Coronavirus Report: The Hill’s Steve Clemons interviews Justin Dangel

The Hill’s Steve Clemons interviews Justin Dangel, co-founder and CEO of Ready Responders.

Read excerpts from the interview below.

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Clemons: Ready Responders had a team in Los Angeles at a Black Lives Matter march giving free COVID-19 testing. How did that go?

Dangel: It was great. A couple of the organizers asked us to set up near the march in order to facilitate those that needed testing to getting the testing they need. And we provided a couple dozen tests on the scene and have several appointments thereafter. So obviously we support people’s rights to protest as they see fit, and we want to make sure that we create as healthy a community as we can.

Clemons: You’re going to homes of people with money and those in public housing projects. Give us a snapshot of what tracks you’re on and what you’re doing, given the huge testing needs in the country now.

Dangel: We provide care to anybody, whether you’re on Medicaid, Medicare or commercial. I think the history of our company has been to focus principally, initially on Medicaid populations in every market we enter. That’s where the biggest care gaps are, those of the patients that have the hardest time accessing the system in many cases now. And so when we prioritize our work, it tends to focus first on Medicaid, but we do almost equal measure Medicaid, Medicare and commercial at this point, and the proposition of our company is that we essentially have a network of responders. They’re often trained initially as the EMTs, paramedics and nurses and then we give them some more training to become responders, and they go to people’s homes and are supported via video on tablets that we supply them with our doctors on the other side. So, we can do just about anything you could do in a doctor’s visit in the home with these responders who typically live and work in the communities they serve, and our doctors via video. They carry with them testing equipment. So, the COVID test is one part of the test that we provide. At this point, about 10-15 percent of our visits involve a COVID test. Most of what we’re doing is providing services that historically have been provided in a clinic and either because the patient finds it more convenient or more effective to get the treatment at home or in many cases today, because the clinics are closed or hard to access or even risky to access, we provide really the equivalent of urgent care or primary care or clinical visits in the home.

Clemons: Have you been able to get test results quickly or is it still a three- or four-day process to know the results?

Dangel: We’ve got a couple great testing partners who typically can turn things around in 24 to 48 [hours]. This is a new world. No one was sitting around in February preparing as well as we all should have been for what ultimately happened. And I think if you look at the last 60 to 75 days, I have deep admiration for our lab partners and all the labs around the country that have ramped up capacity. I think things are catching up to where they need to be. I think we’re in a very different place than we were say in March and early April in terms of getting test results processed in a timely fashion, and I would say most of the time our labs process within a 24- to 48-hour time frame. And there’s very promising new tests coming that will push things down into the 15 minutes to half-hour time frame hopefully in the next month.

Clemons: Can you tell me a little bit about what you’ve done in New York, partnering with Gov. Andrew Cuomo? Tell us what you’ve done in New York and how you’ve made it work.

Dangel: Well, we were thinking we might go into New York at some point next year, but a couple of us happened to be watching one of Gov. Cuomo’s press conferences, and he said, “If there’s any providers out there that can help, we really need the help, we’re the hardest hit place in the country,” and for us, what we believe in as a company, that meant us. So, we quickly ramped up and we approached the governor and Congressman Meeks and the mayor and others and said, “Is there a way we could help?” And I think they were starting to get reports rightly that folks at NYCHA [New York City Housing Authority] were having trouble accessing the health care system as a number of the clinics locally closed for safety reasons. And, we kind of raised our hand and the governor and Congressman Meeks had this idea to try to make us especially available for folks at NYCHA and that’s how it came about. And I think you’re right to say it’s not simple. It is a complex project that has taken us some time to get down right. But I know we’ve made a huge difference in a lot of people’s lives. There are folks that need medical treatment that can’t get it otherwise now. And folks that need a test for whom it’s dangerous to go to a testing facility, and there’s a particular concentration of that population in public housing. And I guess, I hope my investors don’t kill me for saying this, but it’s not as lucrative as some other things we could do. But that’s not really why we set up the company. We set up the company to try to help as many people as we can and close gaps. And that was the biggest gap that we could find in New York to try to help fill. And I’m really proud of the work our team’s done in New York, but also all around the country, whether it’s helping with the homeless populations in Las Vegas, whether it’s helping to support the D.C. fire and the EMS, whether supporting the governor of Maryland or whether it’s just any of the patients, the hundreds of patients who call us directly every day. I’m really proud of what our team has been able to do, and we’re somewhere around 15,000 to 20,000 visits a month now and growing quite quickly around the country. We’re starting to be pretty substantial and looking forward to growing as much as we can if we could find the partners to do it.

Clemons: What is the business model of helping those most in need?

Dangel: I think there’s two points I’d make there. First, we contract with insurance companies as a physician’s group, and we bill physicians E&M codes. I think if I was going to express the part that’s been the most frustrating for me is that some of the payers in these states, some of them have been great, like Centene and United. Others have been quite a bit slower in contracting with new providers. And I have to say that’s been kind of hard to understand as many of them have seen their claims dropped quite a bit in the last quarter or so and particularly Medicaid providers are seeing additional new members. Why they would be slow in expanding their network is beyond me. And I would like to think that since they’re mostly spending money that’s dedicated for Medicaid and Medicare, that the managed care organizations would do what’s right and put the providers that are courageously ramping in the midst of this crisis in their networks and facilitate appropriate billing. But that’s how we make our money. We get paid just like a typical telehealth-based doctors visit. We’re better than a typical telehealth visit cause we have somebody there in person so we can check vitals, draw blood, administer medications, do all the things you do in the doctor’s appointment, and you save a ton of money because we cost the same or less than a typical doctor’s visit. But we provide care that helps lower the use of emergency departments, helps prevent exacerbations, and we’ve been able to show with complex populations in our home city in New Orleans that we can cut readmits by over 50 percent for some of the most sensitive populations. So, we’ve been able to prove to payers that we can really lower costs and to also the government. But it’s important to us to be able to get in network. As it relates to the uninsured populations, fortunately, when I started the company, I was expecting to see a huge percentage of our calls to be uninsured patients and most of the places we operate are Medicaid expansion markets. And so if we see a patient’s uninsured, they’re most often eligible for Medicaid and reimbursable. So, we have a good reserve for uninsured and we provide it quite regularly, and it still fits within our financial model.

Clemons: What cities are you planning to move to next?

Dangel: Washington and Maryland and we’ll be in Virginia soon. We’re in later stages in a market in Florida, in South Florida, and I think we’re looking closely at Texas and Pennsylvania for later in the year. And if anyone’s watching and you think we’d be particularly helpful in your home state, please reach out.

Clemons: Your responders are going out and meeting people, and they’re obviously testing people, finding people who are ill and need support, and there’s that human dimension. We’ve lost you know upward of nearly 120,000 folks who have died in this country from this terrible pandemic. How do you manage that side of the equation? And what should our viewers know about that interaction of helping people that are suffering from COVID-19 right now?

Dangel: Well, our EMTs and paramedics and nurses that comprise most of our responder force are some of the most courageous and selfless people that I know. And they are the sort of people that didn’t pick their career path because they thought it would be the most lucrative. They picked it because they thought it was the best opportunity to help people and as the CEO here, I see it as my job to try to help them do what they already know how to do well and express their values and the values of our company to people. It’s a hard environment. I think anyone that says otherwise is lying. But our folks have the training and the capability to handle what they see. And you know, there’s some people that run away from things, there’s some people that run towards them, and our responders are the kind of people that run toward stuff. We do everything we can to support them. And we’ll continue to try to come up with even better ways to support the folks that work for us. They’re the best people I’ve ever had the chance to work with and know. And I’m just really proud to be a part of what they’re doing.