Writer: Max Crampton-Thomas
2 min read July 2021 — Nashville is the epicenter of the US healthcare industry, said Stu Clark, CEO of Premise Health, in an interview with Invest:, adding that in addition to being the bedrock of the health services industry, Nashville has become a national hub for healthcare IT, data, and security companies of all sizes, from start-ups to large established firms. Management talent, access to capital and a strong networking community is very attractive to firms looking to relocate or to launch, he said.
What differentiates Premise Health from other healthcare providers?
Premise Health is not a volume-based, fee-for-service provider. We have been quality-driven and outcome-driven since our inception because if we do not improve the health and well-being of our client populations, and therefore help them control total spend, then we’re not doing our job. In our world, higher volume is better for the patient and for the client because it gives us more patient contact, creates opportunities to navigate them to the highest quality providers, and allows us to take accountability for the whole patient.
When a member walks through the door, our goal is to not just treat their earache but to use the interaction to have a bigger conversation about their overall health. The real costs in healthcare are related to lifestyle and family history, which is why our approach centers on how people are living and what they inherited from their parents. If we can begin to attack those two categories, we can improve the lives and well-being of people and save their employers money. The traditional fee for service system is not aligned in that manner, and its accountability is questionable. Value-based care is coming quickly to commercial healthcare.
In what ways are your digital wellness programs helping transform the way in which healthcare is viewed and implemented?
The pandemic accelerated by two to five years the use of data, claims, and engagement tools to identify, stratify, engage and measure results of patient populations. The delivery of preventive health, chronic condition monitoring, and behavioral health through virtual means grew by orders of magnitude, and there is no going back. Patients and providers are much more comfortable using these tools today than they were 18 months ago, making this a very exciting time to be in the digital healthcare space. While engagement is an overused word in the industry, there is no doubt that we have more opportunities now than ever to engage people in their health – and the commercial healthcare sector is in the early days of the development and use of engagement tools.
At Premise, our clients are self-funded organizations, often employers in the Fortune 1000, as well as midsize employers in municipal and state government sectors as well as some smaller employers. All of these organizations share a big fear – that pent-up demand will explode their total healthcare spend this year and in the next several years. With our ability to deliver care either digitally or physically, our mission is more relevant than it’s ever been in the 30 years I have been doing this. All of this is driving demand through the roof for direct primary care that includes a broad product line spanning both in-person and digital delivery models.
Would you say digital is a component of the healthcare cost-reduction equation?
Without question. When looking at cost concentration and population health, to date, 5% of healthcare service members account for 60% of annual spending. In a fee-for-service model, the predominant model in commercial healthcare, you are there for a specific reason. The provider comes in, executes on the reason for that visit, and you are out. In Premise’s world, we talk about lifestyle, family history, behavioral health, what is going on at home during COVID, obstacles to care, social drivers of health status, and more. These are things that the primary care model in this country is not set up to address. We have a comprehensive relationship with the member. Our platform technology interacts with thousands of personal devices, which enables monitoring and can trigger intervention by our providers before an adverse event occurs. The combination of the physical relationship that has been established, and the trust that is endemic to it, along with our tech-enabled digital ecosystem, allows provider and patient to be more engaged and more proactive. This both improves health and lowers costs.
What is your near-term outlook for Premise Health and the overall healthcare industry?
Premise is growing quickly because demand is beyond anything that we could have ever imagined. What used to be a benefit of employment or a nice-to-have benefit back in 2016 is now a standard offering if your organization is above a certain size. We truly believe commercial healthcare is going to pivot to value-based care and accountability quickly. That has all kinds of implications for use of data, analytics, tech-enabled processes, digital engagement and how we incorporate these tools with the physical practice of medicine, nursing, pharmacy, physical therapy, fitness and all the things that we do.
There is no doubt: employers cannot sustain the rates of increase year-over-year that are likely to occur. Hope is not a strategy. The deteriorating health status of the American public is a known fact, we have all seen the data. Employers are faced with a cost within their business that is unsustainable and undermines their competitiveness. The silver lining is that COVID served as a forcing function for the healthcare industry to become more efficient and more digital. Premise will have a broader appeal and will play a disruptive role in the commercial cost of healthcare in this country.
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