At startup Zócalo Health, founders Erik Cardenas and Mariza Hardin set out to build a health care model with their families in mind.
Growing up, Cardenas remembered his parents discussing who could afford to take a day off work to bring him to the doctor — and how they would make up for the lost income that week. At his first visit to a pediatrician's office with an aquarium and Highlights magazine, his mom thought she had to pay for the coffee.
Hardin remembers, as a child, helping her parents fill out Medicaid forms and her grandparents complete Medicare forms. As an adult, she found she was still doing the same. While working at Amazon Care, the company's soon-to-be-shuttered health care service, she remembers thinking: "What if Mom could also experience this concierge-like service?"
Now, Hardin and Cardenas, another former Amazon Care leader, hope to bring individualized care to their mothers, families, friends and the Latino population with a new startup, Zócalo Health. The company is working to build a system that will incorporate a patient's culture and history, foster relationships between providers and patients, and shorten the time it takes to get an appointment.
Zócalo Health, founded in Seattle in August 2021, raised $5 million in seed funding this month to support the launch of its virtual primary care services in California, Washington and Texas.
It saw its first patient in California in July. After a moment of reflection, both founders stopped to call their moms "to say, 'It's happening, we did it,' " Hardin said.
"The biggest problem that we have here is that for too long we've let the Latino community depend on safety-net services," Cardenas said in an interview. "There's a ton of opportunity especially with such a large demographic to really bring just a new way of delivering care."
Different model
Zócalo Health offers a subscription model for patients — $350 per year for an individual and $550 for a family membership — or a $50 single-visit consultation. Patients will work with a primary-care team that includes physicians, nurses and mental health therapists as well as a promotor de salud, or community health worker.
That community health worker will help personalize the experience for each patient and focus on more than just physical health, starting with an onboarding call that could lead to discussion of behavioral health and environmental needs.
The community health workers will also follow up with patients if a prescription isn't picked up to see why. If cost is a burden, they'll help find a lower-priced option. If getting to the pharmacy is the holdup, they'll set it up for delivery.
Zócalo Health hopes to offer patients something beyond the one-size-fits-all model that is so common in health care today, Hardin said.
"It really means being able to take in someone's background, their family, the environment they're living in now, paired with their history and where they came from as all part of the health care experience," she said.
The founders don't see the startup as having many competitors in the space. Instead, it's filling a gap that has been left untouched.
In Washington, 13% of the population identifies as Latino but just 3.4% of the state's 14,700 practicing physicians self-identified as Latino, according to a 2020 report from the University of Washington's Latino Center for Health.
Several predominantly Latino counties in Central and Eastern Washington don't meet the federal standard for ratio of primary care providers to population, the report found.
Nationally, Latino resident physicians have been underrepresented in health care for years. A study of Census Bureau data from 2001 to 2017 found the U.S. had an average of 37 physicians per 100,000 people but the Latino population had only 14 per 100,000 people.
"We're tapping into a need that's been ignored for many generations," Hardin said.
Before starting Zócalo Health, Cardenas worked on the tech behind Amazon Care and Hardin worked on business development as the health care service got off the ground. Hardin later also worked for Amazon Web Services, its cloud computing arm, as a health and human services program manager.
Now, Zócalo Health is part of the AWS Healthcare Accelerator for Health Equity, a mentorship program for startups that are using the cloud services to increase access to health care and reduce disparities in the system.
Like Amazon, Zócalo Health is customer-obsessed, Cardenas said. And it's focused on data — hoping to collect information that "goes beyond the exam room" to provide a holistic patient experience — and efficiency.
It doesn't see technology as the backbone of the startup but does expect that putting the right tech in the hands of the right community health workers will speed up communication with patients and connect them with the right services to address their needs faster.
Because every patient wants "their health care experience to be as easy as an Amazon purchase," tech companies are raising the bar for other players in the space," Hardin said.
"It causes us all to double down on customer experience, on making sure we're meeting the customer where they're at," she said. "You are forced to think big when Big Tech enters the room."
Goodbye, Amazon Care
In August, Amazon announced it would end its health care service at the end of the year after determining it wasn't the "right long-term solution" for its customers. But it planned to stay involved in the industry and sees health care as "ripe for reinvention." Even without Amazon Care, it will offer direct patient care through its acquisition of One Medical, a primary care provider that serves about 767,000 people. That deal is still subject to regulatory approval.
Cardenas doesn't expect Amazon's decision to end its own health care service will slow the innovation momentum in the industry. "The ripple effect of what they've done and what they'll continue to do will have a lasting impact on the health care industry," he said. "As long as they remain in that space, it's only a good thing."
Zócalo Health plans to partner with nonprofits and community groups to hire health workers already living and working in the states where it plans to roll out its services. The founders didn't have an estimate for the ratio of community health workers to patients and did not disclose how many patients are currently using the service.
The company has five full-time employees and eight contract workers.
Zócalo Health's virtual services are set to roll out in Washington in October and in Texas by the end of the year. In the future, the company hopes to serve patients nationwide — and act as a blueprint for other populations who lack access and resources to the current health care model.
"What we're building right now is a playbook that can be used for other populations, other groups, other hyper-focused solutions that can be used in other communities," Hardin said. "What we're trying is something that hasn't been done before."
"We listen and we provide a vehicle for talking about any and everything with a physician," she said. "And we don't cut you off."
