Technology

Taking telehealth to the masses is his Uber-like mission

Scott Decker is CEO of MDLIVE, a national telehealth provider based in Sunrise.
Scott Decker is CEO of MDLIVE, a national telehealth provider based in Sunrise.

When Scott Decker told friends and colleagues in Portland, Oregon, he was going to be taking the helm of MDLIVE in South Florida, they were surprised.

“The outside perception is that there is no technology market down here and that is clearly not the case,” Decker said. Today, MDLIVE, a fast-growing provider of telehealth services, has more than 300 employees and has been growing about 60 percent a year, he said.

The longtime health-tech executive was named CEO of the Sunrise-based MDLIVE in November, succeeding Randy Parker, MDLIVE’s visionary founder and now chief business development officer.

Decker joined MDLIVE with nearly 30 years of experience as both an innovator and health information technology leader. Most recently, he served as CEO at HealthSparq, where he built the industry’s first cloud-based shopping/transparency platform for healthcare consumers. In four years, HealthSparq grew from startup to servicing 70 health plans and 70 million Americans. Prior to HealthSparq, he held CEO and president roles at NextGen Healthcare and HealthVision.

MDLIVE, founded in 2009, was one of the early entrants in telehealth, where the doctor is a click away. The company’s virtual healthcare service covers more than 20 million people for the 2017 health plan year and is on track for 22 million by year end. MDLIVE has raised more than $73 million in venture capital financing, making the company one of the best-funded South Florida tech companies. Nationally, it competes with Teladoc, Doctor on Demand, American Well and others.

22 millionNumber of people expected to be covered by MDLIVE telehealth services in the U.S. in 2017.

Already this year, MDLIVE has launched a new virtual health and wellness package to support the country’s 28 million small businesses that traditionally have a difficult time obtaining affordable health benefits. The offering, MDLIVE Prime, is designed as a cost-effective, stand-alone benefit for businesses that are unable to offer traditional health insurance benefits or as an add-on benefit to traditional health plans, the company said. The package includes virtual doctor visits, including behavioral health, with no co-pay, pharmacy benefits, and second opinion services. MDLIVE couldn’t provide a cost for this service as it will vary widely depending upon the service details selected, but said a virtual care offering typically costs roughly $2 to $15 per employee per month.

MDLIVE also announced this year that it is the first telehealth provider to offer virtual psychiatric services in all 50 states through a network of more than 1,300 mental health professionals, and Decker sees that as a fast-growing part of the business going forward. The market is huge, as about 20 percent of people in the U.S. have a diagnosable mental disorder and current wait times to see a behavioral health expert average 30 days.

MDLIVE also plans to begin offering virtual dermatology visits in a few months.

The Miami Herald interviewed Decker in early April about his transition, the company and the telehealth sector.

Q. You moved from Portland, Oregon, in November. How are you finding South Florida?

A. Portland winters are rainy and cold. Pretty easy transition!

Q. What new set of challenges does leading MDLIVE bring?

A. Most of my background is purely on the technology side, providing technology that helps healthcare organizations be more efficient and effective, and this is combining the two. It’s not only the technology of how do we make it easier for consumers to get to doctors, but in reality we are also running a very large physician practice on the back-end at the same time, where we have more than 1,800 licensed physicians and therapists in our network. It’s marrying those two things together in delivering healthcare in a way it hasn’t been delivered before.

I fully expect that three or four years from now when we are talking, [telehealth] will be as common place as Uber is for how people are getting healthcare delivered.

Scott Decker

Q. Do you think telehealth has lived up to its expectations so far?

A. I don’t know that it has lived up to its expectations, but expectations are low because I think most people still don’t even know the service exists. In a lot of respects I equate it to my early days using Uber. I was an early adopter and I can still remember sitting on a corner in Washington, D.C., and having to wait 20 minutes to get a car because there weren’t enough drivers yet. And we were thinking, ‘Is this really living up to expectations, is it really going to take off?’ That’s where we are in telehealth right now, we are just in the very beginnings of it.

I fully expect that three or four years from now when we are talking, [telehealth] will be as common place as Uber is for how people are getting healthcare delivered. The customer satisfaction level we get of consumers who do use it is off the charts compared to traditional physician visits.

Q. What trends do you see in the sector?

A. We are starting to see adoption pick up fairly dramatically. On an average day, MDLIVE now sees about 1,200 patients a day, whereas a year ago it was half that amount. The bigger trend is we are seeing consumers get comfortable with the basic things we have traditionally [addressed], like ‘I have a sore throat or a UTI.’ We now have launched behavior health services; we’ve launched psychiatry services; we will soon be launching dermatology services. What you are starting to see as we get consumers comfortable with the concept is that we can expand to more and more things that make more sense to do virtually rather than burdening the consumer to go to a physical facility.

Q. Virtual psychiatry — how big a part of your business is that and what is its potential?

A. It’s about 10 percent of our business now. I think its market is tremendously untapped. It could be as big as our core business over time, and it probably fits our model even better than a basic physician office visit. A virtual visit can take away the stigma that has been associated with behavior health issues.

Q. You recently launched a new mobile health platform. What does that bring you that you didn’t have before?

A. We’ve now made it a completely native application — so you get a complete iOS or Android based experience. We’ve incorporated a brand new video conferencing capability that is getting really good reviews from consumers.

Q. What do you see ahead as the biggest opportunities for MDLIVE?

A. We are on the way, to be honest. The opportunity for us is to take advantage at what I think will be a commonplace way to see physicians in the future and making sure that happens sooner rather than later.

Q. Do the new healthcare proposals out there help or hurt telehealth and MDLIVE specifically?

A. The shift toward value-based care as opposed to fee for service just helps us more and more because people are looking for more efficient, cost-effective ways of providing care to broader populations. We definitely fit that bill. There is nothing in the changes that are occurring that we see as a headwind for us, really only tailwind. Generally in the market, what is helping us more than anything right now is two or three years ago, almost no insurers covered telehealth visits. We are well down the path and probably only a year away from almost all health plans covering telehealth as a core benefit. That is probably the biggest barrier that will come down for us.

Q. Can you tell me more about your recent growth?

A. MDLIVE has been trending the last few years at a 60 percent growth rate and does not see anything slowing that down over the next few years. MDLIVE is up to about 300 employees in the company, and more than two-thirds are in South Florida.

Q. Are you fund-raising?

A. Yes. We’re in that high-growth stage, so part of that is to always be out making sure we have the capital in place to take care of that growth.

Q. What sets MDLIVE apart from competitors?

A. For us, it is a lot about customer service and also scale. There are a lot of startups in this space, but I think if you are really going to be delivering care 24/7 365 days a year in 50 states, it’s a pretty big game and you need a big infrastructure to do that. We are clearly one of the companies that has scaled up in this space, and as I was saying, we have really put an emphasis on the customer service side of things, and the feedback we get is that is resonating well, and that’s both in our internal people and also training our physicians in a new way of taking care of patients in the virtual world.

Q. What are some other areas MDLIVE is looking to get into?

A. We have a new offering for small employers, which gives them a packaged opportunity to get access to these services. A lot of times the benefit we provide doesn’t come in the regular health plan package so we give access to these kinds of services with an all-you-can-eat model even for a lot of the small employers. For a small monthly per-employee fee, the employees can get access to as much of our network as they need. That’s a new program we are putting together and it is getting good reception in the market.

Traditionally we work with Fortune 1000 companies, and more and more health plans are working telehealth into their benefits, but a lot of that doesn’t flow down to the small employers.

Q. And you are getting into dermatology?

A. We are launching that later this summer. That’s kind of an obvious one, right? You don’t necessarily need a live visit. You can share pictures of what you are concerned about with the physician network and they can get back to you.

Q. What are some of the qualities a leader should have?

A. Making sure it is really clear to everyone in the organization where you are trying to get to, especially in technology and a high growth market where the future isn’t clear. The second is building a great team; it’s about surrounding yourself with the right people. Already I’ve been pleased with the market in South Florida, the high diversity in the workforce of executive and team players we have been able to bring aboard.

Q. What was the best advice you’ve received and from whom?

A. ‘Always try to find opportunities that can provide five years of experience every year … rather than the opposite.’ That was from my first branch manager at IBM.

Q. What is one thing colleagues may not know about you?

A. I worked on a project for NASA in college analyzing atmospheric data collected by the Voyager spacecraft as it passed Mars.

Q. How are you finding talent in South Florida?

A. I’ve been pleasantly surprised. As soon as I started telling folks I was moving to South Florida and I was hearing, ‘oh my gosh, how are you going to run a tech company down there?’ it’s been anything but. There is probably a cap to it, but for a company this size there is definitely enough talent down there and a great university system to feed into it. We may have to do a little more training to get people onto the top technologies, but I have found there is a hunger for that. We have worked with a lot of incubator and training facilities down here to make sure they are helping us feed our future growth. On the executive side, there are some really talented healthcare and technology executives I have been able to tap into in the local markets. And recruiting up north in the winter does have benefits.

Q. Are you hiring now?

A. Always. We are looking for technical people to customer service to sales and marketing. We are always looking for talent.

Q. Do you have any observations on what could make South Florida a stronger area for healthcare technology?

A. It will feed on itself; it’s an emerging market. What it needs are some good winds and that will attract more talent. The biggest barrier right now is just perception. The outside perception is that there is no technology market down here, and that is clearly not the case. So I think a little bit of PR will help and a few of us need to be wildly successful. So we’ll work on both.

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Scott Decker

Title: Chief executive officer, MDLIVE

Executive experience: President of HealthSparq, president of NextGen Healthcare Information Systems Inc, founder, CEO and president of Healthvision, VP of development at VHA Inc.’s Health Information Technologies business unit, and CEO of U.S. Carelink.

Education: Bachelor’s degree in computer science from Trinity University in San Antonio, Texas.

Books he recommends: ‘Shoe Dog’ and ‘The Emperor of all Maladies: A Biography of Cancer’

Favorite stress reliever: Mountain or road biking

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