Everside Health, Marathon Health merge to enhance advanced primary care access

2024-02-08

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Everside Health, Marathon Health merge to enhance advanced primary care access

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来源: FierceHealthcare

At its core, the merger's resulting care model is designed to let providers spend more time with patients and create positive, long-term behavior change.

Everside Health and Marathon Health announced the closing of their merger to enhance access to advanced primary care in a value-based model.

The two companies serve employer and union-sponsored clients with primary care, mental health, occupational health, musculoskeletal and pharmacy services. Marathon Health is based in Indianapolis while Everside Health operates out of Denver. Their combined reach is 2.5 million eligible patients through more than 680 health centers across 41 states and virtually in all 50 states. Together, they will operate as Marathon Health.

“There’s been a lot of mutual respect and admiration for each of our organizations,” Marathon Health CEO Jeff Wells, M.D., told Fierce Healthcare. “There’s a ton of alignment in our core values.”

After discussing the possibility of a strategic combination in early 2023, the companies decided together, they could accelerate their vision and the value they bring to stakeholders, Wells added.

Apart from strengthening the financial profile of the business, the combined scale will facilitate more regional and national partnerships, enabled by each organization’s knowledge of local healthcare ecosystems that can improve referrals and customer experience.

“Healthcare at the end of the day is local,” Wells said.

The merger will also unlock investment capacity to better support clinical teams and improve the patient experience and enhance Marathon Health’s ability to recruit top talent and enable closer proximity to local leadership support for clients.

At its core, the care model is designed to let providers spend more time with patients and create positive, long-term behavior change. When appropriate, its centralized concierge referral team leverages an AI tool from Garner Health to direct members to external specialists that are of higher value. Marathon also has an e-consult partner, RubiconMD, that lets its providers ask top-tier specialists for advice and eliminates the need for a potentially unnecessary and costly referral.

All of the combined organization’s physical centers have tools to enable virtual care when needed. Additionally, it offers a nationally scaled, dedicated virtual primary care team licensed in all 50 states to support remote employees that aren’t near in-person sites, Wells said.

It is not a transactional or urgent care-type model, but “really designed the same way that all of our care teams are — it’s relationship based, comprehensive or advanced primary care,” Wells said.

Two-thirds of members who engage with Marathon from six months to a year see objective progress in their symptoms, Wells said. And each member costs an estimated $2,000 less a year when cared for by Marathon.

The combined organization hopes to increase employee and union-member access to better outcomes and lower costs through a value-based care model. Members pay a fixed fee to access Marathon services, and the company is accountable to drive value, not volume, per Wells. It has some downside risk-arrangements.

“There’s just far too many people across the country today who have too much pain. …The current model is just not designed to address that whatsoever,” Wells said of fee-for-service.

The members Marathon works with are diverse, including younger and older, rural and urban, and those with language barriers and low health literacy, Wells highlighted. As such, the provider has had to get good at identifying and solving for the social determinants of health.

“We have resources depending on the nature of the given client and team that we’re working with,” Wells said. Some SDOH resources are in-house, while others can be drawn from the community.

The integration of the two companies is expected to be completed within the next year. “We’re excited about the combined growth prospects and have a laser focus on that integration plan over the next six to 12 months,” Wells said.

Everside was created from the merger of Paladina Health, Activate Healthcare and Healthstat and changed its name in 2020. Investors include Oak HC/FT, NEA, Endeavor Catalyst and Alta Partners.