Pivotal Health

Bringing health care to your home

Have you ever fallen on ice and had the pain afterward keep you up at night? Does your child have an ear infection … again? What’s behind that itchy rash? For any of these issues, you might head to an urgent care clinic where it could take hours to see a doctor. The wait, the inconvenience, the unpredictable cost—all of these factors irked Sal Braico, who has led several health care startups in Madison over the past 20 years. A New Jersey native with a bachelor’s degree from the U.S. Merchant Marine Academy and a master’s in business administration from UW-Madison, Braico thought there must be a better way. How about combining the old-fashioned practice of doctors making house calls with the benefits of new technology?

Comfort, convenience, and transparency

Braico enlisted fellow entrepreneur Pete Johnson and emergency physician Andrew Culp. Together, they developed Pivotal Health, a platform that lets patients download an app, input their background and symptoms, and schedule their own appointments at a time and place that works for them.  “The idea is to automate everything around the visit but preserve the clinician’s time for the actual visit. When the provider is interacting with the patient, that’s getting the maximum value,” Braico says.

Patients immediately know their out-of-pocket cost, rather than waiting weeks for a bill and even longer for insurance to respond. “You spend more on health care than on virtually anything else. You wouldn’t buy a car or a TV if you didn’t know how much it costs,” Braico says.

The company’s team of medical personnel, led by Culp, is primarily made up of nurse practitioners and physician assistants. Their services include urgent care and primary care as well as referrals to mental health care partners. “We are taking care of the everyday things, such as upper respiratory problems, urinary infections, rashes, and sprains,” Braico says. On the other hand, a person with urgent breathing problems or chest pains will be told to dial 911 or go to the hospital.

Pivotal Health incorporated in late 2020 and began seeing patients in spring 2021. WEDC provided a $250,000 Technology Development Loan. That loan “was huge” in terms of the role it played, Braico says. “It helped us leverage additional capital.” The startup has since raised $2.8 million from investors in Wisconsin, Chicago, and Ohio, as well as both coasts.

Expanding statewide and beyond

Pivotal Health now has 17 employees throughout Wisconsin and provides services in Dane County, La Crosse County, and the Milwaukee metro area. Plans call for operations to expand to northeast Wisconsin, from Fond du Lac to Green Bay, in spring 2023. The company has handled more than 7,000 patient visits in nearly two years, seeing people at their homes, dorm rooms, offices, and even soccer fields.

Pivotal Health works with many major national and regional health insurance companies and is Wisconsin Medicare- and Medicaid-certified. Braico says 90% of the startup’s patients use insurance, and the visits cost the same as or less than at their regular doctor’s office. “People think this is only for patients who have disabilities. No, this is for everybody and anybody.”

Although the idea is a throwback to the practice that was common decades ago, when doctors routinely made house calls, most of Pivotal’s users are younger people. “They’re used to having things—and people—come to their homes, whether it’s Uber Eats or Amazon. They’re thinking: Why isn’t health care run this way?” Braico says. “People are so happy to have us take care of them in the comfort of their own home.”