Life has been moving fast for the team at Physician Care Coordination Consultants LLC (PC3 Health).
Founded in June 2023 by a group mainly consisting of physicians, the Louisville-based health-tech startup went from working remotely to moving into a new 7,500-square-foot office space at 11709 Commonwealth Drive in Jeffersontown in February. The company purchased the building outright as part of a $2.5 million investment, we reported in January.
In recent weeks, PC3 has signed an undisclosed multiyear contract with UofL Health, its fourth major contract with a medical provider/health system and the third that has a presence in Kentucky (Norton Healthcare and Harrison Memorial Hospital in Cynthiana, Kentucky, being the other two).
The team, which signed its first contract in July with a Louisiana-based provider, has three more contracts in the works that are awaiting finalization, according to Dr. Karan Shah, one of the company’s co-founders and managing partners.
On top of that, PC3 is in the midst of building up its headcount. As of a recent date, the company had three full-time employees, but was in the process of adding at least 10 more by the end of the second quarter — including the five founders (more on them below) as well as five or six other hires. Later this month, the team will be welcoming Sandra Sutton, former associate vice president of denials management at Baptist Health, as its chief officer of revenue strategy.
One of the positions that the company will look to hire is a director of analytics. Although the role has not been filled yet, Shah said his team has been collecting data that can help hospitals look at their own data when it comes to denied claims.
How it PC3's platform works
In simple terms, PC3 has created a platform that offers utilization and case management services for hospitals that help them keep track of patient statuses as it relates to interacting with health insurance companies. These practices can decrease the overall amount of time that observation statuses are used — and thus decrease claim denial rates as well.
“If you’re in observation status, it’s not that you get any different care. You’re essentially getting the same care, but the payment to the hospital and the responsibility of the patient changes depending on the status,” Shah said.
If a patient is in observation status, Shah said, they may be on the hook for up to 20% of the final cost in many cases, which initially pays the hospital less for being an observation status rather than in-patient status.
“How do you translate what medically happens into insurance terms?” he added. “That’s the translation that we provide. That’s on the in-patient side, on the outpatient side, and vice versa. we’re the middle person between insurance companies and health care systems … when it comes to getting the status right, or getting a prior authorization.”
Besides Shah, PC3's other co-founders are Dr. Russ Compton, Dr. Vinay Nidadavolu, Dr. Ronald Payne and Gayle Dickerson — all of whom worked with Shah at Baptist Health.
Shah worked on the leadership team at Baptist from 2020-23. In 2021, he was tasked with starting up the hospital system’s first utilization management physician advising program. In that role, Shah recruited the three medical doctors listed above and trained them how to look at cases in a particular way.
Dickerson was initially Shah’s boss when he began at Baptist, but he later became her boss when he was appointed as the vice president of physician integration.
PC3 was not initially planning on raising outside capital. In recent days, the company, which has been bootstrapped since its founding, is “willing to entertain funding if someone is interested,” Shah said.
Shah declined to disclose revenue figures, but did mention that PC3 is expected to double its revenue over the next quarter from when it started over the summer.
“We were already profitable out of the gate. Hopefully, we’ll be even more profitable as we get more contracts this year,” said Shah.
