Senior Care in Rural America: Q&A with the CFO and COO of Hopscotch Primary Care, a Citi Impact Fund Portfolio Company

In two years, the oldest members of the Baby Boomer generation (born 1946-1964) will reach the age of 80. By 2050, more than 80 million people in the United States will be over the age of 65 . While this demographic shift in the U.S. population is well-documented, we don't often think about where and how older Americans prefer to live, and what this means for healthy aging.

In particular, seniors are a consistently growing share of the population in rural America . Research shows that seniors in rural America face numerous health disparities compared to their urban counterparts. They experience higher rates of poverty and they are 25% more likely to die from the five leading causes of death. This isn't surprising given that rural regions across the country are faced with a stretched and diminishing health workforce. According to the University of North Carolina's Rural Health Research Program, almost 200 hospitals across rural America have closed their doors since 2005.

This is the kind of challenge that we focus on at Citi Impact Fund. As part of our mission to invest our capital in high-impact community solutions, we deploy capital to support innovators that are expanding access to essential services and infrastructure, including healthcare, for underserved communities. This is why we are thrilled to support Hopscotch Primary Care and its aim to transform lives in rural communities through accessible and proactive value-based care. We talked to Andrew (Drew) James, CFOand David Thurlow, COOof Hopscotch who shared more about how Hopscotch Primary Care is transforming senior care across the rural U.S.

Ryan: H opscotch is focused on improving care for seniors living in rural areas. What are some of the biggest challenges for this population and why is now the right time to solve them?

David: People living in rural America tend to have far worse health outcomes. They are 34% more likely to suffer with multiple chronic conditions and 40% more likely to have an avoidable hospitalization. These residents have fewer options for access to high-quality healthcare. At Hopscotch, we intend to change that, and our model is specifically focused on serving these rural communities.

Ryan: Of all the problems to focus on in health, why did you both decide to build this particular business and solve this particular problem?

Drew: I believe primary care is the most impactful area to meaningfully improve patient outcomes and address rising costs in the overall healthcare system. Advanced primary care providers have established a track record of successfully serving urban and suburban populations, and I was excited by the prospect of building a platform specifically tailored to address the unique needs of people in underserved rural communities.

David: Advanced primary care engages patients more deeply and improves their health holistically. In rural communities, the need for this type of healthcare is even more pronounced and the potential to improve outcomes and improve lives is even greater.

Ryan: There are a lot of advanced primary care companies out there. What sets Hopscotch's care delivery model apart from the rest?

Drew: We deploy a comprehensive end-to-end care model tailored to serve the unique needs of people in rural communities. We have full care teams and ready access to specialists and social services needed to supplement their primary care. We spend extended time with each member during visits and provide targeted, individual support including medication management and transitions of care support. We provide expanded access through same-day visits, home visits, virtual care and a 24/7 call center.

For example, a care team recently performed a routine, proactive outreach to a member and found an emerging cancer. With the early detection, they were able to treat the cancer before it could spread.

Ryan: You had many options for capital partners. Why did you decide to work with Citi and Citi's Impact Fund?

Drew: We decided to work with Citi Impact Fund given its mission alignment, with one of its core investment areas being social infrastructure solutions including those that expand access to healthcare for underserved communities. The Impact Fund's focus fits well with our mission to transform lives in rural communities through accessible and proactive value-based care. With its deep experience investing in healthcare services and access to a wide range of resources, we are excited to work with the Citi team for Hopscotch's next phase of growth.

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