Cape and Schwietzer are not the first entrepreneurs to hone in on this problem.
A movement called direct primary care involves charging consumers a subscription fee for access to high-quality doctors, mostly in person. Direct primary care makes up less than ten percent of physician practices, but the Trump administration is now asking how it could help fund some of these practices for vulnerable seniors on Medicare.
Other start-ups are trying to increase access to primary care by experimenting with virtual-only approaches, such as smartphone apps to connect doctors and patients, like Doctor on Demand or AmericanWell. In general, insurance pays for these services, or they charge patients a fee of $40 to $50 per visit.
But 98point6 believes it’s onto something different by blending these two worlds, and leveraging technology to bring down the price. It now offers a messaging service for patients and doctors to connect at an introductory price of $20 a year with no additional fees for a visit (after the first year, it costs $120).
The subscription model can also help patient health by supporting an ongoing relationship between doctor and patient, Cape believes. “Our hope is that will engage with our users literally every month about something related to their health,” he said.
Apart from the price tag, the big draw for consumers is the ability to message a doctor at any time, Cape believes. As more consumers start to use it, that will cut down on the administrative work that is “burning out” doctors, potentially turning them into advocates for the product.
One example is the 98point6 assistant, essentially a bot, that conducts about half of the initial interview with the patient and presents that information to the doctor (Cape expects that percentage to increase over time, as the technology gets smarter).
98point6 is also pushing to get companies to cover the service.
The company told CNBC that about 50 self-insured employers have signed up so far, ranging from Seattle Children’s Hospital to Washington-based Red Lion Hotels. Cape said that the utilization rate for their service, meaning the percentage of employees who take advantage of the benefit, is higher than most at about 6 percent (the average for telemedicine hovers around 2 or 3 percent for a number of reasons, including a lack of awareness among employees).
As a result, growth is starting to take off. The company said it now has 160,000 members, either enrolled through their employer or paying for it out-of-pocket. As of January, it’s licensed to practice medicine in all 50 states plus Washington, D.C.
Cape recruited another Amazon cloud vet, Damon Lanphear, to run the technology team. It has also hired 16 doctors, including a chief medical officer who still practices, Brad Younggren. A former Surgeon General under the Obama administration, Regina Benjamin, now sits on its board.