RamaOnHealthcare May 11, 2021
RamaOnHealthcare and Glen Tullman, CEO of Transcarent, discuss self-insured employer market, consumer experience, alignment among stakeholders, and a learning system.
RamaOnHealthcare: Welcome, Glen, to our thought leadership series. Congratulations on your new company, Transcarent, targeting self-insured employer market in a different way. Let me start with a direct question. What is your company’s mission and game plan and how are you aiming for success?
Glen Tullman: Thank you for having me. Transcarent is creating a new and different kind of experience that puts people back in charge of their health and care. Our mission is to empower people to stay healthy by providing them with 3 things they get in every sector outside of healthcare: unbiased information, trusted guidance, and easy access to high-value care, when and where they need it. And, we allow them to share in the financial upside of their health decisions. But the key is we put them in charge. At Transcarent, we trust our Members to make the right decisions if we provide them with the right information, tools, and incentives.
RamaOnHealthcare: As we hear in your recent interviews, the current healthcare system is complex, confusing, and costly. Please outline how you overcome the current opaque, siloed, fee-for-service, and fax environment to build a seamless, transparent, and cohesive environment, empowering consumers and delivering value.
Glen Tullman: Ask anyone: Healthcare is confusing, complex and costly, and it’s not getting better. Even the arrival of great innovative firms like Livongo has, in many cases, only added to the confusion, for both Members and their employers. The Wall Street Journal reported on this last week that the average self-insured employers deals with 14 companies to deliver care to their employees.
At Transcarent, we want to make it easier to stay healthy. One place to go with people that care and a simplified, customized experience that allows them to make informed decisions. No narrow networks, no restrictions, and often no co-pays, co-insurance or even bills. And no bills printed with “This is not a bill!”. We want to let them focus on getting healthy and letting them drive the decisions about their own care or the care of their families. And this isn’t about “High-Tech, High-Touch”. If you are talking about technology, then the technology isn’t working. Yes, we use high tech, data science, and a host of other tools, but they all focus on improving the experience Members have and making it easier, so you never need a navigator again to make a health decision.
At Transcarent, we trust our Members to make the right decisions if we provide them with the right information, tools, and incentives.
RamaOnHealthcare: The pandemic expedited the adoption of technologies: digital health, telehealth, and remote patient monitoring, which is shifting gears from historic slowness to acceleration, and you’ve said it’s 10 times faster now. Please explain how the things flow for day-to-day health management, enhancing patient experience and engagement.
Glen Tullman: With physician offices closed, hospitals cancelling surgeries and asking people to stay away, and even physical therapy cancelled, care had to move to fully digital for a time. It was that or no care at all. What was amazing was how quickly the technology was able to scale and how quickly people, who traditionally thought could not or would not change, changed.
Now, a year later, people have adopted many remote modes of care that they may have been hesitant to use before. Now that they have used it and see it as a real option that was not only more convenient but in some cases higher quality, many won’t want to do without it. What we saw was that it wasn’t about the technology but about the will to make change happen. Ten years from now, we may look back and recognize the year of pandemic not only for the tragic loss of life, the economic devastation for so many, and the longer-term behavioral health challenges, but also the year that healthcare went digital.
RamaOnHealthcare: The current trend is shifting control from provider, payer, PBM to employer and consumers. How do you see the current business model evolving of payment systems requiring a complex medical coding system and never-ending documentation?
Glen Tullman: All you need to do is watch television to see five or ten new companies attacking the PBM model. Whether it’s more convenient delivery, lower prices, or better packaging, Pillpack, Ro, and a host of others are out there. And the fundamental basis of the industry based on rebates is being both legally and ethically challenged. Insulin has increased 500% over the last 5 years, and it’s not coming from the manufacturers. That has to be fixed.
That is a problem that both self-insured employers and consumers will fix. And that’s part of the reason for Transcarent. As the founders of Haven called out years ago, there is no longer alignment between self-insured employers and so many of the Payers and PBM practices.
Documentation is always going to be necessary from a clinical perspective, but the shift there needs to be toward a less frustrating experience for everyone. From my Electronic Health Record days, imagine any other industry that produces software so complex their users (physicians) can’t use it and have to hire a “scribe” to enter data on an office visit. That is the Epic experience. But Epic is not alone. We all know healthcare today has a problem. Look at the Net Promoter Scores for most Payers. There needs to be a way for the people using the health system, the employers who foot the bills, the providers who do the work, and the payors and PBMs to have a sensitive, HIPAA safe, and accurate flow of information without so much confusion, complexity, and cost for people. This is also an equity issue across many areas of our society.
We need to ensure the future of health and care that puts the people first, and that means making their information readily and easily available to improve their health.
RamaOnHealthcare: There is now a movement on home health delivery, a shift of care services from the traditional hospital and post-acute care based services, that should empower the consumer setting a new mindset. Do you the see the trend for non-clinical, lifestyle, health risk management happening in the coming years?
Glen Tullman: Absolutely, there is a large shift happening into the sphere of non-clinical health experiences. The pandemic kept us in our homes and caused a lot of negative emotions, but it also freed us to explore what works for us outside traditional paths to the things we needed most. For some of us, we realized how to enjoy time outside walking while on a call and how to exercise on a Peloton while attending a meeting. We learned new hobbies and new ways to deal with food and our diets and gained a new understanding of our bodies and perspective on our lives.
Those changes included a new appreciation for health and a new need for health information – even if just about the virus, testing, and the future vaccine – health access outside the normal path to a doctor’s crowded waiting room, access to physical therapy from behind a mask or on a screen, and consideration of options while we waited on (often frustratingly delayed) elective surgeries. So much of health, nutrition, exercise, and treatment shifted to our homes and our electronic screens.
This shift, this movement, will stay with us as we come out of the pandemic into the new-normal. More care at home, an attachment to the convenience and effectiveness of virtual care and most importantly – a profound understanding of the value of a human voice … a personal connection … someone who isn’t a bot or at the interminable end of an elevator music-filled call hold time that actually cares and can help us, rather than frustrate us.
A trend toward our care as we need and want it, giving each of us more control, should and will happen, and I believe Transcarent will be at the forefront of creating that experience. Healthcare on our terms.
RamaOnHealthcare: Soon, we will be living in a “health data” world that will make use of data science to improve care, while at the same time we will face privacy and security issues. What’s the trade off in your mind? Please explain.
Glen Tullman: My answer won’t surprise those who know me. We have to do both. The more we know about our Members’ experiences, needs, and conditions, the more likely we can be there how and when they need us at the crucial moments of their health and care experience. That said, we need to assure them that we will protect and use their data very carefully. And it is their data, which should be made available to them or shared with whoever they ask at any time, at no cost. At Transcarent, we won’t resell the data, use it for marketing, or share it with anyone for other than a specific medical purpose. Everyone should agree to those terms. It’s sad how long it has taken the Electronic Health Record industry to share information. We do it with banks all over the world. This isn’t a technology issue, it’s a competitive one, and it should be required. We need to ensure the future of health and care puts the people first and that means making their information readily and easily available to improve their health. One of my partners, Hemant Taneja, who leads General Catalyst, one of the hottest investment firms in Silicon Valley, talks about Responsible Innovation and Health Assurance. That’s what we need to go forward.
So, once you open that door and people get a taste of what it could be like, I don’t think you can go back. I believe we will see a dramatic change of what we think of as healthcare today, which will now include a consumer digital health component.
RamaOnHealthcare: The transformation we are now experiencing requires a learning system that would educate stakeholders, communities, consumers on a daily a basis. RamaOnHealthcare has been delivering a daily newsletter in the last 5+ years that has become an educational tool on healthcare transformation with a national brand. Glen, you are a fan of our newsletter and please share your experiences and how it benefits the industry.
Glen Tullman: Like so many people in healthcare today, I start my day with the Rama newsletter to get a daily view on the events and trends in the transformation of the healthcare industry. It’s a valuable resource to inspire thought and to help understand the ebb and flow of progress and tracking the changes we’re seeing ever more frequently.
RamaOnHealthcare: Where do you see the market for self-insured employers headed in the coming five years and how Transcarent is positioned?
Glen Tullman: If you go back a year, the penetration of telehealth was 3 to 5 percent. We were told it would take five years to get to 30 to 50 percent. But in three months, we saw penetration go to almost 100 percent, and I think it will eventually settle in between 30 to 50 percent. That’s a 10x improvement. We saw similar gains in virtual physical therapy and many other areas. Based on that, the industry learned that we could innovate much more quickly. But to do so, you need to offer what the people, the health consumers, want. At Transcarent, we think that’s a different experience than what they have had to date and that’s what we’ve created. Self-Insured employers, who I believe will drive the change in healthcare, also want change. They want to work with companies that are aligned in their desire for high quality care delivered at lower costs. And that change is coming, both from Transcarent but also other innovators like Walmart, Amazon, and other experience focused companies.
So, once you open that door, and people get a taste of what it could be like, I don’t think you can go back. I believe we will see a dramatic change of what we think of as healthcare today, which will now include a consumer digital health component. Consumer digital health will eventually just become health care, which will mix digital and hands-on, in person care. No “High Tech, High Touch”, just high touch care. And no navigators at high costs, just a system that’s easy enough for anyone to use.
For us at Transcarent, it’s all about the consumer experience that we’re building and alignment with our employer clients. In the future, the companies that win will be the ones that provide people with unbiased and transparent information, trusted guidance, and accessibility, along with alignment in how employers pay for solutions. Think about what Amazon did. They didn’t just give us the option to buy Amazon stuff, but said, you can buy anything you want from virtually every provider on Amazon—even things that competed with their own offerings—we’ll get it to you overnight or the same day, for free—and if you don’t like it, we’ll make it super easy to return. They just wanted to put the consumer in charge and make it a great experience. And that’s what Transcarent is creating for all of us in health and care.