Rushika Fernandopulle came to the United States from Sri Lanka as a young boy and later became a doctor after graduating from Harvard Medical School. He grew dissatisfied with standard systems of care, convinced alternatives that focused on primary care could work better. Fernandopulle eventually became the co-founder and chief executive of Iora Health, a Boston company building a national medical practice to do just that.
Today, Iora cares for nearly 30,000 patients at 35 practices, about 70 percent of whom are covered by Medicare. For many of its patients, IORA employs a “risk-based care” concept, accepting fixed annual payments to care for patients rather than billing for individual services. Gerontology Institute Director Len Fishman spoke with Fernandopulle recently about his ideas on improving medical care. The following is an edited version of their conversation.
Len Fishman: How did you initially become interested in pursuing a different approach to care?
Rushika Fernandopulle: I’m a primary care doctor who trained at Mass. General. I realized that the model we had for primary care was not optimal. It was fragmented and reactive. Patients weren’t getting better and they were unsatisfied with their doctors. I realized that the core of what we were doing was turning health care into a series of transactions. Document, code, bill. All the things we were trying to do to fix health care were just making the problem worse. The simple insight I had was that maybe what we need to do is start from scratch and rebuild the system from the ground up, starting with relationships and not transactions. And that required changing everything — the payment model, the process, the technology, the space. Continue reading