How one doctor fights the pandemic—profitably


Dr. Rahul Khare knows what some people are saying about him—that he’s opportunistic. And to some extent, he says, they’re right.

The Innovative Express Care CEO built a large-scale COVID-19 testing program early in the pandemic that has turned out to be quite lucrative. Now, as one of the only private practitioners in Chicago with access to coveted vaccines, he says he’s inking a deal with Chicago Public Schools to inoculate tens of thousands of teachers and staff.

“Are we profiting from a pandemic? Yeah, I am. I have mixed feelings about that,” says Khare, 46, who left Northwestern Medicine to launch his first clinic in 2015 with only a handful of patients—one of whom was his mother.

Before COVID hit, the North Side primary care, urgent care and behavioral health practice was seeing about 200 patients a day and raking in $1 million a year, Khare says. Now, with eight locations, it’s up to about 3,000 patients a day and $15 million. He used some of the funds to open four new sites in the last six months and aims to continuing expanding.

“People think of me as opportunistic,” Khare says. “Yeah, there was an opportunity to test a lot of people. There’s opportunity for me to give vaccines to millions of people in Chicago. We can help end this pandemic and, yes, I will profit from that.”

A big opportunity to profit came in April with the introduction of antibody testing, which aims to show whether patients were exposed to the virus. The testing operation quickly outgrew the congested clinic parking lot, so Khare moved its orange tents to a former car dealership lot and ramped up to 500 tests per day. Innovative Express Care charges $250 a test to patients who pay out of pocket, but Khare says most people use insurance. Khare also sells at-home, saliva-based COVID testing kits for $125.

Experts have questioned the value of antibody tests since they don’t address a person’s risk of reinfection and could be used to make unfounded decisions about returning to work or traveling, for example. But with so many unknowns, antibody tests allow the curious to learn if they may have been infected by the virus.

Plus, at a time when low payments from health insurers have led some doctors to stop testing patients for COVID-19, Innovative Express Care has found a way to continue offering the necessary service, says Valerie Gutmann Koch, director of law and ethics at the University of Chicago’s MacLean Center for Clinical Medical Ethics.

“They’ve got it up to scale where we know we can go and rely on them to get a relatively accurate (polymerase chain reaction) test, for example, and get results within a couple days—and not pay out of pocket for that,” Koch says. From Zoom to Peloton, “there are definitely companies that have profited from the circumstances we currently find ourselves in. The fact that they’re profiting per se isn’t problematic.”

But how did Khare manage to get his hands on scarce vaccines? City officials say they’re getting a relatively small number of doses from the federal government, and the vast majority of shots are being distributed to city-run mass vaccination sites and hospitals. In fact, Innovative Express Care is one of the few private facilities listed on the city’s Zocdoc scheduler tool, along with Rush University Medical Center and Erie Family Health Centers, a federally qualified health center.

Many local independent medical practices, including urgent care chains like WellNow and membership-based primary care providers like ImagineMD, still can’t get vaccines for patients.

“It started with me being persistent about getting doses for my staff,” Khare says, noting that the city originally told him to send his 300 employees to the mass vaccination site at Malcolm X College. Eventually, after walking the city through his online appointment system and scalable testing operation, he says he got just enough doses to inoculate his workers the week of Jan. 11.

He got another 5,000 doses from the city the week of Jan. 18, followed by 1,000 doses last week and 3,000 doses this week. To date, Innovative Express Care has administered roughly 9,000 shots. The injections are either covered by insurance, the federal CARES Act or offered at no cost to patients.

A Chicago Department of Public Health representative did not comment on how Innovative Express Care came to get an allotment of vaccines from the city, saying only that the practice gets doses the same way as other clinics and hospitals.

With more doses, Khare says the practice could administer around 5,000 shots a day by using its testing sites, which are seeing less traffic as case counts fall.

Meanwhile, he says he’s been awarded a contract to vaccinate tens of thousands of Chicago Public Schools workers covered under Phase 1B of the city’s vaccine rollout. Under the terms of the deal, which is being finalized on Friday, Khare says he would get doses earmarked for CPS each week and receive a fixed payment for each shot administered. CPS did not respond to a request for comment.

Khare says his desire to quickly pivot when COVID hit is partly due to his experience as an emergency room doctor treating people and training clinicians in Haiti after the 2010 earthquake. He recalled the time he spent there, working mostly in a tent outdoors, when figuring out how to efficiently and cost-effectively test patients for COVID.

“Health care and profit—it’s hard to put those words in the same sentence,” he says. “But at the end of the day, if you’re doing a great job you’ll have more patients.”


Source: modernhealthcare.com

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