testing and the Quests and Labcorps of the world, do you see any disruption headed in that market?

Todd Latz: No question. The fact that most consumers today can tell you the difference between an antigen test, a molecular test, and what a PCR is, how different is that from where we were just a handful of years ago? I think that's absolutely disruptive.

A good example, this is a real-time one for us, is RSV. RSV people have, I think, generally known what RSV was, but there's no difference in care if you have RSV; it's going home and taking care of yourself unless you're talking about a preemie right, someone who's younger than six months, certainly not a lot of care differential there.

Before, getting a virus diagnosis was "go home and take care of yourself". Now we have consumers coming in wanting to be tested for RSV. That's an interesting one because there really isn't a differential. Once you have that diagnosis, there's no differential care pathway or treatment plan. But that demonstrates how much consumer demand there is and how much discussion is going on out there amongst healthcare consumers about what types of tests you can get. Then what do you do about that? I think the point-of-care testing will certainly expand well beyond Covid. Then all of that is going to migrate back into the home.

Sanjula Jain, Ph.D.: Well, it'll be fun to track that going forward, like you and I have been talking about some of these things for a couple of years now. It's fun to see the evolution.

Todd Latz: Yes. Well, it's great to be a part of it. I think that the good news here is there's a lot to be done. I think there are some, as you have noted very well, there are dark storm clouds on the horizon if you're just going to execute the model the way it's always been executed. But I think we have time, and the consumer movement is a good thing. We should be happy about that in healthcare. Frankly, the bar historically has been pretty low. You don't have to be amazing out of the gate to be able to improve what we're doing for our patients.

Sanjula Jain, Ph.D.: Well, now we're really in the consumer business.

Todd Latz: That's exactly right. I think we've always been in the consumer business. We're just now coming to terms with it.

Sanjula Jain, Ph.D.: Well, now we have competitors that are much better at it than we are.

Todd Latz: That is absolutely right.

Sanjula Jain, Ph.D.: Yeah. Well, thanks for being with us.

Todd Latz: Yeah. Thank you for having me.