Curai Health, a virtual clinic, is teaming up with California-based Healthcare in Action to serve individuals experiencing homelessness.
Healthcare in Action (HIA) is a street medicine provider offering healthcare services for behavioral health and substance use disorders, navigation and care management for unhoused people in California. Its patients will have access to 24/7, on-demand virtual care using Curai’s app at no cost to the patient. All HIA patients who have phone access can receive Curai services, regardless of insurance status. Most HIA patients are on Medicaid, but about 15% are uninsured, a spokesperson told Fierce Healthcare.
Curai’s visits are primarily asynchronous, though it also supports phone or video visits. The announcement was shown in advance to Fierce Healthcare.
California accounts for more than half of all unsheltered people in the U.S. HIA relies on health information exchanges and laptops with cellular connectivity to check medical records and record services outside the clinic. Its mobile vans also have connectivity hot spots. About two-thirds of HIA patients have phones, a spokesperson told Fierce Healthcare. Patients will only be able to access Curai using a phone.
“There is a shortage of medical providers to support unhoused patients in dire need of medical care,” Michael Hochman, M.D., CEO of HIA, said in a press release. “We are excited to partner with organizations like Curai that will help us find creative solutions to our capacity challenges.”
Curai founder and CEO Neal Khosla had a revelatory moment about care delivery when his mom, who had been discharged from the cardiac ICU at Mayo Clinic, experienced complications. Khosla texted her physician on a Friday evening at 9 p.m. to get her medications adjusted. That’s when it hit him: all patients deserve, but don’t have, that kind of access to care.
“Everybody should have a Mayo Clinic physician they can text,” Khosla told Fierce Healthcare.
Curai, which serves patients in all 50 states, aims to use AI to augment clinicians’ skill sets. Its tools range from AI-based questionnaires to ambient note-taking to AI-powered summaries of patients’ medical charts. In 2020, it began building out enterprise partnerships with the goal of bringing affordable primary care to payers, employers and public-sector organizations.
As a potential collaborator, HIA’s mission and patient population were particularly appealing to Curai’s team, Khosla said.
“They’re trying to deliver care to populations that get nothing,” he said.
By prioritizing getting care to people who need it before they end up in the hospital, HIA is helping everybody win.
“The state ends up bearing the cost for these things anyway. I just think their model is such a better, more proactive way of expanding access to care,” Khosla said.
But because HIA’s patient population has complex needs, handling them all in person is a “very cost-sensitive model,” Khosla said. Instead, partners like Curai can help scale the care HIA is delivering while keeping costs to a minimum.
Khosla is looking forward to demonstrating to local and federal officials that this type of model can meaningfully improve population health.
“People at the bottom of society can’t get access to care,” Khosla said. “Then, the government has to pay more money because they didn’t want to pay less money upfront.”
Much of telehealth delivery today is not appropriate, Khosla believes—it is often video, which is not the most optimal type of telehealth for everyone. Either patients don’t have time for a video call or they are missing the right data plan that supports it. “We think chat and text is a much more appropriate modality,” Khosla said.
Telehealth generally has also not been significantly more affordable than in-person care, in Khosla’s view. That’s partly because many types of televisits have not necessarily made clinicians more efficient. “You’re still paying for 15 minutes of their time,” Khosla noted.
Editor's Note: This story was updated with clarifying details from Healthcare in Action on the insurance status of its patient population and how patients will be able to access Curai services.