How does Crossover Health make money?

Crossover charges a membership fee that is paid either by an individual or their employer

The primary care relationship is changing, for a variety of reasons, most notably COVID, which changed how both doctors and patients viewed healthcare, taking it from a once a year annual visit to 24/7 continuous care, in which patients can access their doctor whenever they need to, where they already are.

Of course, even as telehealth grew exponentially during the pandemic, there will always be a place for in-person care as well, as not every ailment can be diagnosed and treated over video chat. It seems like the system is heading toward a hybrid approach, combining in-person and virtual care, rather than simply relying on one or the other.

That's the approach taken by Crossover Health, which provides care that can be accessed virtually, as well as in onsite clinics that are set up in conjunction with employers, and in nearsite health centers. 

Founded in 2010, Crossover is available to adults age 18 and over, either through an individual paid membership or as part of an employer sponsored benefit, covering conditions related to primary care, behavioral health, optometry, health coaching, physical medicine, and acupuncture. 

The company takes a care team approach, meaning that members will see the same primary care doctor, mental health therapist, physical therapist, and health or fitness coach each time they need care. Members are able to message back and forth with their Crossover care team through the patient portal anytime or they can schedule video appointments when needed.

If a member lives near one of the company's eight shared health centers, which are currently open in Texas, New York, and California, they can also schedule appointments to meet with their Crossover care team in-person. In addition, Crossover also operates private, on-campus center in partnership with employers; the company currently operates 34 of these centers for companies including Amazon, Microsoft, LinkedIn, Facebook, Apple, Visa, and Comcast.

Crossover's physical health centers include in-house labs, as well as optometry and acupuncture at certain locations. If in-person care is needed, and the member doesn't live near a in-person location, their Crossover Care Navigator will help them schedule in-person visits with in-community providers and arrange for any needed tests or lab work.

On top of that, last year Crossover introduced Be Well, its online health and wellbeing community, which contains a multimedia library of health content and programs. 

"At Crossover, we believe that 'not sick is not good enough.' That’s why you can dive into our Be Well community for everyday health and wellbeing no matter where you are on your personal health journey," the company says on its website. 

"Built exclusively for Crossover members by Crossover providers, you’ll find self-care inspiration, programs to help you improve your health (everything from Acne to Quitting Tobacco), free group fitness classes, plus, podcasts and videos on relevant, timely topics. We’ll keep it fresh by adding member events and interest groups regularly."

Crossover makes its money by selling its plans either directly to its members, or to its employee partners, rather than by billing insurance. 

For members who have access to Crossover through an employer sponsored benefit, Crossover works with their employer and insurance to cover their annual membership fee and the care services. Those members are billed for their visit fees (if there are any), as well as for other services that are not covered by their membership. That can include specialty lab work or enhanced care services, like acupuncture or vision care, which may not be included in their benefits and insurance guidelines.

In a 2019 blog post, Crossover founder and CEO Scott Shreeve outlined why he believes the Crossover model is the best one for both everyone in the healthcare ecosystem.

"Fee-for-service simply generates activity without promoting outcomes. That’s no good for patients who feel like they’re simply a means to generating fees, for employers who want to see a real return on their healthcare investments, or providers who truly want the time and ability to solve health challenges," he wrote.

"So rather than focusing on generating fees, we’re concentrating on achievement and improving health scores across our populations, and are willing to put some skin in the game by assuming risk when we miss our own goals."

Crossover Health has raised $281.5 million from investors that include Gurnet Point Capital Norwest Venture Partners,  OrbiMed, Perceptive Advisors, Foresite Capital, SharesPost Investment Management, Deerfield Management, Irving Investors, Avidity Partners, and PFM Health Sciences.

(Image source: crossoverhealth.com)