Healthcare, while crucial and necessary, is also very big business. According to Insider intelligence reports from January 2023, U.S. national health care spending is estimated to reach $6.2 trillion by 2028 (up from about $4 trillion today), according to the Centers for Medicare and Medicaid Services. In an industry made up of traditional providers such as insurance companies, hospitals and other healthcare providers, it is poised for disruption. One of these disruptions will be home care provided by doctors and nurses, and that’s really happening now.
a McKinsey report dated February 1, 2022 stated that up to $265 billion in medical services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift home by 2025. Why the shift? By 2030, people age 65 and older will make up 20 percent of the U.S. population. About ten years later, this population is expected to double and exceed 70 million people. This means that there will be more elderly people living in the US than ever before. And with various trends such as dying on the spot, mobility issues for the elderly and insurance companies supporting GP visits (lower costs), this shift will accelerate.
To better understand what this shift entails, we looked for entrepreneurs starting home care-focused startups and found one… in Rome, Italy. What follows is an interview with one of the co-founders, Dr. Andrea Guerriero van MedinAction, based in Rome, but the company already serves all major cities in Italy and Spain and is rapidly expanding to other countries in Europe. MedinAction is a healthcare provider that provides English speaking doctors and nurses for home/office visits and online medical consultation for expats, international people working abroad, students studying abroad and holiday travelers.
We recently met to discuss the growing trend of home care services on a global level. Here are his insights and observations of this burgeoning market of home and office services, based on that interview.
Bernhard Schroeder: What is MedinAction? How many doctors and nurses do you use? How many patients does your company see in a year?
Andrea Guerriero: MedinAction is a healthcare provider that employs English speaking doctors and nurses, who provide on-the-spot and online medical advice via our app or website to people who are usually not from the host country. We initially tested the service with just a few patients, learned many lessons, and in 2017 MedinAction was formally launched as a start-up company. Today, we have hundreds of doctors and nurses in our provider network and conduct thousands of patient visits per year.
Schroeder: How does MedinAction work? Where are your services offered?
Guerriere: When you are abroad, it can be difficult to navigate the healthcare and insurance system of the country you are visiting or working. We can usually provide an English speaking doctor or nurse within 1-2 hours and we will see the patient in person or through an online consultation. If, after the medical consultation, we determine that the patient needs a specialist visit or more medical support, we can work with local hospitals to provide the patient with the care they need and deserve.
Schroeder: Why and how does a medically trained doctor create an entrepreneurial startup?
Guerriere: Honestly, I always had an entrepreneurial mindset in high school and medical school, but I didn’t know what to do with it. I discovered that one of my greatest passions was solving people’s health problems with the right solutions. Once I actually started working as a doctor, within the hospital system, I felt I could do more 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 that I had to find my co-founders and prototype the service and app and test the business model that became MedinAction.
Schroeder: What are the types of treatments you provide at home/office?
Guerriere: We do home and office visits, online consultations, GP and pediatrician services, pap smears (Covid and Strep) and even intramuscular injections and blood tests. If more advanced care is required for the patient, we call in additional services from other clinics or even hospitals.
Schroeder: What was it like working with the insurance companies in the early days of the business and has that changed over the last five years?
Guerriere: In the beginning, the insurance companies were unsure about what we are doing and were hesitant to lend their support. However, when the insurance companies realized that what we were actually doing was delivering a higher level of personalized care while reducing overall medical costs, they began to embrace our business model. Today, we have developed mutual and trust-based relationships with the insurance companies, which greatly benefits patients.
Schroeder: What are the company values you also look for when recruiting doctors and nurses for your team?
Guerriere: When we hire doctors and nurses, we always look for highly skilled and qualified people who are passionate about caring for a patient. They also need good communication skills so that they can quickly build a relationship of trust with the patient. And finally, they must be committed 24/7 to a higher level of patient care, without healthcare bureaucracy.
Schroeder: How do you see the home care trend growing over the next five years?
guerriere: Since we founded MedinAction, home and office medical services have grown very quickly. In the US, startups like ours have raised billions in recent years to deliver healthcare to the home or office. Over the next five years, this marketplace will grow from a niche to a much larger market. Technology is driving this growth, as is the aging population around the world. Innovations in telemedicine, the ability to rapidly collect and share data, and the emergence and quality of wireless, IoT, and mobile solutions all combine to fuel this segment of the industry.
Schroeder: What advice would you have for other entrepreneurs looking to improve patient services in healthcare?
Guerriere: First, you should never forget who your customer is, the patient. Second, regardless of technology, people are people and deserve services delivered by kind and caring professionals. Third, this is an evolving and fast-growing market with what appear to be simple human services, but delivered through potentially technical solutions. So understand that you need to constantly adapt your technology solutions and capabilities. And lastly, with the rapid pace of change, you need to be flexible, curious, humble, constantly learning and reading and listening to other experts. All to provide a patient with the most amazing healthcare experience.
‘This interview has been edited and shortened for clarity.’