OP’s ModRN Health helps patients find cheaper care, understand insurance plan

by Apr, 2021News

The U.S. spends more money on health care per person than any other country, but it doesn’t translate to top health care rankings, ModRN Health COO Derek Sherry told the Kansas City Business Journal.

“You’ve got to scratch your head and go why is that? You’d think the U.S. would be leading, so what’s going on?” he said.

Founded in 2015, Overland Park-based ModRN Health thinks the core reasons are barriers to care and a complex, confusing system.

“What we want to do is make this idea of bringing health care to the community a mainstay, and right now, it’s not. It gets hung up on all sorts of issues, like health insurance and the plan design,” Sherry said.

ModRN Health aims to break down the barriers and make it easy for members to become engaged in their health.

It can connect members to outside resources, such as financial assistance, help them understand their insurance options and find cheaper prescriptions.

For example, the company helped a diabetic member save $5,200 a year on his prescription medication costs. Another member wanted a vasectomy and found a urologist he liked outside of his network, which would cost $3,000. ModRN Health did some digging and discovered the doctor also performed procedures at a different clinic that’s in-network. The member’s out-of-pocket cost was $500.

If a member needs help finding a specialist, ModRN Health will find out who’s recommended within network and then schedule an appointment, along with checking in with the member ahead of time to answer questions and outline what to expect during the appointment. Through a member portal, patients can receive appointment reminders and view results and care plans.  

Although ModRN Health serves individuals and families, its core customer base is employers. Instead of seeing a rotating base of nurses or doctors, employees are assigned a registered nurse and doctor. That consistency builds relationships. The registered nurse also regularly checks in with patients to find out how things are going, including how a new medication is working out and whether it needs to be adjusted. Response times are rapid — a nurse will answer a request within 15 minutes and can then conduct a virtual or phone call appointment.

Virtual Critical Care

ModRN Health recently was picked to participate in a pilot for the National Emergency Tele-Critical Care Network, a multi-agency federal government initiative to address the need for a rapid response of clinical expertise during disasters such as hurricanes and flooding. The opportunity is recognition of ModRN Health’s skill set, Sherry said. Recently, the initiative has addressed staffing shortages at hospitals with a surge in Covid-19 patients. For the project, ModRN Health hired 55 ICU nurses and trained them to virtually provide their expertise and guide nurses and interns on caring for patients.

“Something like a ventilator seems pretty simple to understand, but it can do a lot of damage if you don’t know how to do the settings,” Sherry said.

The project puts ModRN Health on a national stage and could lead to commercial contracts with hospital systems, he said.