Health Business Blog

Increasingly, family caregivers with no formal training are doing the kind of work more commonly associated with hospital-based nurses: operating dialysis machines and ventilators, administering IVs and injections, and using monitors for blood glucose, oxygen saturation and more. AARPs’ Public Policy Institute and the United Hospital Fund have released a new survey on the topic. The Boston Globe has a good article on the subject.

Many of the caregivers are performing advanced tasks such as those described above, but few report getting appropriate (or any) training to do these jobs. In my experience the equipment can be complex and it’s extremely easy to make a mistake. (See my recent, related post about managing a complex pediatric regimen at home.)

It’s unlikely that a great influx of trained, affordable nurses will be arriving anytime soon, but there are a couple paths that hold promise:

• Hands-on training for caregivers, integrated into doctor visits, with follow-up available by phone and videoconference using Skype and similar readily available technologies
• Intuitive, consumer oriented equipment and supplies, akin to what Apple has done in the consumer electronics sector. You see it to some extent already in self blood glucose monitoring for diabetes, but there’s a lot further to go. FDA should encourage better consumer usability in its approval process

Share

Medication mix-up’s are a well-known source of errors and harm in the hospital. So we shouldn’t be surprised that similar errors occur in other settings, including the home. Medication Errors in the Home: A Multisite Study of Children With Cancer in the journal Pediatrics documents the high rate of errors in at-home administration of medications for pediatric cancer.

Error types include administering at the wrong dose or frequency, incorrect label, missed doses, using expired medication, and using the wrong administration technique. Many of the errors have the potential for harm, some caused actual harm.

From the article:

“In our study, parent administration errors were often caused by miscommunication between parents and clinicians or between in-home caregivers regarding changes in oral chemotherapy dose. Frequent changes in dose, which caused the bottle label to be outdated, were often a root cause of parent errors.”

I’ve seen similar things happen outside of oncology. Sometimes a patient is taking 10 or more medications and supplements, so it’s very hard for a parent to remember what to do even when they are well educated, organized, and have the best of intentions.

I’d like to see someone come up with a comprehensive solution to managing multiple, frequently changing pediatric medications in the home setting. I don’t have a specific solution in mind, but would be very appreciative if one came on the market.

—–

By David E. Williams of the Health Business Group.

Share

Health Payment Systems (HPS) helps consumers understand and pay their bills. In this interview, HPS CEO Jay Fulkerson answered my questions about the origins of the company and what they are trying to achieve.

What challenges are you trying to address?

As a technology company, we look for ways to close existing gaps or delays by streamlining the healthcare payment and billing process and connecting its various components. The current payment system is convoluted, confusing and wasteful. We need to rethink it from the ground up if we’re serious about doing the very best for healthcare consumers. We hope to bring an increased understanding of the process and simplification for the patients and providers, as well as empowerment for consumers.  Data shows patient satisfaction with their provider decreases 10 percent from the time of discharge to after receipt of the bill. We’d like to see that turn around—where the payment process is another opportunity to affirm the strength of that provider’s brand and mission

What is the Super EoB and why was it developed?

The Super EOB was developed after one of HPS’ founders, James Brindley, underwent treatment for cancer and saw the bills begin to mount.  After a full recovery, Jim gathered his stack of paperwork, met with his neighbor who was in the healthcare field and said, “There’s got to be a better way to make sense of all of this.” After two years of research and planning, they incorporated Health Payment Systems. Sometimes patients need to simply focus on getting well, and the overwhelming medical bills and EOBs do not help.

The Super EOB benefits three entities:

• Providers receive a single electronic payment from HPS for both the benefit plan and patient portions of a bill
• Employers save money because HPS passes along savings it secures from providers
• Families receive one monthly statement, the Super EOB, which includes healthcare services from all HPS providers, for all family members.

It’s really a win-win-win for all involved.

What kind of feedback are you getting from patients?

We know that patients can easily understand what they owe, where to submit payment and by what due date. A process like this saves time, trees and money, plus patients understand it better and don’t have as many questions for employers.

In a recent focus group, we asked employees of a local county government what they thought about the advances in claims technology and the ability to receive something like a Super EOB. Participants liked that information for all family members was on the same page, and that they could make one payment for everything on the statement

Who are your customers? What is your business model?

Our customers range from small employers to large, self-funded companies.  We have a large portion of municipalities and school districts, as well as healthcare providers. As a healthcare technology company, our business model is aimed at taking waste out of the claims administration process, while making the healthcare payment experience easier for consumers to understand. Our provider network includes more than 6,500 healthcare practitioners in Wisconsin. We enroll more than 75,000 patient members and have 40 employees.

What impact is ACA implementation having?

The ACA was created to provide affordable healthcare to everyone. In order to do so, steps need to be taken to make healthcare more affordable.  Removing waste from the payment of health care services is our primary business, and is one factor that will help make healthcare more affordable.  There is no better time for employers to embrace the single payment technology offered by HPS.

Why did you develop the YouTube video? What do people think of it?

To tell our story better, we put together a short, animated YouTube video that demonstrates just how much paper the average family receives related to healthcare billing.

It’s a fun, easy-to-understand explanation of the current state of healthcare paperwork from the patient’s perspective. HPS actually has a stack of EOBs and bills that we counted to get to the numbers mentioned in the video. We have some pretty fascinating data that I’m not sure anyone else on the claims or provider side has researched before.

The response to the video has been positive.  It has helped HPS tell our story, as well as allowed our employees to share with their family and friends to help them understand what they do at work.

What’s next?  How else are you hoping to improve patient experience?

We have been out starting the conversation—meeting with providers and employers to see what their changing needs are and how we can help address them.  We need to shift our idea of competition in order to work together toward better value for patients and communities. That said, we would love to partner with a local provider about launching a Payment Value Stream. It would allow us to examine each step in the current process to see where we can remove waste and create value. From a lean perspective, this is an area of care not many people have looked at, and we think it’ll give us great insights. We continue to work at incorporating the voice of the customer and transparent performance data into our approach.  Finally, we are working on a consolidated billing product, will soon be rolling out a more robust patient portal and are looking at additional ways to empower consumers.

—-

Bio: Jay Fulkerson joined Health Payment Systems (HPS) in 2011 and serves as the president and CEO of HPS. Previous to his role at HPS, Fulkerson served as chief executive officer of Touchpoint Health Plan in northeast Wisconsin. Following the acquisition of Touchpoint by United Healthcare, he served as chief executive officer for Wisconsin and then as regional chief executive officer for United Healthcare’s Midwest Region.

Interview conducted by David E. Williams of the Health Business Group.

Share

The business and operational needs of health plans are changing so quickly that it’s no wonder they’re running into information technology challenges. At the same time plans are by their nature are conservative about changing how they operate and swapping out old systems for new ones.

In this podcast interview, Joe Marabito, CEO of ikaSystems lays out the complexities of the health plan IT world, describes how health reform is providing new opportunities for administrative innovation, and speculates about the role Accountable Care Organizations will play in transforming the payer world.

ika provides a variety of next-generation IT infrastructure to health plans and so has a front row view of the changes.

—-

By David E. Williams of the Health Business Group.

Share

David Williams interviews ikaSystems CEO Joe Marabito [ 19:54 ] Play Now | Play in Popup | Download

Patients are often confused by the medical bills they receive from providers and have difficulty matching them up with the so-called Explanation of Benefits (EOB) forms they get from health plans. The result: frustration, wasted time and bills that don’t get paid. This problem befuddles not just to the ignorant or feeble-minded; I freely confess that it afflicts me as well.

In this podcast interview, Simplee co-founder and CEO Tomer Shoval explains how his company’s medical wallet and self-service payment platform help patients understand and pay their bills and help providers collect payments faster and at a lower cost.  Shoval has a background in e-commerce (he’s ex-eBay) and that experience shows through in Simplee’s approach.

By David E. Williams of the Health Business Group.

Share

David Williams interviews Simplee CEO Tomer Shoval [ 17:41 ] Play Now | Play in Popup | Download

This is the transcript of yesterday’s podcast with Castlight Health President John Driscoll.

David E. Williams:  This is David Williams from the Health Business Group.  I’m speaking today with John Driscoll, president of Castlight Health.  John, nice to speak with you today.

John Driscoll:  Great to be with you, David.

Williams:  John, we’re going to talk about two topics today.  One is the new Castlight Pharmacy product and another is Castlight’s emergence in my home market of Massachusetts with its first health plan deal with Harvard Pilgrim.

Let’s talk about pharmacy first.  What is this Castlight pharmacy product?  What is the need that you’re addressing?

Driscoll:  As you know, David, we are absolutely aggressive about making sure that consumers have real time information that allows them to make the best choice.  And we are focused on the lack of cost and quality information in marketplace.  That’s an entirely new area for consumers and patients.

The one area where consumers are ready and able to make smart purchasing decisions is pharmacy.  So we thought it was important to invest in a new capability to allow consumers to make decisions right after they’ve left the doctor’s office with their mobile device or when they’re searching on the Internet.

Consumers are very focused on how much drugs cost.  And many patients are trading off drug costs against their weekly budget.  So we thought it was important to invest in this capability and roll it out quickly because we knew that patients and consumers needed it now.

Williams:  Pharmacy, as you said, is an area that consumers are really ready and able to engage in it.  It seems like that’s partly because it’s a discrete product that they identify as opposed to going to a hospital and not knowing what set of services they’re receiving.  But it also is maybe because it’s an area where there’s been some focus both from health plans and from PBMs.  I know you spent some time in that industry.  So can you distinguish what Castlight is doing from what’ already out there?

Driscoll:  It’s clear in other categories where we are providing cost information for the first time to patients.  But even in the pharmacy world, even with all the information and tools that health plans provide, they’re not focused on providing real time information at the point of decision in a way that impacts consumers immediately.

That’s probably a function of the fact that at Castlight we have a major focus on consumer behavior. Frankly, this is all we do.  We provide the best tools with the best information. So much of how you get a consumer engaged and keep them engaged is providing simple consumer-oriented tools that are as sophisticated as a consumer needs.

It could be as simple as making sure they know the difference between branded and generics and home delivery versus a local pharmacy.  Those basic choices –and providing them in a way that consumers can act on– extends the value of their benefit at the point where they are given a script.

Those tools really don’t exist in the marketplace in a way that really engage the consumer.  There’s an art to putting together the consumer interface and the product and then making sure that we’ve got real time information that is directly relevant to where the people are in their benefit.

Williams:  Unlike with medical benefits, there seems to be a fair amount of competition at the retail level on drug prices. So you have Wal-mart, which kicked things off with the $4 generic program and you see it extended into some pharmacies that offering low priced Lipitor or free antibiotics.  Can that information be integrated into Castlight pharmacy or does that stand outside of the system?

Driscoll:  What we are focused on is what’s covered under the insured benefit. Any part of the benefit that employers are paying for is integrated into the tool.  And it’s integrated in a simple way to enable the consumer to make a decision at the point of shopping.

Williams:  Is there a connection between what you offer on Castlight Pharmacy and the medical part of the benefit or are they standalone tools that are used separately?

Driscoll:  They’re really standalone tools, but the great thing about pharmacy is the richness of the data and the fact that the consumers are ready to comparison shop. What’s hard is integrating in a simple way that enables the consumer with limited time to make a decision.  And that’s really what this component of the product is.  It sits on top of the traditional Castlight transparency product.

Williams:  Does Castlight Pharmacy serve the Medicare Part D market or is this more for commercially insured patients?

Driscoll:  Today, our pharmacy product is focused exclusively on the commercially insured, but we absolutely are going to be looking at Medicare and Medicaid, because there are opportunities for consumers to save in every market.

Williams:  My understanding is that with Castlight, a consumer would need to have their employer be a customer of Castlight in order to access the tools.  Is that the case with the pharmacy product as well or is it available to individual consumers?

Driscoll:  Yes.  The employer has to buy it. It’s through the employer purchasing that enables us to gain access to information that powers the tool and allows the employee to understand exactly how much is covered and exactly how much things cost.

Williams:  Let me turn to another topic: health plans. I think about Castlight as somewhat of a competitor or threat to health plans. You may be revealing information to their customers that they perhaps should have revealed themselves.  And yet it seems you’re starting to work with health plans, beginning with Harvard Pilgrim, which is often ranked as the number one health plan in the U.S.

Can you talk about what you’re thinking with health plans and then what specifically is going on with Harvard Pilgrim?

Driscoll:  First of all, I would say that health reform is a team sport. We look at all of the health plans that work with us as partners. We’re all driving better outcomes and lower prices; the vast majority of people in the health insurance industry want to do that.  We feel like we’re all playing for the same cause.

We will partner with health plans in small ways or large to deliver value for their covered lives.  And we’re very excited to be able to adapt the cost estimator, our technology and our approach and to work with such a great partner as Harvard.

We look at the health plan marketplace as a real opportunity for Castlight.  In some cases, we’ll be working with employers. In other cases, we’ll be working directly for the health plan and with employers in that marketplace.

For us, it’s just a variation on what we think is a huge need in the market place – for better information and an empowered consumer.  As it happens, there’s a complete values match between what Harvard wants to achieve in the market place and what we’d like to achieve in the market place.  They are very focused on transparency and may want to empower their approach to have Harvard Pilgrim.

Williams: John, it’s interesting to see that you signed your first health plan in Massachusetts, which is a market that has led the way with health reform. The Affordable Care Act was modeled on the Massachusetts plan.  We’ve also been quite active in transparency.  Did the legislation and the move in the policy sector toward transparency have anything to do with why Massachusetts is the first market you’re entering with health plans?

Driscoll:  There is no question that the health plans in Massachusetts are particularly progressive. And obviously, Harvard Pilgrim is one of the best and the highest-ranked plans in the country.  I think it is no surprise that we are finding great partners in the most progressive markets in the country.  What’s interesting about the Massachusetts marketplace is its employers, its legislators, as well as health plan leadership that are driving a much more transparent system.  And I think where you’ll see transparency not just on cost but also on quality and outcomes.  It’s also a place where there’s a lot of very interesting and enlightened thinking around how to compensate for value and how to measure value.  It’s really a laboratory for the rest of the country in health reform innovation.

Williams:  Yes, it’s interesting.  We also had one of the earlier all-payer claims databases in Massachusetts.  My impression is there’s been a lot of information put into that database. The plans have submitted that information, but not all that much has come out of it.  Does Castlight complement the all-payer claims database?  Is it a substitute for it?

Driscoll:  I think it complements the all-payer database.  There’s still a fair amount of data gaps in every public database that’s been put up, but every time another database is developed and is improved, it’s another step towards having a more transparent system. That means a fairer system, a more accurate system and a system where not just software companies are selling services, but the patients and doctors and health plans and everyone else will gain from having a system where you can measure and then drive better results.

Ultimately, Castlight is more interested in getting access to information that historically folks haven’t had access to, making it actionable for employers and employees in a way that helps them drive better outcomes and lower costs.  And as of today, we need to be able to get more information and provide it in a particularly elegant way and constantly improve it. The bigger Castlight gets, the more we know about the consumers and we can create tools that have meaningful impacts on cost and quality.

Williams:  You talked about health reform being a team sport. Clearly Castlight and health plans and employers are on the team.  Are providers part of that team as well and if so, how do they play?

Driscoll:  They are.  We’re only in the first few innings of transparency for employers and employees, but I’m not even sure it’s the first inning of transparency for providers.  The majority of providers want to do the right thing but don’t have actionable information.  They don’t have tools they can use.  They don’t have tools that are meaningful, that fit their workflow and that can furnish providers with better information on cost and quality.

One of the concerns I have about some of the more progressive markets like Massachusetts is making sure that providers have access to that same information that Castlight currently provides to employers. Without that, to compensate doctors and hospitals on performance metrics seems unfair.  We will only have a fair system that can function and create better performance if providers have access to the same kinds of information that Castlight is currently providing to employees.

Williams:  Obviously, physicians are under a lot of pressure.  They’re being asked to do things that they weren’t asked to do in the past and didn’t learn about in medical school. They’ve got a lot of requirements to adopt health information technology, a lot of compliance requirements, and an imperative to do more with less.  And as I look at a lot of information systems that are out there, the providers really don’t have such great access to the kind of transparency data that you’re describing.

What’s the solution there?  And how long does it take?  And are there ways to see milestones along the way that may indicate longer term success?

Driscoll: Providers are only going to use tools that are meaningful.  They want to save money for their covered lives and the patients they serve and they want to create better outcomes.  But they don’t have information right now and certainly nothing’s been built into workflow. I think the next step is working, these companies life task is working with health plans to provide their network participants better information and to make certain that it is meaningful, simple and doesn’t slow down the hard work that doctors are doing.

The promise of companies like us or the promise of technology is to create this frictionless change where people can actually do more with less hassle. If you can integrate software tools into physician and hospital practices with the kind of information that the health plans have, doctors will make wiser choices.  There’s a real opportunity right now but I’m concerned that without those kinds of tools, that putting doctors on new kinds of performance metrics like bundling, or bonusing them more on value is unfair unless they have the information to make wise choices.

Williams:  I’m a member of a health plan in Massachusetts, a different one than the one you described, and my primary care physician is part of a contract that does pay based on value. I’m wondering what kind of information would it be useful for her to have that she probably doesn’t now that could help me and could help her?

Driscoll:  I don’t know what information your doctor has access to, but certainly every doctor needs to have better feedback for the covered member that they’re taking care of, what’s covered and what’s not.  For the doctors they refer to, what are their historic outcomes, how frequently have they done certain procedures, how satisfied are patient, and how do they fit into an episode of care? In a fee-for-service world there are informal referral networks.  We want to create a system leveraging information that creates an informed referral.

Williams:  I’ve been talking today with John Driscoll, President of Castlight Health.  We’ve been talking about the new Castlight Pharmacy product and also talking about Castlight’s first health plan customer, Harvard Pilgrim, in Massachusetts.

John, thanks so much for your time.

Driscoll:  Thank you.

Share

Health care transparency leader Castlight Health has launched a tool to manage pharmacy costs and signed its first deal with a health plan: Harvard Pilgrim. In this podcast interview, Castlight president John Driscoll and I discuss:

• What the new pharmacy tool adds to the offerings already on the market from health plans and PBMs
• Why the first health plan customer is in a market (Massachusetts) that’s already a leader in transparency
• The role of health care providers in the transparency movement

Share

David Williams interviews Castlight's John Driscoll [ 17:17 ] Play Now | Play in Popup | Download

This is the transcript of my recent podcast interview with Healthbox CEO Nina Nashif. The company just kicked off its second business accelerator program in Boston with 10 companies, in conjunction with Blue Cross Blue Shield of Massachusetts.

David E. Williams:  This is David Williams, president of the Health Business Group and author of the Health Business Blog.  I’m speaking today with Nina Nashif, CEO and founder of Healthbox.  Nina, thanks for joining me today.

Nina Nashif: Thanks for having me.

Williams:  What is Healthbox and what unmet need was Healthbox created to serve?

Nashif:  Healthbox was founded in January of last year and was intended initially to support health care entrepreneurs by providing seed capital, mentorship, a rigorous process to help them think about their business and how they grow it, as well as support in raising money at the end of a four-month program.

As we’ve evolved our program Healthbox has also shifted its own business model. We believe that it’s not only important to support health care entrepreneurs, but it’s also important to serve as a catalyst of change within the health care industry by exposing hospitals, payers and pharma and other types of organizations to new and different ways of thinking about how to solve the industry’s greatest challenges.

Williams:  Is the process that you’re using generic?  Could it be applied within other industries or is there something different about innovation in health care that makes it so that you’ve chosen a particular approach?

Nashif:  It’s really important that we develop a process that’s relevant in the health care industry.  So as we thought about creating the Healthbox platform we thought about the different nuances involved in building a company in health care.  As we know, the health care system is complex.  There is often a difference between who’s buying the product or the solution and who’s actually using it.  There are so many different stakeholders and different revenue models that make sense depending on the type of organization you’re selling into.

Given all of the dynamics it’s important to work with a company throughout the lifecycle and to think about how are they building their business in the context of the industry that they’re selling into.  We’ve refined the process that helps entrepreneurs think about these critical issues and develop a customized product and a business that will scale in the industry.

Williams:  You’re based in three cities. If somebody would ask me to guess what those three cities were just based on the description of your business, I would have guessed Boston, New York and San Francisco.  But you’re in Chicago, Boston and London.

So tell me how you thought about those three places and also how you incorporate what’s going on in London to what’s happening in the U.S., considering that the US and UK health care markets and health care systems are so different.

Nashif:  I’m actually based in Chicago and so is Sandbox Industries, which is the organization that I was working for when I founded Healthbox.  Our first program was based in Chicago for that reason and it actually ended up being a great place to start Healthbox, because despite what people may think Chicago does have a very vibrant health care community. There’s the strength of many large hospitals, many associations, and there’s pharma present. Many different dimensions of the health care system do exist.

Our first program was in Chicago.  As a result of the success there we were asked by Blue Cross Blue Shield of Massachusetts to consider bringing this program to Boston and the rationale for doing that was their interest in engaging in the broader community.  There’s a lot of activity in Boston and a lot of strengths in the health care industry.  But a lot of the activity from an entrepreneurial perspective is really revolving around the universities. TechStars has a strong program here in Boston, the MassChallenge and all the resources that you know that exist in the community.

But from a health care perspective, there wasn’t really a single external platform that was tying together all the unique organizations that are interested in innovation in Boston.  So we were pleased that our second program launched in Boston just because all of the existing activity that’s going on and we’ve been really well received and very happy to be testing the model in a new environment and to be working across the region.

London was a strategic decision and our presence there probably happened a bit quicker than we initially expected. I lived and worked in London before and so making the transition there was quite easy for us, relatively speaking.  But health care is global and we always knew that we wanted to be a global platform. So as a stepping stone to the rest of Europe, London and the UK just made sense for us.

Williams:  How does the Healthbox program work?

Nashif:  The Healthbox program initially was modeled after the spirit of a traditional tech accelerator program.  We took a lot of the same components in terms of the seed capital that’s provided, although we knew that starting a company in health care requires more resources, not because IT companies and health care aren’t capital-efficient businesses, but because the sales cycle takes longer and requires just a little bit more business development time.

We provide $50,000 in exchange for 7% equity.  We have a national network of mentors that represent different parts of the health care industry that are available to provide strategic advice, make introductions to their network and other potential customers or experts that can help the entrepreneurs.

We also have a pretty rigorous curriculum or process that we put the companies through.  From the very beginning we’re actually going back to my original comment about helping these entrepreneurs understand their business model, refine their business model, think about it in the context of the health care industry. We help them think about who is the buyer, who’s the user, what kind of revenue model would make sense given what they’re trying to develop.

We have a proprietary process that we’ve developed and we put companies through the three –and now expanding to four– month process.  At the end we help match entrepreneurs to investors and help them think about the right customers as well as investors that can help them grow their businesses in the long-term.

So those four are the main components that make up the Healthbox program.

Williams: I know that Healthbox is pretty new and you just alluded to the long sale cycles that are inherent in a lot of health care businesses.  But with that in mind, can you provide any examples of success stories or organizations that have been launched or accelerated as result of going through the program?

Nashif:  Sure.  There is a company called SwipeSense that went through our Chicago program. Given that they’re a year out, they’re a really good example because they’ve moved themselves through the product fund-raising and business development cycle in the last year.

They focus on what they call hand-hygiene 2.0.  The lack of hand sanitization in hospital environments is a big driver of hospital acquired infections.  It results in more than 100,000 deaths per year and adds billion of dollars worth of costs to the broader health care system.

There are two amazing entrepreneurs who are graduates of Northwestern University’s design school. While they were in school came up with a small device that clips on to a nurse’s scrubs.  The company is called SwipeSense because as a child we always think that if our hands get dirty we’re going to wipe our hands in a downward motion on our pants in order to get whatever’s on our hands off. This mimics that gesture in terms of a nurse who needs to sanitize his or her hands would swipe their hand down this device that will be clipped on to their scrubs.

They came in to the Healthbox program with a prototype of this product already developed, and throughout the process of going through Healthbox and talking to a number of different experts they were challenged on what business they are really in. They evolved their business to become a software as well as a hardware business and went through a process of getting feedback in the market from focus groups of nurses in different hospital settings.

By the end of the program they were able to secure a couple of new pilot sites.  So as they came in to the program with two pilots, they left with six and now as a result of coming out of the program and continuing to network, they have ten pilots that are ready to begin.

Also, as a result of going through some of the focus groups and their initial pilot, they ended up redesigning or streamlining the device that they’ve created because the feedback that they got was that it just needed to be a bit smaller, needed to clip on in a different way.

They also built out their web application and have continued to gain customer traction, and they also raised more than a million dollars at a pretty strong valuation.  So they have accomplished more than they had on their own as a result of coming through Healthbox.

Williams:  You’ve mentioned before that you had evolved to change the Healthbox business model.  Can you talk a little bit about that evolution and what your current business model is?

Nashif:  Given that Healthbox makes investments in companies, we’re set up as a venture fund.  We are a for-profit model, unlike some of the other accelerators in the industry.  As I mentioned before we’re making a $50,000 investment in exchange for 7% of the equity in these companies.

We also have funds available at the end of each program that are used to make follow-on investments in the form of a convertible note.  But Healthbox makes money as a result of the companies being successful.  We’re incentivized to help these companies grow in the long-term and become sustainable and scalable businesses.

We have an upside in terms of when these companies potentially exit and that’s really how we’re compensated in the long run.

Williams:  If you look back in a few years from now, how will you know if Healthbox has succeeded beyond the dollars and cents?  Are there other measures that you might look at to say this has really been what you were hoping it would be?

Nashif: As I mentioned before, I think that the traditional accelerator measures their success based on the number of financings immediately after a company leaves the program.  The typical metrics are on how many companies have raised X amount of dollars, how many companies have added jobs. There is an economic development aspect of this.

There’s also the metric around how many companies are even in business one year to two years or three years later, given that we know that across any industry there’s just a certain percentage of companies that don’t make it.  And so I think for us all of those metrics are really important, but as I mentioned before we’re also trying to be an agent of change in the industry.

We measure our more immediate success also around how many companies get pilots and how many users they are attracting and whether they are actually able to gain attraction in the industry, because if they’re not doing that then the financing is going to be harder to get. Because I think venture investors are traditionally even more risk averse.  They tend to like to see the customer attraction and validation of the market before they’ll invest and so I think those are some early metrics for us.

We certainly value the relationships we have with investors and with the broader entrepreneurial community.  But for us to really effect change and be successful at supporting our portfolio we need strong relationships in the industry, at all levels of the industry, and we need to gain broader attraction with opening up the industry.  I call it “unlocking the knowledge” and unlocking the industry to entrepreneurs so that they can be successful.

We also need to work on the other end of the value chain. So what I would want to say five years from now is that we built a great portfolio of companies.  We’ve had one or two exits that we feel proud of and we have really strong relationships across the ecosystem.

Williams:  I’ve been speaking today with Nina Nashif.  She is CEO and founder of Healthbox.  Nina, thank you so much for your time.

Nashif:  Thank you for having me.

Share

Healthbox provides seed capital, mentorship, industry connections and guidance to startup companies in the health care field and exposes large, established organizations to innovation and entrepreneurship. In this podcast interview, Healthbox founder and CEO Nina Nashif describes the Healthbox process, compares health care innovation with the experience in other industries, identifies early Healthbox success stories and explains why the company’s initial operations are in Chicago, Boston and London.

Share

David Williams interviews Healthbox's Nina Nashif [ 13:46 ] Play Now | Play in Popup | Download

Most physician offices are set up to bill commercial health plans, Medicare and Medicaid. Patient balances are more of an afterthought. That was fine in the era of $5 co-pays, but it’s a big problem now. The growth of high deductible health plans, plus an increase in  deductibles, co-pays and co-insurance for more traditional plans means that in many cases the majority of payment for a particular visit or service is owed by the patient. Despite that, the main focus of the office’s billing system is on getting the insurer to adjudicate the claim and pay its share.

Of course physician practices are gaining an awareness of this challenge and are starting to do something about it. In this podcast, Tom Furr, founder and CEO of PatientPay explains how his company is helping physician offices address the problem of patient balances. In short, PatientPay makes billing a patient more like billing an insurance company. The objective is to get paid faster, make bills simpler for patients, tie in to existing practice management systems, and reduce costs.

Share

David Williams interviews PatientPay's Tom Furr [ 17:47 ] Play Now | Play in Popup | Download