Rajeev Singh, Chief Executive Officer honor, And Glen Tullman, CEO transparent, Both agree on one thing: the healthcare system is damaged.
How they try to solve the problem is where their views are completely different. This was evident in a recent interview with Singh. HLTH Boston meeting. He believes that nursing navigation is the key to helping self-insurance employers bend the health care cost curve through the use of data, technology and human resources. At the same time, at the same meeting, Talman and the nagging Jonathan Bush took the stage to discuss a healthy future, and basically used a derogatory term in any industry to describe nursing navigation: the middleman.
But first, some background and background.
To be fair, Accolade stands out among the many companies that want to sell its software solutions to mainly self-insurance employers and help their employees navigate the healthcare sector.
Rajev Singh, Chairman and CEO of Accolade
This Pennsylvania company and other employer-oriented companies have a simple proposition: Managed care companies and insurance companies cannot prevent large self-insurance employers from the ever-increasing cost burden of providing employees with medical benefits. With the consumerization and digitization of healthcare, this upstart group aims to combine the power of technology, data, and interpersonal relationships to not only reduce the cost curve, but also provide employees with superior experience and clinical results.
Accolade went public during the pandemic and received Successfully listedThe stock is currently trading at approximately US$40, well below the 52-week high of US$65.25.However, 10 out of 11 Wall Street analysts recommend Buy stocksSingh said in an interview that the nursing navigation company has about 400 customers. The top four customers are Comcast, State Farm, American Airlines and Lowe’s. Accolade also made some major acquisitions this year, enabling it to provide such Second opinion with Virtual primary care and mental health consultation.
The Accolade Care product combines virtual primary care with mental health care. Accolade One is a full set of services provided by the company, where employees can obtain care providers, mental health care and nursing navigation services, and can also use expert second opinion services and tools to help manage chronic diseases.
The following is how Singh described his vision to improve healthcare through a slight excavation of Teladoc, a telemedicine company that uses The jaw-dropping $18.5 billion transaction:
You need to navigate the team. They need to be supported by primary care doctors and mental health specialists who can actually provide care. We have done this in a virtual model, and it says,’You will go to the primary care doctor and they will be with you through your journey. It is not transactional, such as Teladoc. If you need expert advice, it will be human. There will be a mental health professional in each of your care teams. Therefore, we will be people-oriented, data-driven and measurable.
So, how does Accolade get paid? Singh said that regardless of whether all employees use Accolade’s nursing navigation benefits, the company will charge employers all employees. And this is precisely a starting point between the two.
Turman Transcarent was launched earlier this year The goal is to reach risk-based agreements with large employers to guide their employees to a higher quality and lower cost care environment.in a An episode of MedCity’s Pivot podcast, Tullman did not name any companies, but widely criticized other non-risky companies, these companies only charge each employee a monthly fee, regardless of the employee’s use of the benefits provided. When asked about Tullman’s views on HLTH, Singh did not flinch.
I think there is a problem with Glen’s model of only charging people in need, that is, people don’t know where to go when they need help. Glen’s model is proof after the fact, and this kind of call me after the fact, if you need my model, it has been proven time and time again that it will not improve the results, nor will it control the cost of health care. We do charge the entire population. Models like Glenn say-“I will give you a better treatment result” [but the employer is thinking] “I bought all these services to improve my respite care, but my trend line is rising”, this has been true for buyers in the past 25 or 30 years.
Singh went on to add that having this relationship with employees and using data to guide them to better, lower-cost care is what sets Accolade apart. He explained that when an employee receives an insurance ID card from an employer, the phone number listed later will be forwarded to Accolade.
“When I said I would take away every number on the back of your health insurance card, it meant that if you lost your ID, I would answer that call,” he said. “Someone might say, you are wasting time, why did you answer the call. The insurance company should answer the call. I would say you need that ID card because you are going to see a doctor…”
Later, Singh pointed out that “one-third of our expenses are related to customer performance guarantee risks”, and Accolade has proven that it can even further reduce employers’ healthcare costs by 4% to 6% in the first year. Decrease in the second and third year.this The company commissioned Aon Research Six customers provided more detailed information about such savings, he said.
After that in-depth interview, I watched a live discussion featuring Jonathan Bush, who became famous for Athena’s health, now at Health elder sisterAnd Tullman, hosted by VC Christina Farr and OMERS Ventures, who are journalists.
“I know Transcarent is not a navigator,” Bush said, turning to Turman. “But combining navigation with childbirth in a doctor’s way-wouldn’t it be great if the doctor is your navigator? Didn’t we all assume it in the past? Now there are these navigation companies, I have invested in them, and I am proud of them What I see is not the navigation in the middle, but the establishment of very interesting technology leveraged care alternatives. These alternatives have basically found out how to provide care flows in the business model in response to the singularity, which actually will Become cheaper and faster and more efficient every year.”
Glen Tullman, CEO of Transcarent
As expected, Talman’s idea of nursing navigation is less benevolent.
“I’m not very friendly to navigators because I think navigators are another step in the process. You can’t navigate a broken system. When we were in Livongo and [employers] Will say, “We have a navigator” instead of going directly to our people, but through the navigator. Okay, when we use it directly, we will get 35% and 40% of people opt-in, when we go through the navigator, It’s about 12%. So this is just another step, people want simplicity. “
So the first thing is that you cannot navigate a broken system.If you break glass in a room, if you are in the healthcare industry, you would say, “I want a little space” and then [I] Hire someone when I want to walk through the room and they can remind me of the route. Most of us only clean glass outside of healthcare, so we must clean glass.
Compared with health care providers, hospitals are not a problem, and providers are not a problem. They provide care. I do not know you. I don’t want to have heart surgery at home now. I would rather go to the hospital. We need both sides of the equation. We are healthy consumers and we are the real payers. It’s us and the people we work for. Then on the other side is the provider. This is all necessary.
Good software removes the middle part. This is where the friction lies. This is where the challenge lies. This is where all the costs are. Moreover, this sucked all the profits today.
After 18 months of isolation, the HLTH conference is an excellent way for the largest thought leaders and future innovators in the healthcare sector to meet to celebrate the success of healthcare and to open the way for fairness, inclusiveness, cost reduction and better results. [Disclaimer: MedCity News is a partner of HLTH]. But delve deeper, and you will find that behind the inevitable self-congratulations at such gatherings, there are substantial debates about a healthy future.
Photos: HAKINMHAN, Getty Images, Accolade, Transcarent
