Portland-based ZoomCare to accept Medicare and Medicare Advantage

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By Elizabeth Hayes – Staff Reporter, Portland Business JournalJan 16, 2025

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ZoomCare is now accepting Medicare and Medicare Advantage at all 45 of its clinics in Oregon and Washington, a sea change for the chain that began life asa single urgent care location in the Portland area.

Previously, Zoom only accepted commercial insurance or self-pay, notMedicare or Medicaid. But a couple of years ago, CEO Jeff Fee said and the board decided it was time to serve an aging population.

“When ZoomCare was first founded, it was hyper-focused on millennials,” Fee said in a Tuesday interview. “We have a number of people who have usedZoomCare as their primary care provider for years who have aged into the ranks. Our goal is to make health care easy and simple, and allowing this patient population, the silver tsunami — why wouldn’t we provide our model of care to my mom, my uncles? These are family members that deserve access to this great model.”

About 20% of the population in Oregon and Washington, or 2.5 million people, are enrolled in Medicare and Medicare Advantage plans, according to Zoom, citing data from the U.S. Centers for Medicare and Medicaid Services.

Fee said it’s anyone’s guess how many Medicare patients ZoomCare will serve, but they’re anticipating it could be 15-20% of overall volume.

Accepting a different breed of payer was not a simple task. ZoomCare had a proprietary technology solution that wasn’t Medicare-certified. The quickest path was to purchase an off-the-shelf solution, so the company ended up going with Athenahealth’s Medicare-certified software platform. It allows ZoomCare to access and share electronic health records with other providers.

“It was a pretty disruptive process,” Fee said. “You can’t convert an (electronic medical records) system without it being disruptive.”

ZoomCare started seeing traditional Medicare patients in Seattle last spring and rolled it out on a wider basis in December. By Jan. 1, it was accepting bothMedicare and Medicare Advantage at all clinics. It has not done any outward promotion, but that’s in the works.

While Medicare is known to reimburse at lower rates than commercial plans,Fee said ZoomCare has not raised its commercial rates to compensate.

ZoomCare was founded by Drs. Dave Sanders and Albert DiPiero, who oversaw explosive growth and the addition of primary and specialty care, in addition to urgent care. The pair sold the chain in 2018 to PeaceHealth, a $2.6 billionCatholic health system based in Vancouver. ZoomCare has 220 providers who treat 187,000 patients annually.

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