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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

2 hours ago - World

U.S. will give Russians written response to NATO demands, Blinken says

Blinken and Lavrov shake hands in Geneva. Photo: Russian Foreign Ministry / Handout/Anadolu Agency via Getty Images

Secretary of State Antony Blinken confirmed after a meeting with his Russian counterpart on Friday that the U.S. will provide written answers to Russia's security demands next week.

Why it matters: Russia claims to be waiting for "concrete answers" to its demands that NATO rule out further expansion and roll back its presence in eastern Europe before deciding its next steps on Ukraine. But the U.S. and NATO have called those proposals "non-starters," and Friday's meeting offered no breakthroughs, so it's unclear how written answers might change the equation.

More surprises await scientists at Antarctica's "Doomsday Glacier"

Cliffs along the edge of the Thwaites Ice Shelf in West Antarctica. Photo: James Yungel/NASA

Researchers like David Holland, an atmospheric scientist at New York University, are in a race to understand the fate of a massive glacier in West Antarctica that has earned a disquieting nickname: "The Doomsday Glacier."

Why it matters: Studies show the Thwaites Glacier (its official name) could already be on an irreversible course to melt during the next several decades to centuries, freeing up enough inland ice to raise global sea levels by at least several feet.

Updated 4 hours ago - Health

The case for Operation Warp Speed 2.0

Illustration: Annelise Capossela/Axios

Omicron's blitz around the world has underscored the need for a new arsenal of COVID vaccines and therapeutics, experts say — and that may require an effort akin to Operation Warp Speed 2.0.

Why it matters: The virus will continue to evolve, potentially in a way that further escapes vaccine protection, and the best way to prevent more global disruptions to everyday life is to have tools ready to combat whatever comes next.