At 15 East 30th Street in Manhattan, where apartments start at $1.4 million, residents have access to sweeping floor-to-ceiling windows, skyline views, hot tubs and pools, and (since last year) membership of their own private emergency room. Madison House, as the building is known, is one of a growing number of properties that are offering specialty medical care for their residents that now includes at-home COVID-19 testing.
North Madison or NoMad, the neighborhood above Madison Square Park where Madison House is situated, is a former commercial district that has in recent years become home to glass-walled condo buildings and glitzy rooftop bars. Madison House holds the title for being NoMad’s tallest residence, though among luxury buildings its amenities are pretty standard fair. They include a spa and fitness center, a residents-only club, and a wood-paneled wet bar, all illuminated with the honey glow of soft lighting. But what sets the Madison House apart from its peers is that it now offers new condo buyers a one-year subscription to Sollis Health, a members-only primary care and emergency medical facility.
“I wouldn’t say that it’s something that has been the standard for a long time,” says Dr. Scott Braunstein, Sollis Health’s recently hired medical director in Los Angeles. “But I think people as they have been in their homes more and have felt vulnerable from the pandemic are paying more attention to their health and appreciate even more getting care in a concierge manner.”
The demand for Sollis Health’s services reveals how America’s wealthy are staying safe amid a pandemic: by bringing healthcare to themselves. While most Americans are able to access doctors over telehealth platforms, they still have to contend with a broken medical system, including hospitals that at times have no space for new patients and an inability to get test results in a timely fashion. Contrary to what some thought at the beginning of the pandemic, COVID-19 has not been some great class equalizer. Data show that Black, Latino, and Native Americans have suffered greater hospitalization and death from the disease compared with their white counterparts, because of an array of systemic barriers including poverty. It should not be surprising then that for the right price, a person can avoid overwhelmed hospitals, testing shortages, and even a week-long delay in receiving test results.
COVID-19 has not been some great class equalizer.
Sollis Health members pay between $3,000 and $5,000 a year for unlimited telehealth consults, house calls, and visits to its health centers, all of which feature a private emergency room. At the end of 2019, the company had two locations in Manhattan’s Tribeca and Upper East Side neighborhoods, and it provided summer house calls to any of its 2,250 members who happened to be vacationing in the Hamptons. Since March, when the U.S. was engulfed by the global pandemic, Sollis Health has expanded its operations in the Hamptons and opened a new facility in Los Angeles. Its membership has since doubled, to 4,500 members.
Before COVID-19 struck, Braunstein says house calls were a small component of the company’s service. Patients were more interested in having access to Sollis Health’s concierge-style emergency room, which has ultrasound, x-ray, MRI, and CT machines, along with its own lab for processing certain medical tests. All of this is available to Sollis members without the usual emergency room wait. Now, 50% of its business is house calls, which doctors and nurses make to 40 luxury residential buildings in New York City.
About 35 of those buildings belong to Related Companies, the real estate firm behind Hudson Yards, an enclave on Manhattan’s west side for the über-rich. The company has been offering a new amenity that feels particularly lux amid a pandemic: at-home testing for COVID-19. Related also has a deal with Mt. Sinai hospital, which has a medical facility at Hudson Yards, to do testing for nearby residents. For the rest of its buildings around Manhattan, Related is paying a team of nurses at Sollis Health to come to its buildings once a week to administer tests. Residents sign up for a time slot and pay for the test through their insurance. Turnaround times have been a quick 24 hours. Dr. Braunstein says Sollis Health is also looking into point-of-care tests so it can run the tests, speeding up results even more. Elsewhere in New York City, the delivery of test results has been less consistent. Earlier this summer, it took some New Yorkers more than a week to get their tests back, though the city has since partnered with additional labs to help bring that timing down. Related’s residents never experienced those delays.
At-home testing is not all Related is offering its most prime residents in these times. Since the pandemic took hold of New York City, the real estate firm has launched an array of services including food delivery from butchers, farmers’ markets, and other local purveyors, as well as prepared meals that residents can pop in the oven or microwave. It is also providing school-age children with access to tutoring, a socially distant homeroom where they can Zoom into classes, and other academic enrichments.
This set of pandemic-era accoutrements allow those with means the ability to access the outside world without ever having to leave the house, whether for food or for medical help. “People are so fearful of going to the hospital. In some cases we’ve actually recommended that they go and they insist that we continue to treat them at home, which we do to the best of our ability,” says Braunstein.
When clients test positive for COVID-19, Sollis Health can bring equipment into a patient’s home to monitor and treat the disease. The company has portable x-ray and ultrasound machines as well as oxygen concentrators, which supply a person with additional oxygen. Braunstein says Sollis Health’s team of physicians can check in on patients daily and monitor their vital signs through a combination of telehealth and in-person visits.
“It’s quite a luxury, not having to go through ERs,” says Samir Qamar, founder and CEO of MedWand, a telemedicine device designed to take vital signs remotely. Qamar previously served as the resident physician at Pebble Beach Resorts, a four-star resort near Monterey, California. He says the trend toward at-home care will continue to grow. “When you’re used to that, like anything, it’s hard to go backwards.”
We live in a society now that likes care wherever they are, whether it’s medical care, whether it’s a delivery service, whether it’s ordering movies on Netflix.”
“We live in a society now that likes care wherever they are, whether it’s medical care, whether it’s a delivery service, whether it’s ordering movies on Netflix,” Qamar says. “We live in an on-demand, stay-at-home type of society now where if convenience can be had—why not?”
Of course, as we know now, staying at home is itself a luxury that not everyone has access to. Essential workers such as mail carriers, shipping warehouse workers, nurses, meat processors, and phlebotomists cannot work from home. Related says while it is not offering this concierge-level service to the residents at the 55,000 affordable housing units that it owns (roughly 70% of its apartment rental portfolio), it has connected some of them with testing in certain locations. It did not offer more specific details on those programs.
Qamar says that he thinks telemedicine could make concierge-like health services more broadly available, but telemedicine has its limits. The New Yorkers who have had to leave their house every morning and evening to work through the pandemic are also the ones who suffered through limited testing availability and too-late test results. Telemedicine can certainly help identify probable COVID-19 cases if the patient is symptomatic, but it cannot track asymptomatic cases, which matters when you are asking people to continue working in ways and places where the disease can be transmitted. Most of all, telemedicine cannot push the people who need testing and care the most to the front of the line. In our current system, only money can do that.