Jason McMillan is founder and CEO of InterHealthcare. What makes InterHealthcare distinct is its healthcare ownership model, which offers a sustainable business framework to AHPs who want to retain a degree of autonomy. Jason believes that flexible partnerships with multidisciplinary clinics, rather than a top-down corporate ownership structure, encourages innovation and has the potential to improve primary care outcomes. As of 2023, InterHealthcare has partnered with 22 allied health businesses across 75 sites on the east coast of Australia.
We spoke to Jason about developing the healthcare ownership model, the rapid growth of InterHealthcare, and his vision for the future of allied health services.
In 2014, Jason sold his shares in a successful group of chiropractic clinics to his longterm staff and moved into business consulting. Through this, he recognised that many of his clinician colleagues were struggling with the challenges of managing businesses and juggling multiple responsibilities, motivating him to assist with crafting more sustainable business plans. This would become particularly pertinent with the growth of the NDIS. Following a false start with a corporate advisory firm, he developed his own healthcare ownership model, aiming to offer a sustainable and purposeful business framework for healthcare professionals in the prime of their careers.
“I thought, if anyone’s going to do this, it needs to be done with purpose and principle, it needs a model that actually makes sense to that 35-to-45-year-old clinician who’s got another 20 years ahead of them in their career, who was in the same situation that I was in. So I set about creating an ownership model, which is the InterHealthcare ownership model, and then set about raising appropriate funds to build the platform to eventually start a business in this space.”
How did you build up and scale InterHealthcare?
“We initially self funded and brought in some “seed capital” from a number of small investors over 2018-2019, and then brought on a private equity firm at the end of 2019 to provide the capital to make a number of acquisitions and literally start a business. I learned everything from tax and accounting structures, to raising seed capital, to investor roadshows, funding and transaction documentation, due diligence, etc. It was a pretty steep learning curve and a tough journey going from start up to having 450 staff overnight.”
“We made sixteen acquisitions, and then ran headlong into bushfires and floods in January 2020, which were pretty disruptive across our network. We had a good February, and then COVID broke out in March 2020, which has still had an effect up until probably the last six months, I’d say. We managed to expand the business during that stage—we made a second round of acquisitions at the end of 2020, taking the business up to another level.”
How do you form and develop partnerships with other allied health businesses?
“We’re dealing with about 75 sites on the east coast of Australia, all run out of a central support office, which does all the risky, stressful things for clinicians at practice level: HR, payroll, finance, cashflow management, budgeting, legal, business development initiatives, cybersecurity. We apply resources back to our businesses so they’re not exposed from a HR perspective or from a cyber perspective. You can come to us and say, ‘look, I’m 40 years of age, I’ve had a good career in my practice, but I don’t like the stress of all of this back end stuff. I could grow and have an impact across more people in my community, if I could cleave away things that I don’t enjoy doing’. Our job is to be the partner who takes away the back-end, stressful elements, deals with them appropriately, and then shares in the journey going forward.”
“Our ownership model enables our partners to get on a journey to thrive with us; it’s not one of those things where you feel like you’re being controlled inside a big corporation. We’ve got certain things that we have to deliver to our partners, and they then have an ability to get out there and grow and develop, which creates innovation. We’re about solving problems within the industry. We can look back to all of the principals across our business, all of our partners and say, ‘where’s the problem in your world? How can we solve it? And then enjoy the process of achieving a successful outcome together.’ This morning, for example, we had a meeting on how AHAs may be used to circumvent issues with healthcare delivery in remote and regional Australia. We’re doing it. Why are we doing it? Because we see a problem that we can fix by using our platform and some really principled people. It’s exciting and it’s fun.”
What are your thoughts on the allied health assistant workforce?
“We’ve got a whole workforce out there that we’re not taking advantage of with regards to delivery of services and it can be done so much better. I’d like to think that we’re able to create a blueprint for how that may work, and certainly it looks like it’s working very well at the moment for us—accessing that workforce and training it to get up to a certain level is the next challenge. That’s the exciting stuff that you get a chance to do when you’ve got the scale to do it, and you’ve got some really motivated people that you can leverage off.”
How would you differentiate your partnerships from franchisees?
“Very different. We leave autonomy in the hands of our principals—that is really critical. I don’t like the concept of a franchise in this space. We’ve got leaders in our business that are typically entrepreneurial. To ask somebody to fit a mould is really not where we come from; I wouldn’t work well in that system, and neither would the majority of those within our organisation and this is probably a differentiator between InterHealthcare and some of the other businesses in the industry. Some people will gravitate towards InterHealthcare because we are not a franchise, whereas others will gravitate to other models like franchises.”
“We’ve got 22 brands that operate underneath us, and each brand is led by principals/individuals. We’re very particular about governance, we’re particular about the quality of care, and the outcomes for our patients, those sorts of things are critical and requires good governance. Once these items are covered off, we actually encourage each of our partners/brands to express their individuality and creativity, and to be able to support that creativity, and I like the idea of a local brand. A local brand has a history and an area and a community; a franchise can depersonalise the principal and the original brand that we invest in. I don’t think that a ‘big banner’ is what communities want in this sector, they want trust, and trust comes from the people that they know. They know their local provider, which we’re here to support.”
How varied are the allied health professions that you partner with?
“We have preferences towards multidisciplinary care. So if you’re a single modality practitioner, it probably doesn’t really fit our model; we like to know that you can be part of an ecosystem. Health’s a journey—it’ll deviate, the road will take different forks, and it’ll go up and down—you need to be able to address the various aspects of that journey, and that takes a multidisciplinary team. If we don’t have that service on site, we want to be able to access it for you. You might need to psychologist at one point, and at the same time you might need some physical intervention of various different sorts, or some exercise or a dietitian—it has to be multidisciplinary. Most of our clinicians are physios, because physios were open to the diversification concept and multidisciplinary care much earlier than the other disciplines, and now the other disciplines are starting to catch up on that.”
“When I kicked my career off in this consulting space back in about 2015, we found the industry was moving towards a multidisciplinary model of care—medical clinics and physio clinics were moving towards it faster than anybody else—so that’s where we did a lot of our work at that time.”
What lessons have you learned during the growth of InterHealthcare—obtaining funding, how you’ve partnered with AHPs, and how you’ve managed growth?
“Everybody will jump on board to a good idea, but who’s actually got the expertise, resources and who’s going to do the work? It’s very hard for a health professionals to back themselves to an outcome—we’re analytical people, but we work within a framework. Health professionals are health professionals for a reason, because they actually care—it’s getting that balance between commerce and quality of care that I pride myself on pushing through an organisation; I’m not convinced that is the motivation behind a lot of people outside of the industry who get behind these things, because everybody sees healthcare as a goldmine, effectively. Staying true to your values is probably the most important thing. I’ve had to make a lot of decisions in very difficult circumstances, particularly during COVID. You get asked the question all the time: ‘how did you come to that conclusion?’ Well, it’s the right thing to do, and I think that’s always been the governing decision maker: ‘is it the right thing to do by patients and clinicians in this particular circumstance?’ As opposed to ‘is that the right thing to do by another stakeholder?'”
“We aim to change an industry for the better—you’ve got to hold that to the core of every decision you make. That’s probably what has gotten us to where we are today, it’s not been easy, it’s been incredibly difficult, probably the hardest thing I’ve ever done. But by the same token, I look at it and say, well, we navigated COVID as a new business—not a small business—and a business at this scale costs a lot of money to operate and run. You’ve got more risk when you’re at that stage and you’re disrupted by COVID, than you have when you’ve got a small operation that you can just sort of bunker down and get through. We’re very proud that we got through COVID—that we kept our workforce intact, that we supported our principals, and it came down to making decisions based on what is the right thing to do for patients, our clinicians, and our principals.”
“Anybody can jump on board to a good idea for the potential benefit of a financial outcome, but not everyone will jump on board just to pitch in and help. There are some incredible people out there who have been through circumstances in business that are very genuine, who will sit there and advise and support and give you their time. That to me has been quite overwhelming, the number of people that have will have been willing to provide advice or support, because the purpose was right. There’s so many learnings from the various different circumstances and the people that I’ve worked with over the journey—the lessons you could write a book on, the good and the bad. I look at everything as a learning opportunity, and don’t try to put too much emotion to it. I just keep going back to ‘what’s the right thing to do’, make a decision based on that, back myself to keep moving forward, and keep the business moving forward accordingly, and balance stakeholders accordingly from that—so the learnings are quite immense. “Good people, good purpose”—remaining true to that is the most important thing.”
What are your thoughts on COVID’s potential impact on innovation in allied health?
“Look, COVID was a period of innovation, and everyone will point to telehealth—but is it really that innovative? It was always there, it became the solution to a problem. We needed an event like COVID to find solutions to problems—telehealth technology has been there for a very long time. COVID was a massive disruptor, and I reckon it changed our industry, and it will continue to change our industry for many different reasons. I think it’s an innovator, because it has forced people to do things differently and think differently. All of a sudden, we had choice: ‘do we want to find a way to be able to engage with patients through [Zoom or telehealth], actually do four days a week like this and be more productive?’ It’s created an opportunity for change, and it did make telehealth mainstream, but is it the best way to do things? Not necessarily, but it’s a solution to a problem if you’re in remote Australia. If you’re a psychologist, is it a better outcome in certain circumstances, because you take away the confrontational nature of a face-to-face meeting in certain circumstances?”
Telehealth for chronic pain management
“COVID made us look at our pain program where at the time people would come on site, and they would be assessed—they would sit in a facility with a group of people to be educated about how to deal with chronic pain in the longer term, and then they would turn up to sessions thereafter to get an outcome. That’s geographically limited, right? We looked at that and thought ‘we’ve got telehealth available now, and we can fund this stuff remotely, so why don’t we start having our initial consultations and education sessions on this sort of forum?’ This takes chronic pain intervention to a bigger group of people. We can have a full education session without you having to travel, enabling us to say, ‘you live in a remote area, we can grab an exercise physiologist out there and we can brief them on our program and how they can assist locally with the delivery of an innovative persistent pain education program. The therapy stops and the exercise starts so you can build your resilience’. We can educate that exercise physiologist to be able to deliver what we want, as a program that fits with your insurance company to enable you to get through that stage of chronic pain and return to a more productive and enjoyable life, regardless of where you are in the country.”
“COVID created the opportunity for resources that were already there to be scaled into a different direction. We haven’t gone back to the face-to-face in our pain program, because we don’t need to, and it’s less confronting to people with chronic pain to be on a screen to do this. It has enabled us to have practitioners who work in remote locations to work in this environment, because that’s where they’re comfortable and what geography and technology now permits. It’s created an opportunity to be flexible, and then use the resources that we already have to get better outcomes.”
What’s your vision for the future of InterHealthcare and for allied health services in general?
“InterHealthcare is on a journey, but it’s only partway down the track. What we want to do is continue to be recognised within the industry as being the friendly resource; the place where you can take your business when you’ve reached that stage in your career, and know that you’ve got a great partner to continue the journey. Altruistically, we want to get the scale and volume to positively influence the health profile of the average Australian, and I think that’s a message that’s coming across from a whole different set of resources now: insurance companies are talking the same thing. I’d like to think that we are big enough to materially impact that over the course of time, which requires more growth, more innovation, and more opportunity.”
“We also want to improve the conditions for AHPs in Australia. We were involved during the COVID period with lobbying and advising industry bodies and government for allied health to be declared an essential service, to be able to operate, to work out what the right health and hygiene processes were; some of that research was done in our practices, and the protocols were set by us, which I’m pretty proud of. We want to continue to support our industry: better pay conditions, better recognition within the health system, more opportunities, career development opportunities, keeping people in their industry for longer. For a long time, we were really pigeonholed with who we were and what we could do—remuneration-wise and recognition wise—we really don’t get that acknowledgement within the health system for the amazing job that we do. For us to be able to continue to raise the profile of allied health professionals, improve the conditions, and improve the opportunities for AHPs is in part what we’re here for.”
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