Driving Innovation: Three Key Approaches Redefining Primary and Virtual Care
After several healthcare giants announced their decision to wind down virtual and primary care offerings, the flood of headlines provided our team with an opportunity to reflect on our distinctive thesis for this space.
Historically, we’ve focused on three key approaches that deliver value and economic sustainability:
- Strategic partnerships that enhance outcomes and overall economics
- Vertical reimagination in areas that are ripe for disruption
- Clear differentiation that delivers highly personalized care
It may not have been surprising to learn that simply bringing a doctor visit online — or steps away from the checkout line — won’t fundamentally address misaligned incentives and chronic healthcare challenges. But there are plenty of lessons learned that can be applied moving forward, and we strongly believe that nimble startups focusing on these approaches will play a key role in the future of primary and virtual care.
Strategic partnerships that enhance outcomes and the overall economic model
The telehealth boom introduced questions around whether moving care online would further fragment the care experience, a long standing issue within healthcare. That’s why we invested in Concert Health, which leverages the virtual collaborative care model in partnership with health systems.
Concert integrates the health system’s primary care providers with their behavioral health team. They virtually screen referred patients and provide them with ongoing clinical care, as well as offer primary care providers with ongoing feedback and guidance to help reduce their patients symptoms. Concert’s approach expands the clinical care model for health systems, provides a strong referral partner that reduces patient acquisition costs, leverages extensive payer networks, and creates a superior clinical care model that focuses on whole person health.
Today Concert partners with some of the largest health systems, including Advent Health, Mass General Brigham, Mercy, CommonSpirit Health, and WellSpan Health. They’ve also been able to demonstrate strong results in strong clinical outcomes and patient satisfaction:
- Half of Concert patients see at least a 50 percent decrease in anxiety or depression symptoms in less than 90 days
- Concert patients also overwhelmingly express strong satisfaction with their experience with a 72 NPS score
Startups like Concert that recognize the value of working “within” the system and building strategic partnerships with healthcare organizations have the potential to reach larger patient populations and drive high quality outcomes, all supported by a strong economic model.
Vertical reimagination in areas ripe for disruption
We have always believed that strong primary care provides a critical foundation for an effective and efficient healthcare system. With this thesis in mind, Centivo provides an innovative end to end commercial health plan for employers by partnering with local leading health systems, specialist practices, and a primary care-centered design that drives superior savings, outcomes, and member experience compared to traditional carriers.
Centivo’s comprehensive approach enables employers to offer their employees a generous plan design while driving care toward high quality providers and taking pressure off the overall healthcare system:
- Employers using Centivo see a 20 to 30 percent reduction in their healthcare expenses
- Employees using Centivo have an average annual out-of-pocket cost of $409, compared to the industry average of $1650
- Employees also have 30 percent more primary care visits, 15 percent fewer emergency room visits, and 13 percent fewer inpatient admissions
With nearly half of lower-income working Americans afraid to use their company health plans, the need for innovation in the commercial market is clear: Centivo directly addresses this unfortunate reality through a comprehensive offering that incumbents cannot match. Walmart Health’s closure demonstrates that scale alone will not solve our industry’s challenges: truly meeting the needs of members and employees requires an end-to-end solution that accels across all facets from care delivery to experience to outcomes.
In fact, just as the healthcare giants started scaling back on virtual and primary care, Centivo is doubling down with its acquisition of Eden Health. In addition to rolling out nationally, Centivo is expanding its virtual advanced primary care practice and broadening its clinical services to include mental health care, urgent care and workplace pop-up clinics.
Clear differentiation that delivers highly personalized care
We saw virtual care adoption and engagement spike largely out of necessity during the pandemic. But what would happen when consumers could go back and see their doctor in person? That’s why we’ve partnered with companies like FOLX Health that are driving stickiness by tapping into an underserved market with a differentiated approach.
Launched in late 2020, FOLX is the first digital healthcare and wellness platform for the LGBTQIA+ community, designed to meet the specific needs of a patient population largely ignored and often discriminated against by the traditional healthcare system. FOLX provides affirming, inclusive, and high-quality care for a wide range of needs, delivered by a specialized network of queer and trans clinicians. It’s a radically different kind of healthcare experience because it’s personalized to their patients needs and expectations.
This is a significant advantage that startups can hold over incumbents: differentiation is in their very DNA. But approaches need to go beyond a surface-level brand wraparound. When we incubated FOLX, the plan was always to build a D2C model that would eventually expand into enterprise. By tapping into an underserved market with a differentiated approach, FOLX captured more of their healthcare spend as they expanded their services. Now FOLX partners with employers and is in-network with several large health plans including Cigna, Aetna, and Evernorth.
While we’ll likely never get much beyond speculation of the big swings and misses, it’s important to navigate this discussion with resilience and a commitment to drive meaningful change. Startups that build their novel approaches on the foundation of clear differentiation, a willingness to navigate and even integrate within our complex ecosystem, and a relentless focus on meeting the needs of all stakeholders are much more likely to drive meaningful change.