Stu Clark, Chief Executive Officer, Premise Health
Stu Clark, CEO of Premise Health, spoke with Invest: about major shifts in traditional healthcare models and how improving employee health can directly improve a company’s bottom line.
What shifts or trends over the past year have most impacted Premise Health’s trajectory and in what ways?
Over the past year, one of the most significant shifts has been the evolution away from fee-for-service and volume-driven models. Premise Health operates on a different paradigm — we’re not paid by insurance companies; rather, we are paid directly by large employers, unions, and municipalities that have elected to invest in the health of their people through onsite or nearsite wellness centers. Our focus is on managing the health of employers’ workers and their families through advanced primary care, which encompasses family medicine, pharmacy delivery, behavioral health, care management, and care navigation. Essentially, we manage the patient’s health journey throughout the entire care ecosystem. Contrasting this with traditional healthcare, which is often “treat ’em and street ’em,” our approach is centered on comprehensive, continuous, and personalized care.
The most profound change nationally has been the decline in overall physical health. People are generally sicker today, and costs associated with treatments are rising sharply for both employers and families. As such, healthcare costs have shifted from a primarily HR concern to a CFO-level issue as one of the most expensive line items affecting company profitability. It’s become an earnings-per-share issue.
Furthermore, the ongoing shortage of healthcare providers is a looming challenge — projections indicate that by 2035, the country will face a shortfall of approximately 50,000 primary care doctors. To address these trends, Premise has doubled down on primary care because it’s less expensive, more sustainable, and effective in reducing downstream costs while improving overall health. In our model, we establish large onsite and nearsite health centers for major employers and organizations like unions, where we serve as their designated primary care providers. This enables us to treat the whole patient effectively and proactively, while actively directing them to the right specialty care in the community.
How would you characterize demand for new models like yours and what key trends are playing out in this market?
Demand for quality healthcare has never been higher, and we’re seeing a surge in interest from large employers and unions to invest in primary care solutions, which is a direct response to rising healthcare costs and the need for better health outcomes. Employers are increasingly recognizing that a healthier population results in significantly lower costs over time, through reduced medical expenses, not to mention increased productivity and retention. Ultimately, the organizations we work with want to decrease reliance on costly and avoidable specialty and emergency care, which often results from delayed or inadequate preventive care.
The typical $120 million health plan (that is, an employer that spends that amount in a year) with a 10% annual increase is unsustainable for organizations. High-value, easily accessible healthcare is not just a nice-to-have anymore — it’s a financial imperative as improving employee health can directly improve a company’s bottom line. So this shift has primarily been driven by the critical need to control costs and create much needed access to primary care.
Premise Health recently partnered with Centivo to launch a primary care-centered health plan. What challenges does this solve for employers and employees looking for better solutions for their health benefits?
Our partnership with Centivo exemplifies our strategic move into alternative healthcare plans centered around primary care. Currently, with existing high-deductible plans, employees often face deductibles that are prohibitively expensive — almost always reaching into the thousands of dollars. This makes access to timely, quality care difficult, and results in both delayed treatment and worse health outcomes. By offering a plan that is significantly less costly, we alleviate the financial barrier.
This plan design builds on the foundation of a designated PCP by coupling that care with virtual elements and streamlined access to specialist care within the community. When members need specialized services, we know exactly which providers in the community deliver high-quality care and can coordinate appointments for them. This is accomplished by utilizing our technology and data. Essentially, instead of a fragmented and often costly approach, we provide an integrated, accessible, and affordable primary care solution — one that feels more like an added benefit, rather than an added expense. This approach helps employers reduce healthcare costs while simultaneously enhancing employee well-being and satisfaction. It’s a win-win scenario that addresses the core needs of both groups.
Premise Health also partnered with the National Coalition of Labor Partnership in recent years. Can you explain this partnership you have with the NCL?
One of our most gratifying initiatives has been serving American unions as it allows us to provide accessible and comprehensive care to populations that often face barriers to accessing quality healthcare. These workers aren’t just walking into a clinic and seeing a doctor for everyday concerns — they are also receiving care needed for health issues related to their line of work. For example, incorporating physical therapy and chiropractic care — both critical components of preventative and rehabilitative health — is key to helping union members stay well. That said, behavioral health is in great demand across the country, and that is certainly true for the trades and their families, as well. This is why behavioral health is an important part of our advanced primary care model.
Our goal is to build health centers within these communities that are affordable and accessible, ensuring that members can get the continuous, proactive care necessary to prevent more serious health issues down the line. Our partnership with the National Coalition of Labor aligns perfectly with our strategic emphasis on preventative care, integrated health management, behavioral health, and affordability. By combining personalized and accessible primary care, we aim to improve health outcomes, reduce unnecessary costs, and foster a healthier, more resilient member and family.
What’s top of mind for Premise Health now and what’s the five-year outlook for Middle TN’s healthcare industry?
We continue to focus on evolving our advanced primary care and primary care-centered health plan products, and we’re coming off a three-year period of heavy investment in data and technology. Our efforts are centered around utilizing our data to effectively identify patients who need more care and ensure that they receive it. Our goal is to fully leverage and deploy these advancements to enhance our service delivery.
We are also committed to recruiting and retaining top talent for both our corporate offices and centers across the country. We are proud to be recognized as a Tennessean Top Workplace for the tenth consecutive year, reaffirming our position as one of the top healthcare companies in the state. Our organization has earned a spot on Fortune’s Best Workplaces in Health Care list for five consecutive years, which significantly aids in our ability to recruit the best talent in the area. There is an abundance of healthcare talent available here, more than in any other location, and we are truly honored to have our operations based in Nashville.
