Former CMMI director’s new company will focus on value-based rural healthcare

A new company has entered the rural healthcare arena, armed with value-based strategies that aim to improve care coordination. Called Main Street Health, the company was founded by former Center for Medicare & Medicaid Innovation Director Brad Smith.

The company launched on Tuesday through Smith’s healthcare firm Russell Street Ventures. This is not Smith’s first time founding and leading a company. He co-founded and served as CEO of home-based palliative care provider Aspire Health, which he sold to Anthem in 2018.

Main Street Health’s first order of business is to implement its primary care-focused Extra Access Program in West Tennessee. The program will pair Medicare and Medicare Advantage beneficiaries at participating primary care clinics, urgent care centers and independent pharmacies with a local health navigator.

The navigator — who can be a social worker, licensed practical nurse or pharmacy technician — will be available to patients via a phone line as well as in-person at the participating sites. Smith, who will also serve as CEO of the company, believes this will provide patients with ongoing support regardless of whether they have an acute or chronic condition.

“So if you have congestive heart failure or chronic obstructive pulmonary disease and you come in to one of the [participating] practices, the health navigator will be calling you periodically to check in,” Smith said in a phone interview. “[Also] if somebody goes to the hospital, the health navigator may come see them in the hospital or when they get home.”

Technology will also play a key role in Main Street Health’s operations. For example, the company will pull pharmacy claims for patients in the Extra Access Program and run them through algorithms to check for things like drug interactions. This information will be then provided to the health navigator who can work with the participating sites to ensure medications being provided to patients are safe for them, Smith said.

The program provides a benefit not only for patients, but for the participating clinics and pharmacies as well. The navigator can connect the teams at those sites with a centralized Main Street Health care team that includes a physician, pharmacist, nurse practitioners and social workers. For small practices and pharmacies, adding even one more professional can make a huge difference. So having access to a centralized team can provide otherwise resource-constrained sites of care with a wealth of new expertise, Smith said.

“The main thing people report on is rural hospitals closing but the reality is it’s not just the hospitals,” he said. “There are also a decreasing number of primary care physicians in these areas, a smaller number of specialists.”

Companies advancing value-based primary care are not new, but they are mostly relegated to urban and suburban areas. Companies like VillageMD, Privia Health and agilon health have been in the space for years, but Smith believes that Main Street Health’s focus on rural America fills in a gap.

“[Main Street Health] is a rural-specific version of [those models],” he said. “For example, the biggest city we are going to…is a place called Dyersburg [in Tennessee], which has a population of 17,000 people. The average city [we will go to] is 3,000 or 4,000 people.”

Main Street Health’s Extra Access Program will launch in 34 clinics across eight counties in West Tennessee, rolling out in waves through July. Though it will initially focus only on seniors, in the next three years the program will be expanded to include other populations.

Russell Street Ventures is also thinking beyond Main Street Health. Though Smith did not provide any specifics, Russell Street will likely launch another company this year as well as one or two more in 2022.

“The common theme will be…very specific populations, where we think there is a chance to move to value to provide a better solution for that patient population,” Smith said.

Photo: marekuliasz, Getty Images