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Healthcare at Any Address: Why We Must Reimagine the Broken US Healthcare System

Dr. Stephen Klasko is a healthcare executive, former CEO of Jefferson Health, Executive in Residence at General Catalyst, and Independent Chair of the Board at DocGo.
Image Credit: Thomas Jefferson University Sidney Kimmel Medical College Alumni Bulletin (Winter 2022)

Sesame Street, the TV show, did not hurt books. Yes, it was on television, competing for the attention of children across the globe. But far from depressing the book industry, it gave those children the tools to use more books effectively. Today, I’d call Sesame Street a perfect example of non-disruptive creative change.

I believe the same is true of DocGo and the Proactive Healthcare Revolution to deliver “healthcare at any address.” Like Sesame Street, this movement is designed to give people the tools they need to use healthcare more effectively.

Creative change will be our country’s way out of a system that today makes too many people frustrated, confused, and angry – patients, employers and clinicians.

As a healthcare leader and physician of almost 50 years, I’ve witnessed our system’s reluctance to transform firsthand. While serving as CEO of Jefferson Health, one of Philadelphia’s largest academic health systems, I came to a stark realization: the old math model in healthcare was doomed.

This traditional model, built around the in-person hospital or doctor visit, simply cannot sustain itself. Healthcare systems continue investing billions in buildings and beds while patients increasingly demand convenience and accessibility. Operating margins are shrinking, staffing costs are skyrocketing, and the pandemic exposed how fragile facility-based care truly is. Meanwhile, digital innovators are eating away at the most profitable segments of healthcare via virtual visits, leaving hospitals with complex, money-losing services.

Years ago, while on an advisory group for Apple, Steve Jobs said something that stuck with me: “I don’t want to waste time going from 4% to 6% of a commoditized market.” That insight fundamentally changed my thinking about healthcare innovation and how we can improve the system.

From Hospital-Centric to Patient-Centric Care

At Jefferson, instead of following the traditional hospital expansion playbook, we went back to first principles. We started asking a simple question: how do we get quality care to where people are?

As a result, we invested $35 million in telehealth back in 2013, a bold and seemingly reckless step at the time. Yet we weren’t trying to compete with the University of Pennsylvania health system in a commoditized market. We wanted to think like a startup.

Let’s be clear: if a patient has pancreatic cancer, they must come to the hospital. But for less acute conditions, patients don’t need to visit an office or urgent care facility, both money losers for many systems. Patients can access the necessary care in the comfort of their home or via telehealth.  This is the essence of the “Healthcare at Any Address” model: care where you need it, when you need it. It’s about defining a health system by the quality of care you provide, not by where you provide it.

Change is Overdue

Today, 40% of health systems are still losing money because nonprofit boards don’t want to try anything new. They’re just watching their systems slowly decline into obsolescence.

This isn’t working for patients. People think the healthcare system is purposely designed to make access complicated. And they’re not entirely wrong. The system is incredibly fragmented and fundamentally resistant to change. The uncomfortable truth, put humorously, is that we have Star Wars-like capabilities paired with a Fred Flintstone delivery model.

Take the concept of “value-based care.” It’s largely a myth. Value-based care is supposed to be a healthcare delivery model where providers are paid based on patient health outcomes rather than the volume of services delivered. In theory, it incentivizes quality over quantity. However, you would be hard-pressed to find a large health system where more than 20% of revenue is truly value-based. Everyone claims to want it, but few are really implementing it.

Each sector of healthcare is geared toward maximizing profits for hospitals, payors, and pharma; not patients. These individual and often amazing institutions are not to blame. It’s a fundamental misalignment of incentives. Let’s face it, when your industry gets to the point of being satirized in South Park, it’s painfully obvious to everyone that change is overdue, and until we transform payment models, we’re facing an uphill battle.

Reasons for Optimism

Despite these challenges, there are reasons for optimism, especially around staffing shortages and AI.

At General Catalyst, we’re exploring “infinite staffing” with companies like Ellipsis Health and Hippocratic AI. Rachel, the AI nurse, can place check-in calls to seniors every week. AI can help radiologists achieve near-zero error rates. We’re also seeing AI being used to predict suicide attempts in depressed patients. NeuroFlow, for example, can predict depression or suicide risk with 90% accuracy.

Of course, providers are skeptical. Health tech has made a lot of empty promises. But generative AI and modern machine learning may finally deliver the transformation we’ve all been waiting for. That’s why General Catalyst acquired a health system in Akron: to prove we can use AI and other tools to make medicine more efficient and make providers’ lives easier.

A New Model for Healthcare Delivery

Companies like DocGo offer a best-of-both-worlds model and exemplify this future. By facilitating care in patient homes, the company is able to get a clearer picture of social determinants of health.   For example, while providing an annual wellness visit, clinicians can notice if there is mold in the home – identifying a root cause issue that can help fundamentally improve the patient’s health, which is also a benefit for insurers and health systems. Even in today’s environment, DocGo can arrange for high-quality care at a lower cost, helping hospitals and payors avoid higher-cost inpatient interventions and improving access for patients.

In a future where incentives are more aligned and organizations like DocGo can be everything between the hospital and the home, I believe there’s a trillion-dollar opportunity here.

The Future is at Any Address

It will take true determination to reform our healthcare system. We must move beyond our hospital-centric model toward one that delivers care wherever patients are.

The future of healthcare isn’t found in gleaming new hospital towers. It’s in our homes, our communities, and our smartphones. It’s healthcare at any address, delivered with quality, compassion, and efficiency.

There’s no question whether this transformation will happen. It’s whether traditional healthcare institutions will lead it or be left behind.