Direct Primary Care: ZDoggMD, Zappos and Iora Health Change Healthcare in Las Vegas

Downtown Project lands a provider for downtown medical clinic

The doctor enlisted to “help fix health care” in downtown Las Vegas has found a partner for the ambitious venture.

Zubin Damania, recruited last year to Las Vegas by Zappos CEO Tony Hsieh, said Iora Health will be the medical provider for a clinic that could open by the end of the year.

The idea is to provide downtown Las Vegas with a model of direct, primary care that’s paid for like a gym member­ship and focuses on keeping people healthier and reducing trips to specialists that can result in costly and sometimes unnecessary procedures.

Backers say that if it works the model could be expanded beyond the proposed clinic at 701 Bridger Ave. to other parts of the city, including places where low-income residents currently have little access to compassionate and effective primary care.

The key, according to Damania, is a subscriber-based model that for less than $100 per month can offer unlimited access to doctors and health coaches who would see fewer patients than they would under a traditional, insurance-based system.

“You can only practice that way if you have time, space and relationships,” Damania said. “We are going to work on it locally, but we want it to happen nationally.”

Under the plan, Downtown Medical, a company that counts Damania among the investors, will oversee a 7,000-square-foot space occupied by Iora, which will operate the clinic. The space is owned by Downtown Project, the company Hsieh formed to invest in his $350 million urban renewal effort downtown. Downtown Project has also hired Lisa Shufro from TEDMED, which sponsors health theme talks and artistic performances. Shufro will consult on the clinic.

In addition to providing space for Iora to operate, Downtown Medical will act as a conduit to recruit patients and forge partnerships with specialists, hospitals and other medical services.

Patients would pay a monthly fee, which Damania said would be less than $100, in exchange for unlimited access to the clinic, its doctors and health coaches.

In addition to in-person visits, patients could communicate with staff on the phone, by email or by video conference.

Damania said more than 80 percent of a patient’s health care could come through primary care under the Downtown Medical model, because doctors have more time to help patients get well and stay healthy, which reduces the need for specialist referrals.

Because patients are paying cash for care, the clinic has a financial incentive to keep people healthy, as opposed to insurance-based models under which providers are paid for seeing more patients, making referrals or ordering procedures without regard to the outcome, he said.

“We have to take care of you or you walk away. So we want to do everything right for you instead of to you,” Damania said.

At full capacity, the Downtown Medical clinic could serve about 5,000 patients. It will be cash or credit card based at first. Eventually, it could be packaged with insurance plans that want their customers to benefit from the enhanced primary care while still being covered for more expensive specialist services, surgery or other treatment.

The Downtown Medical clinic would be the fifth for Iora, following clinics in Hanover, N.H., Brooklyn, Boston and a Las Vegas location sponsored by Culinary Local 226.

Iora, founded in 2011, received $14 million from several investors, including Hsieh .

Contact reporter Benjamin Spillman at bspillman@review or 702-383-0285 .

Published on July 21, 2013

Related Article on Concierge Medicine Journal featuring Zubin Damania:

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Concierge Medicine Journal (CMJ) curates breaking concierge medicine news, and editorial opinion on a wide variety of topics relevant to the practice of Concierge Medicine.

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