Since its launch nearly eight years ago, One to One Health has sought to deliver more personalized and cost- effective primary care by using a physician-owned network of providers and offering onsite clinics and patient assistance to employer groups.
For all its success in improving patient satisfaction and keeping a lid on rising health care costs for employers, the company's move into a Riverfront Parkway office came at an inopportune time last year. One to One created a new exercise and fitness facility and meeting area just before the coronavirus pandemic forced the shut down of such facilities.
"For a while, I had the best personal workout facility in town," quipped Dr. Keith Helton, the founder of One to One Health who moved into the Riverfront Parkway facility in early 2020.
Ultimately, the exercise facility, food training area and physical therapy clinic reopened later in the year along with the physician offices in the upper floors of the former Alstom facility. The complex is designed to offer the type of on-site health care facilities that major employers like Hamilton County government provide for their workers through One to One Health's holistic approach to primary medical care.
"It's all about trying to elevate the patient experience and elevating their health and well being by reducing many of the barriers to a healthier lifestyle and the collective approach of having people really care about you as an individual," Helton said. "We want to treat our patients like they were part of our family, which is why most doctors got into medicine in the first place."
For many chronic diseases like diabetes or obesity-related ailments, One to One tries to figure ways to improve the diet and lifestyle of the patient to help prevent the underlying problem, rather than medicate the symptoms of the disease or health condition. Having quick and accessible referrals and treatment facilities is key to patient compliance with physician recommendations, Helton said.
"What's always frustrated me is you come see me and I tell you you need to get on an exercise program or you need to see a nutritionist and I send referrals out but who knows if the person ever does it," he said. "Here, we take you down to our fitness facility and the physical therapist and we get you launched on a program the same day."
In most medical referrals for exercise or diet changes, only about half of the patients carry through with any of the recommendations. One to One Health seeks to improve those odds and make it easier for both physicians and patients to follow less costly and healthy lifestyle practices.
The gym and PT facilities are designed to start and train people on what to do, not to be a permanent workout site.
"We're not trying to be like the YMCA or Sports Barn," Helton said. "We're simply trying to get people engaged and launch them into an exercise program which they can do elsewhere for a longer period of time."
Russell Cliche, director of health and fitness for the 2,500-square-foot One to One gym on Riverfront Parkway, said his recommended regimens are designed to keep people healthy, not to achieve some ideal body look.
"There is a much better handoff from the physician to the physical therapist or the exercise trainer here and a lot of people say they really like having their doctor right here," he said. "And we really look at ways to help you get sick less often and lead a healthier life. This is about being healthy, not aesthetics."
Workout regimens focus more on balance, coordination, flexibility and range of motions -"things that sometimes get overlooked in a traditional workout program," Cliche said.
In an adjacent meeting room at the same time as some people are going through an initial exercise routine, a group of individuals is learning about healthier diet options during a cooking and food preparation lesson. During a recent midday class, Health Coach Katie Russell taught a half dozen students enrolled in a food course about how to prepare Swiss chard and make other healthier, natural foods.
"We try to customize what we do for each individual because health is different for everyone," Russell said. "Our classes help people learn to prepare different, healthier meals and hopefully make eating more fun."
Next door, other persons undergo physical therapy sessions.
"We encourage our patients to use facilities such as this so they can transition their lifestyle," said W. David Bruce, an orthopedic surgeon in the RiverRun Health practice also located in the Riverfront Parkway complex. "I even come see my patients in physical therapy here. It's better for the patient and a better overall setup that allows me to see how each individual is progressing."
One to One Health is providing such services on a fee-for-service basis and as part of an overall package. The services are designed to make it easier to lead a healthy lifestyle and avoid costly medical problems.
One to One's physician-directed services range from turnkey health and wellness programs to on-site clinic management, all with the shared goals of reducing healthcare expenses and improving the patient experience.
One to One Health seeks a more holistic approach to health care with more focus on primary care and a healthy lifestyle to keep people from getting sick or going to the hospital as much. The physicians in the network know each other and try to work with better referral handovers and treatment regimens than what many may experience in a more fragmented health care delivery system.
In Chattanooga, One to One covers about 27,000 workers employed at Hamilton and Catoosa county governments, EPB, Lodge Manufacturing, Baylor School and other employers. The company also has major presences in Indiana where it covers employees of Purdue University and in Nashville.
So far, the company has helped improve both the physical health of employees and the fiscal health of the 18 employers in its network, Helton said.
Hamilton County government, which hired One to One Health in 2014 to help provide more cost-effective primary care health services, has succeeded over the past seven years in keeping its employee health care costs relatively stable for its 4,500 workers, avoiding the double-digit cost increases the county had previously been facing each year.
As part of its Cigna health insurance plan, the county added a physician-led clinic on site along with its in-house pharmacy and wellness center at its McDaniel Building in Highland Park. The approach has helped reduce costly hospitalizations among workers and led many to make healthier lifestyle changes, instead of taking more medications.
But for those needing a prescription, One to One maintains many generic drugs on site that can be offered for a fraction of the costs of many name-brand drugs.
Telehealth assistance is also available by phone to help limit the need for some doctor appointments and physician referrals tend to be quicker and more direct, Helton said.
"We try to eliminate the waste in health care, not ration health care," he said. "We try to help people be as healthy as they can with the primary care support and services we provide here and then to make sure when they have to go elsewhere for some specialized care that is high quality and cost effective."
Helton has practiced internal medicine and pediatrics in Chattanooga for more than two decades while serving in leadership roles for both Erlanger Health System and the Galen Medical Group. He helped establish a clinic at Baylor School more than a decade ago, which he still oversees.
Helton was so confident in the on-site health and wellness program that he offered to be paid by Hamilton County, at least in part, on the savings he expected the county to reap by giving better access and monitoring of primary medical care and improving referral to other physicians and specialists in its network.
In 2017, One to One expanded to Sumner County in Middle Tennessee and began covering workers at Purdue University in Indiana. Last year, former U.S. Sen. Bob Corker joined One to One as its chairman to help expand the health care model to more markets.
Contact Dave Flessner at dflessner@timesfreepress.com or at 423-757-6340.