Running a medical center isn't easy. Running 63 medical centers at which the average patient is 73 years old during a global pandemic is many degrees more difficult. But founder and CEO of Cano Health Marlow Hernandez has managed it deftly.

Cano Health
No. 39
2020 Rank
Three-year growth rate
Miami, Fla.

Founded in 2009, the Miami company offers primary-care medical, dental, and vision services across Florida and parts of the Southwest, along with telehealth offerings. It also works with more than 1,000 independently owned medical centers, which use Cano Health's medical software, billing, and back-office support systems, across the U.S. and Puerto Rico.

This year marks Cano Health's second consecutive appearance on the Inc. 5000, an annual list of the fastest-growing private companies in America. It hit No. 39 on the 2020 list with $430 million in 2019 revenue, a surge of 7,162 percent from 2016. It landed at No. 6 on last year's list.

"We've fundamentally improved how to care," says Hernandez about the company's growth, and most recently through Covid-19. "We provide more access to care, so many more touchpoints, and patients have continued to flock to us as a result of just the reality that we're living in."

Given the whirlwind caused by the coronavirus, Hernandez says the company is in the midst of its greatest single year of growth in its history. In the past 18 months, Hernandez's company opened 40 additional medical centers across 20 counties in Florida and is expecting to open at least half a dozen more before the end of this year. This past month, the company launched its first medical centers out of state in San Antonio, and it has plans to expand to Las Vegas in the next couple of months.

The Pandemic

The growing pains have been tremendous, however. Meeting changing needs during the pandemic has been particularly draining. But Hernandez says Cano's access to data through its health systems and biweekly surveys from patients helped the company anticipate the surge of coronavirus cases, which swept across Florida in mid-July. The head start allowed Cano to install new policies like transitioning further into telemedicine for routine care, mandating facemask use, and increasing Covid-19 testing capabilities. 

Cano is now treating more than 6,000 patients per day, up 50 percent from pre-Covid levels. Telemedicine visits, he adds, now make up about 70 percent of that total. All of Cano's physicians, physician assistants, and nurse practitioners are working at the medical centers, or they're making patient home visits. The same is true for other clinicians and clinical support staff at the medical centers. About 90 percent of Cano's corporate staff of roughly 300 people and about a quarter of the company's workforce is working remotely. 

A Surge in Uncertainty

While the growth in demand for medical services gave Cano a shot in the arm, the reality that many patients are suddenly in worse financial positions softened the enthusiasm. Cano Health facilities treat patients who tend to have multiple chronic conditions and generally low incomes, says Hernandez. He adds that many of them have been hit hard, especially financially, by the pandemic. In March, the company stopped collecting co-pays and started subsidizing essential prescriptions for some patients. The company's more than 200 drivers, who previously offered transportation to patients, are now delivering meals and medicine to patients and community members suffering financial hardship.

The overall uncertainty around his business and the economy more generally has taken its toll on Hernandez, too. "For weeks, I did not sleep well," he says. His wife, a dentist at one of the Cano Health medical centers, in July tested positive for Covid-19 from treating patients. Luckily, she had mild symptoms and has since recovered and returned to work. Three of Cano's employees had to be hospitalized after coming down with the virus; two were seriously ill.

Hernandez has mixed feelings about this moment in time. While the business is doing better than ever, his community and, in some cases, employees are suffering. "From a cash flow and operating perspective, the company continues to do very well," he says. "But I'm attached to these people, and having to lead and put the burden [of employees' health] on your shoulder, that's what's most challenging." 

While Hernandez says he hopes the country never has to go through another pandemic, he's glad Cano can offer job security to associates and providers, and a semblance of hope for patients going through difficult times.

"In that way," he adds, "I'm thankful and I feel blessed."