Doctor making a house call for an elderly patient and delivering healthcare services.
Healthcare, while critical and needed is also very big business. According to Insider Intelligence reports from January of 2023, the US national healthcare expenditure is estimated to reach $6.2 trillion by 2028 (up from around $4 trillion today), per the Centers for Medicare and Medicaid Services. In an industry made up of traditional providers like insurance companies, hospitals and other healthcare providers, it is primed for disruption. One of these disruptions will be home-based healthcare provided by doctors and nurses and it is actually happening right now.
A McKinsey report from February 1, 2022 stated that up to $265 billion worth of medical services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift to the home by 2025. Why the shift? People who are 65 years old and above are going to make up 20 percent of the U.S. population by the time 2030 rolls around. About a decade after that, this population is expected to double and consist of more than 70 million people. This means there will be more elderly people living throughout the U.S. than ever before. And with several trends like dying in place, elderly mobility issues, and insurance companies supporting the home doctor visits (lower costs), this shift will be accelerating.
In order to better understand what’s involved with this shift, we looked for entrepreneurs creating homecare focused startups and we found one…in Rome, Italy. What follows is an interview with one of the co-founders, Dr. Andrea Guerriero of MedinAction, which is located in Rome but the company is already serving all the major cities in Italy and Spain and expanding quickly to other countries in Europe. MedinAction is a healthcare services provider that provides English speaking doctors and nurses for house/office visits and online medical consultation for expats, international people working abroad, students studying abroad and vacation travelers.
We met recently to discuss the growing healthcare services at home trend at a global level. Here are his insights and observations of this rapidly expanding market of home and office services healthcare based on that interview.
Bernhard Schroeder: What is MedinAction? How many doctors and nurses do you utilize? How many patients does your company see in a year?
Andrea Guerriero: MedinAction is a healthcare services provider utilizing English speaking doctors and nurses, who via our app or the website, provide onsite and online medical consultation for people who are usually not from the host country. We initially tested the service with just a few patients, learned a lot of lessons and in 2017, MedinAction was formally launched as a startup company. Today in our provider network, we have hundreds of doctors and nurses and we perform thousands of patient visits per year.
Schroeder: How does MedinAction work? Where are your services offered?
Guerriero: When you are in foreign country, it can be difficult to navigate the healthcare and insurance system of the country you are visiting or working in. We can provide an English-speaking doctor or nurse usually within 1-2 hours and we will visit the patient either in person or via an online consultation. If after the medical consultation, we determine the patient needs a specialist visit or more medical support, we can collaborate with the local hospitals to help get the patient the care they need and deserve.
Schroeder: Why and how does a medically trained doctor create an entrepreneurial startup?
Guerriero: Honestly, I always had an entrepreneurial mindset in high school and during medical school but did not know what to do with it. I found one of my biggest passions was to solve people’s healthcare problems with the right solutions. Once I actually started working as a physician, within the hospital system, I felt that there was more I could do to help patients. The question I asked myself is instead of helping 15-20 patients a day, how could I help thousands? The answer to that question was for me to find my co-founders and build a prototype of the service and app and test the business model that became MedinAction.
Schroeder: What are the types of treatments you are delivering in the home/office?
Guerriero: We do house and office calls, online consultations, General Practitioner and Pediatrician services, swab tests (Covid and Strep) and even intramuscular injections and blood tests. If more advanced healthcare is needed for the patient, we bring in additional services from other clinics or even hospitals.
Schroeder: What was it like to work with the insurance companies in the early days of the company and has that changed over the last five years?
Guerriero: At first the insurance companies were unsure about what we doing and were hesitant to provide their support. However, once the insurance companies realized that what we actually doing was delivering a higher level of personalized care while reducing the overall medical cost, they began to embrace our business model. Today, we have developed mutual and trust-based relationships with the insurance companies and that benefits the patients greatly.
Schroeder: What are the values of the company that you also look for in recruiting doctors and nurses to your team?
Guerriero: When we recruit doctors and nurses, we always look for very highly skilled and qualified people and that they are passionate about caring for a patient. They also need good communication skills so that they can quickly build trust with the patient. And last, they need to commit to a higher level of patient care, without the healthcare bureaucracy, on a 24/7 basis.
Schroeder: How do you see the trend of home-based healthcare growing in the next five years?
Guerriero: Since we founded MedinAction, the home and office medical services industry has grown very rapidly. In the USA, billions have been raised by startups like ours over the past few years to deliver healthcare services in the home or office. In the next five years, this marketplace will grow from a niche to a much bigger market. Technology is driving this growth as is the aging population across the world. Innovations in telemedicine, the ability to rapidly gather and share data and the emergence and quality of wireless, IoT and mobile solutions all are combining to fuel this segment of the industry.
Schroeder: What advice would you have for other entrepreneurs looking to build better patient services in the healthcare industry?
Guerriero: First, you must never forget who your customer is, the patient. Second, no matter the technology, people are human and deserve services delivered by kind and caring professionals. Third, this is an evolving and rapidly growing marketplace with what seems like simple human services but delivered through potentially technical solutions. So, understand you need to constantly adjust your technology solutions and capabilities. And last, with the rapid pace of change, you need to be flexible, curious, humble, constantly learning and reading and listening to other experts. All to deliver the most amazing healthcare experience to a patient.
‘This interview has been edited and condensed for clarity.’