Platform-enabled ecosystems, in particular, can be well-aligned to help the transition to value-based care. Here are a few examples:
- Memora Health is a complex care delivery platform that can empower care teams to better monitor and support patients by automating clinical and administrative workflows.4 Memora Health’s platform integrates with electronic health records, embeds into existing workflows, and offers tools such as remote patient monitoring, scheduling, virtual care, and outcomes management, to help enhance the patient and clinician experience. The platform uses natural language processing to automate follow-up communication with enrolled patients and categorize care management tasks.
The intelligent, scalable platform enables clinicians to focus on serving patients throughout the entire care journey in areas including cancer, surgical, gastrointestinal, chronic, maternal, population health, and more. It can reduce clinician burnout by reducing repetitive, manual administrative tasks and decreasing the number of patient portal messages that need to be answered. According to Memora Health, the platform has reduced inbox messages by 40%.5 Furthermore, it has reduced emergency department visits, increased patient education and screening rates, and improved medication adherence.6
Our assessment of platform principles:
o Underutilized asset: Gives nurses more time to spend on patient care.
o Ecosystem delegation: Delegates tasks appropriately to different types of clinicians as well as administrative departments (e.g., billing) and partners with other patient and clinician experience platforms including remote patient monitoring systems, billing services, and telehealth tools.
o Modularized components: Uses a single platform to customize experience for providers; provides ability to turn care modules on and off.
o Focus on consumer experience: Reduces the friction in patient interactions by using a convenient and easy mode of communication: text messages.
o Positive network effects: Allows clinicians to spend more time with their patients, deepen the provider-patient relationship, and build trust. This allows clinicians to drive medical interventions that produce better outcomes, reduce costs, and help health systems transition to risk.
- Transcarent aims to make health care simple, accessible, transparent, and trusted.7 Users can access health care information and services at any time of day through an app. They are either connected with a health guide who helps provide the information and services they need, or directly with a clinician through text or video. At-home and in-person visits are also available, with Transcarent steering users to vetted physicians.
Through its merger with BridgeHealth, Transcarent providers its users with access to surgery centers of excellence that offer high-quality surgery at contracted rates, though Transcarent also partners with other surgery centers.8 Transcarent also recently announced plans to partially acquire 98point6, an AI-powered primary care startup.9 This will give Transcarent access to 98point6’s physician group and software. Transcarent is offered through some employers and is paid based on how much it saves employers, aligning incentives and moving toward value-based care.10 According to Transcarent, the platform has reduced unnecessary urgent care and emergency department visits by 40% and reduced readmissions and complications by 80%.11
Our assessment of platform principles:
o Underutilized asset: Provides multimodal (virtual, in-home, on-site), asynchronous, convenient care and reliable health care knowledge through a health guide as well as access to primary care physicians and surgery centers of excellence.
o Ecosystem delegation: Partners with employers, clinicians, pharmacy, behavioral health, surgery centers of excellences, and chronic condition management apps.
o Modularized components: Uses a single platform to triage users, assist with navigation and engagement with the health care system, and address multiple care needs ranging from urgent care and primary care to specialty care.
o Focus on consumer experience: Enables users to quickly access care from pre-vetted sources with the assistance of a health guide, all from their smartphone.
o Positive network effects: Attracts more employers by understanding which interventions are improving health outcomes the most.
- StartUp Health, an investment company, has funded several health moonshots aimed at “accelerating the pace of progress in health innovation.”12 One of its moonshots focuses on access to care and includes startups focused on value-based care such as Cityblock.13 Cityblock focuses on community-based care for underserved patients using a tech-enabled delivery model that includes virtual, in-home, and on-site care. Practicing compassionate care that offers medical and behavioral health, as well as addressing drivers of health (social determinants of health), Cityblock has reduced inpatient hospital admission rates, improved quality outcomes, reduced costs, and increased revenue.14
Our assessment of platform principles:
o Underutilized asset: Provides multimodal, compassionate, holistic care.
o Ecosystem delegation: Focuses on drivers of health as well as behavioral health, while working with health plans, community-based organizations (including shelters and food pantries), local providers, and paramedics and EMTs that provide urgent care at home.15,16
o Modularized components: Leverages their own tech-enabled delivery model.
o Focus on consumer experience: Places the focus on patients first; for example, additional specialties are brought in while the patient is being seen, rather than scheduling follow-up appointments.
o Positive network effects: Provides compassionate care that has improved outcomes and decreased costs.
Platform-enabled ecosystems can use data to automate predictions and/or change care pathways. They can also expand their reach beyond the initial core business and move into either disease areas or focus areas, all while continuing to help improve the end user’s experience and provide value.
