How Hybrid Models in Healthcare Can Work
Jun 21, 2021
Liz Madison
Vector illustration in flat simple style - online healthcare consult doctor and her patient having video call

As society inches its way out into a post-pandemic world, what “lessons learned” will stick? What habits will return like they never left? In some ways, society could be seen at a crossroads, but are industries and services in a place where they can forge their own path?

COVID-19 particularly brought insights to healthcare—most notably in telehealth. Once born out of necessity, video visits and other telehealth options are now readily embraced by patients. But some providers remain curious about what care can look like in the future. Is it in person? Is it virtual?

Why does it have to be either…when it can be both? Hybrid modeling can apply to healthcare, and more versions of it are emerging.

Take for instance, Tera. It is a virtual-first approach to primary care. Patients have a traditional primary care provider with the additional benefits of a dedicated care team, personalized coaching and on-the-go messaging at no additional cost. It was established long before the pandemic, but its model helped reinforce the concept that safe and convenient care can coexist.

“COVID radically accelerated what was there,” said Chris Waugh, Sutter Health’s chief innovation officer. “Tera allows us to go to a patient’s environment versus them coming to ours and depending solely on the answers to a provider’s questions. This allows for broader understanding of what’s happening in their environment and provides a more tailored plan to the challenges of the patient. Do they have support? Kids? A safe place to live?”

Diagram showing a patient in the center who is supported by various clinical team members for their healthcare needsenter

A diagram shows how the Tera program supports a patient’s personal healthcare needs.

Tera first debuted from Sutter’s Design & Innovation team in April 2018 and in collaboration with Yumi Taylor, M.D., and Palo Alto Medical Group. In South San Francisco, she served as the primary care provider, alongside a nurse and a health coach. Together, they have served around 800 patients using video, phone, email messages and in-person visits when needed. This level of access can help reduce the need for in-person appointments, as members can reach out to the care team to ask questions and treat symptoms as they arise.

Bob Wiley, who became a Tera patient in 2020, has benefited from the program’s flexibility and accessibility.

“The health coach program has been so instrumental in helping me to lose weight and improve my health during the pandemic,” the 83-year-old said. “During the pandemic, I always felt safe going into Sutter’s care facilities, but it was nice knowing that I didn’t have to and that I could easily access my Tera care team conveniently from home.”

man with buzz cut sitting at desk talking on the phone

Bob Wiley

Wiley’s health coach found additional ways for him to incorporate exercise into his daily routine after his local fitness club was closed because of COVID-19. While he was sheltering in place, his health coach also provided guidance on ways to reduce sodium from his diet and improve his health through monthly virtual check-ins, helping him lose more than 50 pounds.

Patient satisfaction is a major driver of Tera’s success. Patient surveys show people are highly satisfied with the program (4.9 out of 5) and that they would recommend it to others. Early results of the Tera model also indicate a risk adjusted 23% total cost of care savings. This combination of patient satisfiers and greater affordability is helping propel Tera’s expansion. Since 2018, the model has expanded to three locations with new pods in the Bay Area to help improve access for patients. An additional 42 sites are now planned throughout Northern California over the next five years.

While Tera helps carve out a path in the future of value-based care, the grounding fundamentals of its practice are what keep its approach enduring. Currently, Tera is available at no additional charge for patients with an HMO.

“It’s healthcare that is convenient and highly customizable for our patient’s specific needs,” said Dr. Taylor. “We are guiding our patients and providing personalized support and resources to help them better manage their health.”

Recent Articles