Employee Benefits, Payers

Health Tech Startups Show Stakeholders How Digital Solutions Can Offer ROI

A panel during the MedCity News INVEST conference discussed what digital health technologies need to do to demonstrate return on investment for payers, providers, and other stakeholders.

The go-go days of health technology startups raising venture capital dollars hand over fist are gone. Companies are still raising money, but they’re also facing more pressure to justify the investments. Feyi Olopade Ayodele, CEO and co-founder CancerIQ knows about those questions and she has answers.

The technology of Ayodele’s Chicago-based startup is a platform that helps physician engage patients in order to gain understanding about their cancer risk. Ayodele said that coming from a financial background, one of the first things she made sure the company did was show that its technology demonstrated financial return on the investment.

“You really have to show people the money,” she said.

Ayodele’s comments were part of a health outcomes panel Tuesday during the MedCity News INVEST conference in Chicago. She was joined by Nathan Linsley, senior vice president, government solutions at Health Care Service Corporation (HCSC); Kate Wolin, principal owner of Circea, and partner at PACE Healthcare Capital; and Shannon Skaggs, president of Quantum Health. The panel, which was sponsored by Quantum Health, was moderated by Ellen Herlacher, principal, LRV Health.

Quantum Health, a company that helps self-insured employers work with their employees so that they can better understand and use their health benefits, provides its employer clients with various offerings to control healthcare costs. Skaggs said partnerships in the employer space are often concerned more about the initial launch and less so about long-term maintenance and improvement of the relationship.

In some cases, preferred partnerships can be like the Eagles song “Hotel California” and its often quoted lyric: “You can check out anytime you like, but you can never leave,” Skaggs said. Once those partnerships are in place, the parties never leave. Quantum Health aspires to be different with its preferred partnership program. Skaggs said re-evaluation will continue over the life of the partnership, which is what the company’s employer clients want and demand.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

HCSC’s Linsley said his company, an insurer, partners with more than 700 vendors. For the industry to move faster, parties need to conduct pilots that are truly pilots and not full integrations. A pilot is a close approximation to what a service would look like without actually getting there, he said.

Ayodele said CancerIQ is allergic to the word “pilot.” Instead, her company uses the phrase “phased implementation.” A phased implementation contract holds a vendor accountable to at least the first step of what the pact aims to achieve. For example, if the objective is to decrease late-stage cancer, that goal won’t be achieved within one year. But there could be measurable benchmarks within a one-year span, such as showing patient adoption of a tool. Those benchmarks are measurable steps toward the ultimate goal of reducing late-stage cancer.

It’s important for companies to think about engagement and what they need in a pilot program before implementing the full program, Wolin said. That means knowing what you want to measure. The worst case is not knowing what success looks like, she said. Pilots are both intensive and expensive so companies need to know what the desired outcome is in order to achieve long-term success.

More engagement is always better, but sometimes little engagement can actually a good sign. When people are healthy, they engage with a technology less, Wolin said. Companies need to account for changes in engagement with the understanding that as people’s health status changes, their engagement with a digital solution will change accordingly.

Wolin pointed to published research from Heather Cole-Lewis at Johnson & Johnson that modeled engagement behaviors. Wolin said the research showed that in order to change behavior—the “Big E” engagement—it’s important to achieve the “Little e” of engaging with a digital solution. The latter form of engagement is key to achieving the longer-term health and financial outcomes that a digital technology is intended to achieve.

“If no one has opened the app in the first six months, you’re not going to get to that financial outcome in three years,” Wolin said.

Photo: sdecoret, Getty Images