A few years ago, I was meeting with a potential investor to go over our go-to-market strategy at Wellth. When I described that we wanted to take on the challenge of serving Medicaid eligible populations, he was quite confused. To this very successful healthcare investor, this segment sounded complex, slow to change, and difficult to reach. He asked me “Why Medicaid?”.
I replied, “Because we want to help the populations who need the most help.”
Where he saw “complex”, we saw an opportunity to create a meaningful difference in populations that are underserved by the broader healthcare system. Where he saw “slow to change”, we saw a Managed Care market where states capitate risk to MCO’s and work together to improve the cost and quality of healthcare. Where he saw “difficult to reach”, we thought that our unique Behavioral Economic approach would create patient activation, engagement, and outcomes in ways that other health tech companies could not and provided us with a durable competitive advantage.
We did not get an investment from this gentleman. He didn’t see what we saw. He didn’t think innovation in Medicaid was possible. When he thought about our business he looked at it in terms of dollars and cents. When we thought about our business, we looked at it in terms of the members we could serve, the lives we could improve, and the outcomes we could create. We saw a healthcare system that was created with the false assumption that all patients will act rationally in their own best interest once a doctor prescribed them the right treatment course. We wanted to change this system into one that embraces and does not deny the beautiful imperfections of humanity. One that understands that sometimes patients need a little extra motivation to spark new behaviors and care habits.
Our announcement today about our collaboration with Arizona Complete Health reminded me of that meeting several years ago.
“Telehealth is changing the standard of healthcare by allowing for improved access and better health outcomes for people who face barriers to receiving traditional care,” said Arizona Complete Health’s Vice President of Pharmacy Operations, Jill Hanson. “As a pharmacist, I have seen firsthand how important it is to give patients who are challenged with chronic conditions the tools they need to manage their own medications. We are excited to offer this mobile app and empower our members to take charge of their own health.”
Since that meeting with that investor, I have gotten the chance to work with so many great people who have devoted their careers to serving the Medicaid market. In these people I have found kindred spirits. People who see their profession not just in terms of dollars and cents but instead in terms of the impact they can make. I see a whole thriving system that is devoted to innovation, improvement, and impact, from state regulators to large Managed Care companies, and to digital health companies like all of our friends from Health Tech for Medicaid.
For change to happen, it takes the whole system to commit. Arizona’s Medicaid agency, AHCCCS, is not only open to innovation but actively seeks it out. Jami Snyder, the Director of of AHCCCS, is recognized nationally as one of the most innovative Medicaid regulators, and is a leader on the board of the National Association of Medicaid Directors. We worked closely with the AHCCS team to ensure our program was fully compliant with all of their regulations and executed in a way that improved the cost and quality of healthcare for Arizona beneficiaries.
Many large Managed Care Organizations are by their very nature risk-averse and slow to move. Arizona Complete Health, and Centene more broadly, is the opposite. They have been tremendous to work with since our very first meeting together. Dr. Scott Van Valkenburg, Chief Medical Director, Jill Hanson, VP Pharmacy Operations, and the rest of their team are phenomenal. In every implementation, there are setbacks to get through but we were able to launch together in the midst of a global pandemic. When others may have decided to delay and wait out the pandemic, they stayed committed to doing the right thing for their members. As the pandemic worsened, the value of Wellth to remotely engage, motivate, and reward members proved to be even more important. While members were unable to engage with in-person care and faced financial challenges, we were able to outreach and enroll several thousands of members in a matter of months, produce an ongoing daily adherence rate in excess of 90%, and provide rewards that members have used to buy key supplies and groceries when they needed them the most.
I am grateful for the chance to work with this group of leaders who see the world in terms of the impact they can make to the members they serve. All the stats and results have been great to see but nothing is more important than when we hear directly from our members on how we are able to help.
“This program has saved my life…my blood sugars are normal now, occasionally high but nothing like before. Even my eating habits changed for the better during the program. You all are awesome. Thank you so much for saving my life.” — Anonymous Arizona Complete Health Member
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While people usually intend to adhere to care plans and build healthier habits, the complexity of human motivation all too often stands in the way. By bridging the intent-to-behavior gap with frequent financial rewards for completing an action, Wellth has demonstrated the ability to create long-lasting results.
Even when selecting for previously nonadherent patient populations, Wellth members demonstrate 89%+ average care plan adherence over a 12-month period, generating a 2-8X ROI to Wellth’s customers.
By utilizing the Wellth platform, our partners, such as AdventHealth, Optum, Desert Oasis Healthcare and Healthfirst (NY) have seen results such as a 45% reduction in readmission rate after heart attacks, a 92% decrease in avoidable emergency department visits, and a 1.3 reduction in HbA1c levels amongst high-risk diabetics.
Wellth’s customers have also achieved a Member Net Promoter Score of 88, which leads to improved member satisfaction with their health plans and providers.