After serving a quarter century as a hospitalist and hospital C-suite leader, Kevin Neese, MD, has taken an entrepreneurial path to help fill what he sees as an important need.
“Hospitals are excellent at the things that they were built for: the crash, the admission, the procedures, the specialty services,” he said on the “Becker’s Healthcare Podcast.” “I’ve spent 25 years in that world through the medical staff operations, the C-suite and hospital medicine. I still respect it, and believe it or not, still love it, and oftentimes think very fondly of it. But what I couldn’t fix from those seats were the 10 to 20 years before the crash that the patient was having.”
Dr. Neese’s healthcare journey has been winding. After working in private practice out of medical school, he worked as a hospitalist in Indianapolis and eventually served as chief medical officer and then as COO at St. Mary’s Medical Center in Evansville, Ind.; the hospital is now Ascension St. Vincent Evansville. In October 2025, he started a company called Novenza, which employs nurse practitioners who cover nursing facilities. And in January 2026, he co-founded Greenwood, Ind.-based Helix Advanced Medicine, a primary care practice.
“I opened up Helix because primary care really is the only place prevention can truly happen, and most panels in primary care are too large to do it,” he said. “I wanted kind of a real internist office where you do annual exams, sick visits, diabetes and blood pressure management, hospital follow-up, nursing home follow-up.”
He connected with Becker’s to discuss what Helix is designed to accomplish, what the company has adopted with respect to value-based care and what he would do if he were back in a hospital C-suite.
Editor’s note: Responses have been edited slightly for length and clarity.
Question: Helix is built around primary care, an optional concierge membership and advanced programs. Why build all three of these instead of going fully concierge, and how do you keep them from being two tiered?
Dr. Kevin Neese: Going fully concierge was my first thought, and it would have been much simpler and more profitable if you’re just looking at the economics on day one, but we didn’t do that for a couple reasons. The Greenwood/South Indianapolis area still needs a real internist office; I still think there’s a demand for that. A lot of people want a medical home that can’t or don’t want to pay a membership, and they shouldn’t have to go to a 2,500-patient panel to get that service.
There are essentially three doors to this practice. The traditional primary care is our floor, and we still see basic internal medicine patients and bill insurance for that. But that concierge part of this is optional, and as it does in most concierge practices, it buys time and access — those longer visits, priority scheduling when they have a problem, and direct communication. You’re buying a smaller panel designed to notice changes early.
We also have discounted add-ons on traditional things that CMS does not cover in that pathway. We are doing some very basic esthetic services here on site, some 3D infrared body scanning, some discount skincare products, some imaging services here. We also have some other advanced programs like bioidentical hormone replacements, brain health, dementia prevention, weight management, performance testing and even lipid management. They live inside the medical home, so the person who’s managing your blood pressure is the same person who’s reading your coronary calcium scores, for example.
That two-tiered care happens when the patient gets a different doctor, a different standard or a different chart, and that’s not the model here.
Q: What lessons are you taking from value-based care that you’re applying to Helix, and where do those lessons not necessarily fit?
KN: It has reduced spending, like in the reduction of post-acute days; the average admission, the average length of stay now has been decreased two to 10 days. But the national programs that would simply hold a percentage of the SNFs’ payment have not really moved readmissions at all, and that’s one of the biggest things that they look at, and that environment is very complex. What I’ve seen is that the actual reductions in hospital readmissions that you do see are in the high-needs [accountable care organization] and the [institutional special needs plan] patients. That’s the institutional special-needs plan, where those reductions have been moving patients really back to a [do not resuscitate] and no hospitalization status, and that’s where they really move the needle a little bit. So I sometimes question if that’s the definition of quality that we traditionally want to move toward, but I do know it’s the proxy now, and we have to really deal with it.
What I’ve learned from that whole process that I’m trying to apply here at Helix is the discipline — knowing the panel, knowing who your patients are, finding those risks early, close the loop, measure what the plan is actually happening. In the hospital and post-acute work, the expensive event is never a surprise, if you really look. You’re looking at weight changes, unfilled diuretics, nursing home fevers that could have been treated on site. We’re looking more for the risk before the event, so we’re looking at ApoB levels when they dictate aggressive lowering, coronary calcium scores when it changes the conversation, and looking to screen someone’s cognition 10 to 20 years before it becomes obvious. We’re trying to coordinate labs, especially follow up, so that the patient is not their own project manager, and we like to think of that as value-based thinking.
Now, where it doesn’t fit in our practice: I don’t want to let quality dashboards become the visit. I think we’ve looked at [Healthcare Effectiveness Data and Information Set], and you know, for example, just pulling out one of the HEDIS things that you’re supposed to follow, and that is, if someone has been on a statin, you’re really not even looking at what the result of that statin is if they’re taking the drug, and if you’ve really moved their ApoB levels. So we don’t want those things to really dictate our visits. We actually want to see these measures moving. So these measures that I think are out there in the ACOs and in value-based care are really useful floors, but I always feel that they’re terrible ceilings.
Value-based care taught me to measure, but it did not teach me to pretend a metric is the same thing as a life that we’re following here. So our focus will be to improve lifespan and healthspan and keep people healthy.
Q: You’re a former hospital CMO and COO. Looking back on your time in the hospital and health system universe, what would you change if you were back in the C-suite?
KN: If there was a way to cap employed primary care panels at a size where they have that same-week access and a real annual exam that are operationally possible, even if that means hiring more providers, that would be a nice option. I know when I go visit my own primary care physician, it’s a 10- to 15-minute exam discussion, and I bring my agenda, and that person has their agenda, and compressing that into that eight- to 15-minute exam is difficult if not impossible.
Maybe another is to give [physicians] support for the complexity of their patients that they’re seeing. It wouldn’t shock you that you know patients come in with very complex lives, and so having social workers, pharmacists and some back-office support for the myriad forms that come through that office and put psychological pressure on the clinician [would be helpful]. Things like [Family and Medical Leave Act] papers, pre-authorizations, emails. These are things that are taking time away from the patient, and so even if the providers in primary care are not actually talking about this, they will all complain about the large number of interruptions that occur during their days and inability to take care of the complexity of their patients.
