‘You possibly can’t navigate your means by way of a damaged system’: Transcarent’s Glen Tullman on healthcare price, high quality
Digital well being vet Glen Tullman has taken on a number of the greatest challenges in healthcare, from persistent circumstances to digital well being data. After promoting Livongo to Teladoc in 2018 for a whopping $18 billion, Tullman has centered his efforts on the insurance coverage area with the launch of Transcarent, a healthcare platform for self-insured employers.
The corporate, which emerged out of stealth in March, gives a digital overlay to current well being plans. Transcarent gives a completely at-risk mannequin the place employers don’t have any upfront or per-employee, per-month charges. It additionally pays well being methods upfront for surgical procedures.
One of many methods it plans on reducing prices is thru partnerships. Originally of October, Transcarent inked a cope with retail large Walmart in an effort to decrease prescription drug prices and different costs for these within the self-insured market.
“I feel quite a lot of the thrill was that this was Walmart’s first foray into the self-insured market. We work with Walmart’s well being and wellness to create an providing that’s going to be obtainable to each firm available on the market in the present day,” Tullman advised MobiHealthNews.
“It’ll enable them to reap the benefits of Walmart’s shopping for energy. So it brings all of that energy to one of the vital challenges for all of us which can be paying for healthcare, and that’s the absolute price of medicines. If you consider it, not solely employers, however staff have been harm by hovering drug prices over the previous couple of years. That is aimed toward lastly giving that pricing leverage that an organization like Walmart has.”
The deal is pitched as a method to take a number of the legwork away from sufferers and current them with the bottom fee choice.
“Earlier than, you could possibly go to a Walmart and in the event you knew your drug, and also you went in and also you advised them your drug and had your prescription switched and also you have been there bodily, you could possibly do it. Now we’ve made all that straightforward. We’ll really go to firms and we’ll do a internet checkup of all of the meds somebody is taking. We might say, ‘Hey John, you’re on three completely different meds, you’re paying a $20 copay for each. We are able to scale back that copay to $0 and we are able to get these delivered to your house.’ What may be extra handy for John? What might be more cost effective for John? And on the identical time, we’re saving some huge cash for the corporate.”
Tullman mentioned Transcarent isn’t simply specializing in value but additionally on the standard of care it may possibly present to members. He famous that employers wish to maintain their workforce glad — particularly within the present job market when advantages are a part of the compensation package deal.
“We had this principle that employers simply wished low prices, however they don’t. As a result of all of us need well being plans the place we are able to get high quality care, and you may get staff and households taken care of to allow them to deal with going to work,” he mentioned.
That’s to not say that affordability isn’t vital to members. Tullman mentioned the businesses Transcarent works with have various workforces, and value issues.
“So we’re beginning with giant and midsized self-insured employers. However bear in mind who works for them,” Tullman mentioned. “It’s not simply high-end company staff. We’re speaking about Goal, who’s a buyer, Albertsons, who’s a buyer. These are people who find themselves working in shops, who’re working in warehouses. They’re now getting a lot greater high quality care and spending much less cash for it. To me, that’s actually the way forward for care. How can we get greater high quality care — that’s the No. 1 goal. After which, how can we make it extra reasonably priced?”
This variety in consumer base can be regular to Walmart.
“The beauty of Walmart is that they have an incredible affect on how healthcare is delivered. They attain 200 million People every week. They don’t dwell in NYC or Silicon Valley. These are folks all around the nation, they’re not essentially the very best revenue class. They stand for what America appears like.”
So how are payers serious about the way forward for care? Tullman mentioned that Haven, the previous three way partnership between JP Morgan, Berkshire Hathaway and Amazon aimed toward reducing healthcare prices and boosting outcomes, was a warning to conventional payers.
“What it was, was a wakeup name,” he mentioned. “What we’ve concluded is employers shouldn’t need to create their very own healthcare organizations to satisfy the wants of their staff. Though there are some very modern well being plans which were receptive to the Transcarent mannequin, and people are organizations we are able to and can work with down the highway, most payers have put their head within the sand and mentioned, ‘We’re going to maintain doing issues the way in which we wish. We’re going to double down on slim networks, and billing, and shift extra prices to people, and search for the bottom price.'”
Tullman famous that the payer market is barely getting extra complicated, and the buyer desires a change.
“Some insurers are going to search out the Transcarent mannequin and what we’re saying very difficult, and they aren’t going to love it. However … they aren’t doing the job of offering us high-quality healthcare at an reasonably priced price in the present day,” he mentioned.
“For those who survey most shoppers they may let you know that healthcare is extra complicated and extra complicated and extra pricey than ever earlier than, they usually assume it’s getting worse not higher. … In order that opened up a possibility to say, why don’t we take into consideration doing it in a really completely different means? However we couldn’t undergo the identical system. We needed to virtually create one thing that was completely different … as a result of you may’t navigate your means by way of a damaged system.”