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One Medical's clinics are an option for almost 400,000 people. Photo: Smith Collection/Gado/Getty Images

One Medical has filed paperwork to go public, and the growing chain of physician offices has made it clear to prospective investors that large, dominant hospital systems are becoming a lot more crucial to its business.

The bottom line: "Our growth depends on maintaining existing, and developing new, strategic affiliations with health network partners," One Medical executives wrote in their IPO filing.

How it works: One Medical, which preaches convenient and lower-cost primary care, earns money in three main ways.

  • Employers, most notably Google, pay a membership fee so their workers can have unlimited access to One Medical's clinics. Or, a membership on your own costs $199 annually.
  • Hospitals, large medical groups and employers pay fixed monthly rates for a certain population of people, and One Medical is responsible for that group's care.
  • Health insurers create traditional "fee-for-service" agreements where they pay One Medical for each service it provides.

Between the lines: Hospitals are essentially finding a new way to buy patient referrals. They pay fixed sums to One Medical, and patients who need more intensive and expensive care will go to those hospitals instead of competitors down the street.

  • But One Medical benefits, too. In some instances, instead of fixed rates, hospitals "extend their health insurance contracts to us," according to One Medical's filing.
  • One Medical partners with hospital systems that hold a lot of market or brand power — places like Emory Healthcare in Atlanta, Mount Sinai in New York and UCSF Health in San Francisco — which allows One Medical to piggyback on those hospitals' lucrative contracts with insurers.

What they're saying: "Our providers are salaried, and not on a fee-for-service mindset," One Medical CEO Amir Dan Rubin told me in 2018.

  • Having salaried doctors, however, does not mean One Medical is casting aside the current system. It's merely building within it.

Go deeper

1 hour ago - Health

U.S. ahead of pace on vaccines

A health care worker administers a dose of the Moderna vaccine in Ruleville, Mississippi. Photo: Rory Doyle/Bloomberg via Getty Images

The U.S. is now vaccinating an average of 2 million people a day, up from 1.3 million in early February.

Why it matters: That puts us on track to hit President Biden's goal of 100 million doses a month ahead of schedule.

Updated 3 hours ago - Politics & Policy

Harris breaks tie as Senate proceeds with lengthy debate on COVID relief bill

Photo: Oliver Contreras/Bloomberg via Getty Images

The Senate on Thursday voted 51-50 — with Vice President Kamala Harris breaking the tie — to proceed to debate on President Biden's $1.9 trillion coronavirus rescue package, likely setting up a final vote this weekend.

The state of play: Sen. Ron Johnson (R-Wis.) is forcing the Senate clerk to read the entire 628-page bill on the floor, a procedural move that will likely add 10 hours to the 20 hours already allotted for debate.

4 hours ago - World

Netanyahu campaigns against Biden's plan to save Iran deal

Netanyahu campaigns at a gym last month. Photo: Pool/AFP via Getty

Israeli Prime Minister Benjamin Netanyahu indirectly criticized the Biden administration for its intention to return to the Iran nuclear deal and told his supporters he was prepared to "stand against the entire world" to stop it.

Why it matters: This is a major change of tune for Netanyahu, who had been careful in his statements on the Iran deal and avoided publicly criticizing President Biden. The statement was part of Netanyahu's attempt to rally his base ahead of Israel's election on March 23.