Kiio CEO Lydia Zeller talks about the digital musculoskeletal (MSK) startup that guides people through personalized therapeutic programs to reduce and prevent back and joint pain using only their smartphone or tablet.
What’s the genesis story of Kiio and your role there?
Kiio started in 2012 with a mission to transform musculoskeletal care, using in-clinic sensor technology combined with a patient-facing mobile app. I began as a volunteer, and then was asked to consult on various financial management activities. My role evolved to include almost every aspect of the business—from writing our first employee handbook and creating policies to interacting with investors, writing grants, and creating our content library of therapeutic exercises. In 2016, I became responsible for product strategy, where my passion found its home.
Near the end of 2016, we made an intentional decision to reevaluate our technology stack and how we could enhance it to skate to where the puck is headed. I did a deep dive into where healthcare was going, looking at what was possible in innovative care delivery models and the pain points of those paying for healthcare. I wanted Kiio to combine the best in technology with evidence-based medicine to provide MSK consumer-centric care to more people. Firmly believing digital therapeutics was that path, I drove our shift into the digital MSK care space, with a platform offered through health plans and employers. We developed Kiio’s product hand-in-hand with our first health plan clients, and have remained client- and member-focused, expanding the product to cover the continuum of MSK care.
Lydia Zeller
I led the product function until 2020 when I transitioned to CEO. It was a natural change, supported by both our founding CEO and our Board. We had just closed a funding round and had the opportunity to accelerate team growth and product development. I’m so excited about what we have accomplished since then and where we are headed.
What specific need are you seeking to address in healthcare?
Kiio is on a mission to be the easiest, most effective – and most cost-effective – way for payers and individuals to reduce the physical, emotional and financial burden of musculoskeletal pain.
MSK pain has a tremendous impact on individuals as well as employers and health plans. Each year, one in every two people will have an MSK issue, creating significant physical, emotional, and financial burdens. We often think of costs as only impacting the health plan or employer. Yet, in addition to pain and the associated impact on
mental wellbeing, individuals are shouldering significant costs – particularly time off work and the out-of-pocket costs under today’s high deductible plans.
Payers also incur tremendous costs—whether a commercial, Medicare Advantage, or Medicaid health plan, or an employer self-funding their plan. MSK issues cost more than cancer, diabetes, or heart disease and represent one-sixth of all spending in the US health care market. Self-funded employers experience 1.5 times the burden due to lost productivity, missed workdays, disability costs, and workers’ comp costs.
Traditional healthcare has done a poor job of managing MSK conditions, often recommending wasteful tests or treatments that are not clinically indicated and may add risks in the case of opioids or surgery. For example, patients experiencing newly diagnosed chronic musculoskeletal pain are prescribed opioids more often than physical therapy, counseling, and other nonpharmacologic approaches.
At Kiio, we’ve worked to create a member-centric, evidence-based approach to musculoskeletal care so that people receive immediate access, 24/7, to personalized care that is effective, on-demand, and convenient.
Our claims-based studies have demonstrated how Kiio’s immediate access and proven care reduce urgent care visits, prescription pain medication, and over-used aggressive diagnostics and treatments.
Kiio’s quick-start solution is the only one that doesn’t require waiting for equipment, scheduling a clinical consultation, or mastering the learning curve of trackers and sensors. You can answer our screening questions at 3 AM on a Saturday, download Kiio, read your first knowledge material, do your first personalized exercises, and be on your way to feeling better within five minutes. Now that’s truly impactful.
What does your product do? How does it work?
Kiio is a digital solution that provides individualized, on-demand exercise therapy combined with education and support for people who want to relieve or prevent back and joint pain. When a member first engages with us, they answer a five minute screening questionnaire to assess whether we’re appropriate for them and identify their specific pain and risk profile.
We designed Kiio to be broadly applicable to help as many members as possible. With Kiio’s digital front-door technology, the 80% of the folks who screen into Kiio get immediate access to a personalized care program specific to their subset of pain within each joint. (The 20% not appropriate for Kiio are immediately linked to in-network care.) So not everybody with knee pain is going to get the same exercises. Members download Kiio to their smartphone or tablet. Over 50% of Kiio members start their tailored program immediately.
The app has three essential elements.
- Therapeutic exercises with symptom specific tracks built on evidence-based clinical protocols.
- Education modules authored by experts on how pain works with tips to manage it and modify behavior for sustained improvement.
- Support, both AI-driven and through a live care team.
As members engage with their program, we’re querying them on their pain, function, mental well-being, and how they feel the program is helping them. Our software uses that feedback to progress members at their own pace and provides contextual messaging and content. Although most Kiio members interact solely digitally, members also have access to one-on-one interaction with our human care team if they want some extra coaching, additional support, or have questions.
With Kiio, we’re meeting members where they are, enabling them to take charge and find relief. Everything happens exactly when they want it to happen. Members have access to Kiio for a year from signing up so that they can maintain the benefits they’ve gained and prevent and manage flare-ups.
Is this your first healthcare startup? What’s your background in healthcare?
My path may be slightly different from some healthcare startup CEOs in that Kiio was my first foray into healthcare. I firmly believe that there is a significant benefit to bringing fresh perspectives to healthcare, provided that medical subject experts are driving a product’s clinical aspects. Healthcare has much to learn from consumer services in terms of personalization, immediacy, human-centered design, ease-of-use, and creating solutions that are “fun” to engage with and bring joy.
What is your company’s business model?
We have a utilization-based business model where our clients don’t pay unless we engage their members. Because Kiio doesn’t rely on sensors or other hardware to be effective, and because we are using AI to deliver evidence-based care instead of depending on one-to-one virtual care, we can keep the price point relatively low. Clients pay a one-time fee when a member completes our screening and a second fee when a member engages with their digital care program. That fee covers complete care for a year.
We either invoice those fees directly to the client or bill them through the health plan’s claim systems using CPT codes. Claims billing is particularly advantageous for employers because it allows them to flow the fees through the health plan and avoid costs on their administrative side.
Ultimately, we believe that the most appropriate place for solutions like Kiio is to be funded by the health plan and available to people as a fully covered health benefit. Kiio qualifies as preventative care and is a 100% covered benefit, with first-dollar coverage even under a high deductible plan. Members pay nothing out of pocket for Kiio, which aligns with the accessible, affordable, and high-value care we are committed to providing. Still, not everybody has access to Kiio through their employer or health plan. We’ll soon be launching a direct-to-consumer option in partnership with a major national healthcare retailer for those people.
Do you have clinical validation for your product?
We do. Since going live with members at the beginning of 2017, we’ve measured Kiio’s clinical impact, including improvement in pain and function. It’s significant that across our diverse book of business, 8 in 10 Kiio members experience clinically significant reductions in pain and better function. We have also seen strong results tied to mental wellbeing as well as workplace productivity. We are proud to have worked with clients and demonstrated strong results across all lines of business.
On the cost side, we’ve done four longitudinal claims-based database studies with clients to assess the impact of Kiio on their costs. In those studies, we’ve seen up to 64 percent reduction in medical spend, including up to 88 percent reduction in opioid utilization.
We are humbly proud of these results – and personally passionate about their impact on individual members and clients. We hold our core values strong and are dedicated to delivering measurable value to our members and our clients.
To learn more about how Kiio can help reduce pain, lower costs, and empower members, visit the company’s website.
Featured Photo: Prostock-Studio, Getty Images
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