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Included Specialty Care | Innovaccer HXP April 22, 2024
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Together with
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“When you set your patients’ expectations higher and then deliver on it, you get two good outcomes. One, they get better faster, and that alone is worth building a company. But two, you avoid low quality care and the costs associated with it, and that’s something our current system desperately needs.”
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Included Health CEO Owen Tripp
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Where do you go when you’re already tackling primary care, behavioral health, and second opinions? If you’re Included Health, you swim straight upstream to specialty care.
The three bullet history lesson on Included looks something like this:
- In 2021, Grand Rounds (virtual second opinions) and Doctor on Demand (on-demand visits for physical and mental health) merged to provide integrated virtual care.
- The combined company entered care navigation, and now provides benefits guidance, financial support, and advocacy services to more members than possibly every other navigator in the country.
- To make sure every patient felt this care was built just for them, the company acquired Included Health (culturally aware care for underserved communities), and here we are.
Specialty care is a natural continuation of that vision, starting with a trio of centers prepped for a 2025 debut: the Cancer Center, the Center for Women’s Health, and the Center for Metabolic Health.
- Members will have access to a specialist-led care team with integrated primary and mental healthcare, as well as in-home support for prescriptions, diagnostics, and monitoring. That all happens with a single member record, one central form of billing, a unified medical history, within the context of available benefits.
- It’s a giant undertaking, but it’s made possible by roots in expert second opinions that helped grow a nationwide network of 4,000+ specialists and collaborations with over 40 health systems (not to mention a seriously well-rounded partner ecosystem) .
The real strength of the expansion lies in the fact that it isn’t so much a new service line as a massive enhancement to a platform with all of the primary care, behavioral health, and navigation ingredients already baked in.
- Outside of large orgs with the resources to try and coordinate the same breadth of offerings, few companies have had the scale, track record, and plain-old resources to cross the chasm into actual specialty care delivery.
That means Included’s real competition will likely be Included. Can it scale without sacrificing quality? Can it deliver care for “all” that feels like care for “you”? Can it connect the dots between virtual specialists and the in-person care that will inevitably come into play?
The Takeaway
Included Health’s specialty care expansion hits the center of the bullseye with both patients seeking more cohesive care journeys and partners looking to right-size inflated portfolios of point solutions. That strategy also happens to be a good way to land on the shortlist of healthcare companies poised for a major IPO.
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Mankato Clinic Shares Lessons From AI Implementation
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Selecting Your Drug Database and CDS Solution
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Bridging Care Gaps for Underserved Populations
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- Innovaccer Unveils Healthcare Experience Platform: We’re already starting to see the fruits of Innovaccer’s recent acquisition of Cured, with the merged company unveiling its new Healthcare Experience Platform at HMPS 2024. The HXP is as much a unified consumer experience solution as it is a CRM, integrating clinical, demographic, and financial data to create a holistic view for personalized engagement. The product page does a great job outlining its various Outreach, Contact Center, and Market Intelligence components.
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- DrFirst Acquires Myndshft: Medication management platform DrFirst acquired Myndshft Technologies to bolster its real-time eligibility/benefits verification capabilities while expediting prior authorizations. Myndshft streamlines prior auths for both medical and pharmacy benefits, incorporating complex benefits and cost analysis processes across various payers and therapeutic classes into a singular workflow. The acquisition improves DrFirst’s ability to quickly deliver vital specialty medications primarily covered by medical benefits, such as infusions and in-office injectables.
- Pros and Cons of Concierge Screening: One topic that loves to stir up a ton of debate is proactive whole-body MRI screening from firms like Ezra and Prenuvo. Healthcare journalist Christina Farr tackles the issue in a round table-style article in a recent issue of Second Opinion, rounding up a solid mix of opposing views of eight physicians. Embrace debate!
- Two Chairs Lands $72M: Two Chairs landed $72M in Series C funding to expand its hybrid behavioral health model beyond California, Washington, and Florida. The size of the round reflects Two Chairs’ eight-fold growth over the last three years, which it attributes to its focus on matchmaking and measurement-based care. Two Chairs takes the easy-to-agree-with stance that the relationships between the therapist and the patient is the most important factor in determining outcomes, and has a proprietary 300-variable algorithm to ensure it gets matchmaking right.
- VR for Cancer Care: Researchers at Georgetown University and MedStar Health think virtual reality could be the next breakthrough in cancer care. After randomizing 128 cancer patients to undergo either a 10-minute virtual reality session or a “two-dimensional imagery experience” on a tablet, the VR group saw twice the drop in pain levels on a 10-point scale (-1.4 vs -0.7). The researchers were also encouraged by the fact that the VR group’s pain severity remained just as low after 24 hours, while the guided imagery group returned to baseline.
- Carium and Care Directions Launch StrokeCP: Carium and Care Directions teamed up to launch the StrokeCP engagement platform for post-discharge stroke patients, which was co-designed and financially validated at Atrium Health Wake Forest Baptist. StrokeCP enables providers to capture social and functional determinants of health at the point of care, then incorporates remote monitoring, coaching, and proactive patient communication to support personalized care plans.
- Trilliant Opens Access to Health Data: Trilliant released the entry-level tier of its Provider Directory and the national version of its Demand Forecast on Databricks Marketplace, an open exchange for data and analytics tools. Now publicly accessible, the Provider Directory covers information on over 2.9M active physicians and nurses, while the Demand Forecast projects future demand for healthcare services over 10 years across service lines and demographic segments.
- Map of Medicare Advantage Plans: CMS contracts and evaluates Medicare Advantage plans at a highly granular Contract ID level, making it difficult to untangle a master list of plans and their relationships to individual payors. To solve that challenge for himself, Mimilab’s Dr.Yubin Park created an awesome interactive visualizer where you can drill down all the contracts that belong to the same parent organization. It’s a homegrown widget that takes some getting used to, but the juice is worth the squeeze for the great maps of individual players.
- Ilant Seed Round: Virtual obesity management startup Ilant Health secured a $5.5M seed round to fuel its support for employers and government payors across all 50 states, a nice footprint considering it only launched in October. Ilant identifies members who would benefit from obesity treatment and matches them to best-fit care based on medical, behavioral, and social factors. Patients receive virtual access to gastroenterologists, mental health providers, and nutritionists, with care paths ranging from pharmacotherapy (both GLP-1s and non-GLP-1s) to bariatric surgery.
- Maven Clinic Expansion: Maven Clinic is expanding its Fertility and Family Building platform to support individuals seeking help with conception outside of traditional in vitro methods. The new Trying-To-Conceive Coaching program offers one-on-one support, proactive check-ins, and referrals to resources in areas like mental health and nutrition. The backed press release also included a move into male fertility care, providing access to 12 provider types to assemble care teams that may include reproductive urologists, reproductive endocrinologists, or genetic counselors.
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Clinical Support, Whenever It’s Needed
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Glooko Outcomes Using Real-World Data
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The State of Payor Enrollment and Credentialing
We’re on the brink of a new era in healthcare. From AI-enabled chatbots to GenAI, Medallion’s latest report sheds light on how healthcare organizations are prioritizing automation, actively shaping their future with it, and hoping it can live up to its promise. Get the full report here.
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