A Family Office Tailwind Is Boosting Healthcare Consulting Firms

More ultra wealthy families are establishing offices and seeking consultants to help them choose insurance and find the best doctors.


Illustration by II

Last week, John Samuels rebranded his healthcare navigation firm to better reflect its existing clients and the ones he anticipates it will be working with more: the absolute wealthiest families.

Samuels started what is now called Wellworth in 2016, after more than 20 years in healthcare, including as an administrator at New York hospital systems that see hundreds of thousands of patients per year. The firm determines what health insurance is best for its clients, finds and gets them access to doctors, assists in treatment decisions, and manages all the related communications.

Wellworth isn’t a care provider. It has 11 employees, including two emergency room doctors, two family nurse practitioners, and case managers, who consult on things like choosing a primary care physician and analyzing the risks of a sick cousin attending a family gathering.

Samuels always knew that family offices — which manage investments, properties, and many other parts of a wealthy clan’s life — would become clients. But more of them are seeking healthcare navigation than Samuels imagined.

There are an estimated 6,000 to 7,300 family offices in the U.S. alone and most were founded in the past 20 years. They are also professionalizing; hiring institutional investors to manage their portfolios, forming deeper partnerships with asset managers like BlackRock, and adding non-investment professionals. However, some services, like those related to healthcare, are still almost always outsourced because of the specific expertise they require.

Meanwhile, the pandemic caused an “awakening” for many families, including the wealthiest, according to Samuels.

Stability and security in life was once defined as having a home and dependable income but those aren’t the only components now. “The first wealth is health,” as Ralph Waldo Emerson is credited for saying, and that was an inspiration for the Wellworth rebrand, Samuels said.

“I wanted to bring and blend these two things together, wellness and worth, and make that front and center. My view is that people used to think about health and wealth separately, but [life] is more than just about earning money and so forth,” Samuels said. “That’s why we’ve made that change front and center.”

Even the wealthy can struggle to adequately address some healthcare issues. If someone in New York hurts their knee, they are likely to get good care whether they go to the Hospital for Special Surgery, Mount Sinai or others, Samuels said. It’s harder to choose the right care provider or treatment in other situations, such as substance abuse, even when the cost of any program isn’t a barrier.

“For high net worth individuals, there’s a lot of snake oil out there,” Samuels said. “Sorting and sifting through what’s real versus what isn’t is, from my perspective, a task for clinicians. I think that there needs to be real selectivity and thorough assessments of these things, and specifically in the space of mental health and substance use where there’s a greater demand for services. There’s a very wide variety of quality programs and lack of real good oversight into where you go.”

But family offices expect more than just straightforward problem solving. Samuels said they hire Wellworth to establish a healthcare plan, not unlike what their wealth managers do for their finances. Wellworth’s retainers for family offices start at 50 hours for $30,000.

In many cases, family members and their office employees reach out to Wellworth about changes in the appearance or behavior of their kin or employer — wondering if something is wrong or how to approach a situation. Wellworth has discovered that seemingly small things were signs of serious physical or mental health problems. Even close family members and family office employees might not realize “what’s in front of them is a train wreck.”

“Sometimes people see the tip of the iceberg,” Samuels said. “Having an expert look at what’s really going on helps really address the holistic nature of what’s needed.”

As Wellworth and other consultants grow along with the family office industry, the healthcare service providers are also evolving to meet those needs. Since Samuels started Wellworth, home care providers, primary care startups, concierge medicine professionals, urgent cares, and more have popped up.

“There’s a lot more options for patients, which is good in that it increases access. But the challenge is ‘Where do I go? How do I relay what else is going on medically to this team? And where are my records and how does the hospital record see what happened on this app’ and so forth?” Samuels said. “The coordination of that has gotten more complicated, but additional options give us more tools in our toolbox.”