Hartford Business Journal

10 HARTFORDBUSINESS.COM | NOVEMBER 7, 2022 Dr. Vasanth Kainkaryam in the South Windsor office of his direct primary care practice, 4 Elements Direct Primary Care & Wellness Space. HBJ PHOTO | STEVE LASCHEVER Alternative Medicine Membership-based primary care practice aims to challenge traditional business model By Robert Storace rstorace@hartfordbusiness.com L ong wait times to get a primary care appointment. Hassles dealing with health insurance. Quick visits that lack a true connec- tion with a physician, if a patient is lucky enough to even see an actual medical doctor. Those issues define many of the problems with modern medicine. They are also what Dr. Vasanth Kainkaryam is trying to eschew with his three-year-old physician practice that has adopted a relatively new and innovative business model: direct primary care. Kainkaryam, 40, is the founder of 4 Elements Direct Primary Care & Wellness Space, which has offices in South Windsor and Rocky Hill. The practice is unique because it doesn't accept health insurance. Instead, patients pay a monthly fee, which guarantees them shorter wait times and longer face-to-face visits with the doctor, as well as access to phone, text or telehealth services. It also promises no surprise billing for primary care; often lower-cost medications, labs and imaging; e-consults with access to more than 120 specialists; and same-day or next-day sick-care appointments, Kainkaryam said. Doctors, like Kainkaryam, who offer direct primary care — which differs from the better-known concierge medicine model — are few and far between. Kainkaryam is one of only about five direct primary care providers in Connecticut; only 2,500 exist nation- wide, according to the American Academy of Family Physicians. Kainkaryam said he believes the model is the wave of the future because it offers patients quicker and increased access to their doc- tor. It also gives physicians more freedom and control over how they deliver care. So far, it has had appeal. Since its 2019 launch, 4 Elements Direct has built a 200-patient practice, with the goal of adding 100 more in the next few years. He's also planning to hire more doctors and expand to new locations. "Direct primary care takes away all the complexities of billing and coding and what does and does not your insurance cover," he said. "Many doc- tors are not happy with their jobs and have no control over their practice. This (model) gives me full freedom on how to take care of patients." Growing the practice Prior to forming 4 Elements Direct, Kainkaryam climbed the corporate healthcare ladder. He was previously regional medical director of Hartford HealthCare Medi- cal Group's primary care division. He also worked for Iora Health, which partnered with Hartford HealthCare on primary care services, and spent time as the chief medical officer for First Choice Health Centers, a com- munity health center system. It was that past experience that led Kainkaryam to want to open up his own direct primary practice, he said. Kainkaryam said he took multiple part-time jobs to help fund his busi- ness. He didn't take on a bank loan. His wife is also a working physician, helping make ends meet while he pursed his entrepreneurial venture. He said his 200 patients cover the economic spectrum and most do have health insurance (ranging from regular commercial insurance to medical cost-sharing plans or Medi- care and Medicaid) to cover medical needs like specialist care, surgery or hospital visits. But they are willing to pay a membership fee to see a doctor on short notice with face-to- face time they often can't get with traditional health care. "It brings back the feeling of having a community doctor," said Kainkaryam, whose patients include a large swath of small business owners and their employees. Kainkaryam, a board-certified internist, charges $35 to $100 a month depending on a patient's age. His gross annual revenue is at least $250,000 to $300,000, he said. The membership covers a wide variety of services including primary and obesity care, pediatric medicine and telehealth. Kainkaryam said that while many primary care doctors have upwards DR. VASANTH KAINKARYAM Founder 4 Elements Direct Primary Care & Wellness Space Locations: South Windsor, Rocky Hill Education: Doctor of Medicine, University of Rochester School of Medicine and Dentistry; Master's degree in health informatics, Northwestern University

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