In the heart of Downtown Las Vegas, there was a unique primary care practice that offered an affordable and comprehensive alternative to insurance-based healthcare.
Turntable Health was a membership-based clinic that provided access to a “wellness ecosystem” for a flat monthly rate. Patients could enjoy same- or next-day visits, 24/7 physician contact, health coaching, nutrition and yoga classes, and an on-site demonstration kitchen.
However, despite its success in providing superior quality outcomes and high patient satisfaction, Turntable Health closed its doors in January 2017.
In this article, we will explore the reasons behind the clinic’s closure and what it means for the future of healthcare.
Why Did Turntable Health Close
Turntable Health was founded on the principle of providing affordable and comprehensive healthcare to its patients. The clinic’s unique membership-based model allowed patients to pay a flat monthly rate for access to a range of services, including same- or next-day visits, 24/7 physician contact, health coaching, nutrition and yoga classes, and an on-site demonstration kitchen.
Despite its success in providing superior quality outcomes and high patient satisfaction, Turntable Health closed its doors in January 2017. The reasons behind the clinic’s closure are complex and multifaceted.
One of the main reasons for Turntable Health’s closure was the economic challenges of the Las Vegas market. The healthcare system in Vegas is not designed to support the member-based model economically. Insurers shied away from member fees, insisting on more traditional reimbursements, which directly contradicted Turntable Health’s long-term health strategy.
Another reason for the clinic’s closure was the difficulty in finding bridge funding to stay open. Turntable Health, which operated in partnership with Iora Health, also couldn’t continue to finance its operation.
The closure of Turntable Health is not an isolated incident. Two direct primary care providers have shut down this year, with Qliance planning to close its doors on June 15th. Direct primary care is a controversial movement where physicians start membership-based practices and charge patients directly, eschewing third party payers.
Many of these practices use telemedicine, behavior change, and other digital technologies to increase efficiencies and drive down costs so they can keep the business sustainable. However, the viability of this business model is being called into question as more clinics struggle to stay afloat.
The Rise And Fall Of Turntable Health
Turntable Health was founded in 2012 as part of Tony Hsieh’s $350 million economic revitalization project in Downtown Las Vegas. The clinic was founded by Zubin Damania, who was recruited from the Bay Area, and was made in partnership with and modeled on Iora Health, a primary care chain led by Rushika Fernandopulle.
The clinic used a population health and disease prevention approach to improve patient health and lower costs over the long term. They charged per patient per month capitation to sponsors, or $80 monthly membership fees to members, instead of using the fee-for-service model. This allowed physicians to spend more time with patients, with consultations lasting 45 minutes or more.
Turntable Health quickly gained recognition for its innovative approach to healthcare. It was featured on TheNextWeb as one of “eight startups changing the healthcare industry,” and there were plans to expand and build new locations as the clinic approached a capacity of 5,000 patients.
However, Turntable Health faced several challenges that ultimately led to its closure. One of the main challenges was the economic realities of the Las Vegas market. The healthcare system in Vegas is not designed to support the member-based model economically, and insurers were reluctant to adopt the clinic’s capitation model.
Additionally, Turntable Health refused to compromise when pressured by payers to offer fee-for-service options or to begin charging a co-pay. This put financial strain on the clinic and made it difficult for them to find bridge funding to stay open.
Despite its success in providing superior quality outcomes and high patient satisfaction, Turntable Health closed its doors on January 31, 2017. The closure of Turntable Health is not an isolated incident, as other direct primary care providers have also struggled to stay afloat in today’s healthcare industry.
The Challenges Of Operating A Membership-Based Clinic
Operating a membership-based clinic can be challenging for a number of reasons. One of the main challenges is the difficulty in finding a sustainable and viable path for the business model. The healthcare system in the United States is largely designed around insurance-based healthcare, which means that insurers may be hesitant to work with clinics that use a member-based model.
Another challenge is the need for bridge funding to keep the clinic open. Membership-based clinics often have to rely on their patients to pay a flat monthly rate, which may not be enough to cover all of the costs associated with running a clinic. This means that clinics may need to find other sources of funding, such as grants or investments, in order to stay afloat.
In addition, membership-based clinics may face challenges in terms of attracting and retaining patients. Patients may be hesitant to pay a flat monthly rate for healthcare services, particularly if they are used to paying for insurance-based healthcare. Clinics may need to invest in marketing and outreach efforts in order to attract new patients and retain existing ones.
Finally, membership-based clinics may face challenges in terms of navigating regulations and compliance requirements. The healthcare industry is heavily regulated, which means that clinics must comply with a range of rules and regulations in order to operate legally. This can be particularly challenging for smaller clinics that may not have the resources or expertise to navigate complex regulatory landscape.
The Impact Of Insurance-Based Healthcare On Alternative Models
One of the biggest challenges for alternative healthcare models like Turntable Health is the dominance of insurance-based healthcare. Insurance companies often refuse to pay for anything but fee-for-service, which creates a significant barrier for clinics that want to provide comprehensive and preventative care. This means that clinics like Turntable Health have to rely on patients paying a monthly membership fee instead.
Insurance-based healthcare also puts pressure on clinics to prioritize short-term profit over long-term health outcomes. Clinics that focus on prevention and doctor-patient relationships, like Turntable Health, may struggle to make ends meet because insurers are only willing to pay for services that are directly related to treating illnesses or injuries. This creates a disincentive for clinics to invest in preventative care and build long-term relationships with patients.
The closure of Turntable Health and other direct primary care providers is a sign that the healthcare industry is resistant to change. As Qliance CEO Dr. Erika Bliss wrote in a letter to patients, “the more we grew and proved that this really works, the more the system resisted us and made it harder and harder to survive.” The healthcare industry represents 19 percent of the GDP of the United States, which means that there are powerful entities with a lot of money and influence who are not willing to give up their profits without a fight.
Despite these challenges, there is still hope for alternative healthcare models like direct primary care. Clinics like MedLion continue to thrive, and new clinics like Forward are opening with a strong emphasis on data and artificial intelligence. It may take time, but as more patients demand affordable and comprehensive healthcare, the industry may be forced to adapt and embrace alternative models.
Lessons Learned From Turntable Health’s Closure
The closure of Turntable Health offers several lessons for healthcare providers and policymakers. Firstly, it highlights the challenges of operating a member-based healthcare model in a traditional fee-for-service system. Insurers are hesitant to reimburse member fees, making it difficult for clinics like Turntable Health to operate sustainably.
Secondly, the closure of Turntable Health underscores the importance of finding alternative funding sources for innovative healthcare models. Without adequate financial support, even the most successful clinics may struggle to stay afloat.
Thirdly, the closure of Turntable Health raises questions about the viability of the direct primary care movement. While the movement has gained popularity in recent years, the closure of multiple clinics suggests that this model may not be sustainable in the long term.
Finally, the closure of Turntable Health highlights the need for more comprehensive healthcare reform. As healthcare costs continue to rise and access to care remains limited for many Americans, policymakers must explore innovative solutions to provide affordable and high-quality healthcare to all.
The Future Of Healthcare: Is There Room For Alternative Models?
The closure of Turntable Health and other direct primary care providers raises important questions about the future of healthcare and whether there is room for alternative models. With the rising costs of healthcare and the increasing number of uninsured Americans, alternative models like direct primary care have gained traction as a way to provide affordable and comprehensive healthcare to patients.
However, the challenges faced by Turntable Health and other direct primary care providers suggest that these models may not be sustainable in the current healthcare system. Insurers are hesitant to embrace member fees, and clinics are struggling to find adequate funding to stay open.
Despite these challenges, some experts believe that there is still room for alternative models in healthcare. Direct primary care providers like MedLion continue to thrive, and new clinics like Forward in San Francisco are opening with a strong emphasis on data and artificial intelligence.
The future of healthcare may lie in finding a sustainable path for alternative models like direct primary care. As Dr. Zubin Damania, founder of Turntable Health, noted, “We know what works in terms of care. What we need is a sustainable, viable path.” With continued innovation and support, alternative models may yet have a place in the healthcare system of the future.
