Bridging the Gap between PCPs & Specialists

Gil Addo, CEO of RubiconMD https://www.rubiconmd.com and Co-Founder and Carlos Reines President and Co-Founder, were hosted at a recent small group investor meeting in New York City as part of Credit Suisse’s https://www.credit.suisse.com “Healthcare Disruptive Technologies & Innovations” series.

Launched in 2013, the RubiconMD platform is based on building a bridge between Primary Care Physicians (PCP) and specialty care. The platform enables PCPs to easily discuss their e-consults with top specialists via email and text.

With respect to workflow, the company markets the service to customers with a guaranteed response of less than 12 hours, however, the actual average total response time is closer to three hours. The company reports that reducing the response time any further would not really matter, unless the response time could be lowered to less than an hour and the PCP receives the response when the patient is still with the PCP.

RubiconMD currently covers PCPs in 37 states, has 300 specialists on their platform, and employs 40-50 FTEs (two doctors and two physicians are on the staff.) Medicaid along with other low cost coverage, is one of the company’s key markets since the company believes barriers to specialty care such as transportation and cost are exacerbated in those communities One third of physicians are highly engaged every week, one third use the service once in a while, and one third are not using the service often.

Most of the volume for RubiconMD comes from their web-based platform. The Company’s platform is also integrated with EHR platforms such as NextGen and Cerner’s. The platform is mobile enabled with most specialist responses coming via texts.

The company notes that in 90 percent of the cases, a PCP does not need to use the company’s platform. The platform is for the 10 percent of the cases that are more complicated when a PCP is trying to get more information to find the best solution.

The company reports that while their platform covers 120 specialties, roughly ten specialties take 70 percent of the total volume. Some frequently used specialties include dermatology, cardiology, endocrinology, gastroenterology, oncology, neurology, OBGYN, and orthopedics.

Based on feedback from PCPs, about 50 percent of the time, RubiconMD removes unnecessary specialist referrals. On average, the company sees 3-4x ROI for a customer and approximately $500 in savings and consults since not as many specialist visits and/or unnecessary services such as diagnostics and imaging are required.

The company delivers their services to providers and health plans and very rarely deals with employers directly. The customer attrition rate has been very low, and the only customers the company has lost are companies going out of business. Most plans RubiconMD works with are regional plans but the company also has contracts with four of the five largest health plans that have the ability to expand to increase penetration among existing customers.

As for the use of telemedicine, RubiconMD sees some potential competition from hospitals building out telemedicine capabilities. However, the company notes that their platform offers specialists a unique opportunity because their service gets cash right into their pockets and allows for more flexibility. The company notes when using telemedicine there is red tape in the service and how the specialists are paid. However, the company believes that telehealth services are becoming more commoditized not only in the marketplace but to the individual consumer.

Contact Research Analyst Jailendra Singh at jailendra.singh@credit-suisse.com for more information and/or feedback.

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