Transcarent, Changing the Way Employers Experience Healthcare
Episode 5622nd March 2021 • This Week Health: Newsroom • This Week Health
00:00:00 00:08:44

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  Today in Health it, this story is transparent. Glenn Tolman and team are back to change. Self-insured employers experience with healthcare. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT at channel dedicated to keeping health IT staff current.

And engaged VMware was one of the first sponsors of this week in Health it, and now they are the first sponsor of Today in Health it. They have been committed to our mission of providing relevant content to health IT professionals since the start. They recently completed an executive study with MIT on the top Healthcare Trends, shaping it, resilience.

Covering how the pandemic drove unique transformation in healthcare. This is just one of the many resources they have for healthcare professionals. For this, and several other great content pieces, check out vmware.com/go/. Healthcare. All right, let's get to today's story. This is a, this is a fun one.

Transparent is looking to transform the self-insured employer experience with healthcare by empowering the employee and creating alignment with a new revenue model. And this comes from a host of different sources that have covered this. You can just go out and, and search for transparent, TRAN.

S-C-A-R-E-N-T or Glen Tolman, or any, you know, Livongo actually, at this point we'll pull up a number of stories as well. Glen Tolman is coming off the Livongo success, changing the way that diabetes care is really delivered. They had a, a successful IPO. And subsequent acquisition by Teladoc, and he was also formally with Allscripts, and he has taken on the CEO role at Transparent.

And this one is going to be interesting. You have to look at it as a whole to really see why this is different. You know? Is it providing information to the healthcare consumer? Yes. It looks a little like castlight. Is it helping you to navigate care? Yes. A little . Like Grand Rounds and the Doctor on demand merger objectives, uh, in terms of care coordination.

But it is so much more than that because it closes the loop on the transaction like none of these have, and the financial model really changes everything. So let's go ahead and take a closer look. This is a play to the mid to large scale self-insured employer market. This is a very lucrative market for health systems.

They are a bolt-on of sorts and add-on to the existing model. Uh, the employer can keep their PBM, their payer, their providers transparent gist, weaves it all together around the experience that the employer and the employee have with healthcare. All right, so let's take a look at this, providing . The consumer and their families with a set of information, tools and new choices they didn't have before.

So the first thing they provide is unbiased information. Second thing, trusted guidance. And the third thing, easy access. I. All right, so remember this is all about the experience. The self-insured employer continues to bear the brunt of the rising healthcare cost. Payers, providers, PBMs make money every time the cost of healthcare goes up, but the employers are left with the higher bill.

That is one experience. The other experience is the employee who is looking for healthcare. If you've ever sat through one of these benefits meetings, you know. That the stories are not that good. The employee is not empowered. Information is scarce. Choice is limited, and navigating the few choices you have is hard before you have to make this decision.

And after you make this decision, you feel like you just strapped up to a rollercoaster and you're just hoping for the best outcome. Alright, let's look at what makes Transparent different. Let's start with the revenue model. You always have to look at the money. Follow the money. They align themselves with the self-insured employer.

Shared savings. Baseline savings. Simple Bill. From transparent to the employer, the power is in the alignment. This is not about transactions, copays, and other things. This is about savings and experience, so that's the money. Let's break down what this looks like for the employee. I'll assume we're looking at a digital tool.

The unbiased information can be a quality score, cost, or outcomes delivered straight to the employee. Right. There's a trust that is given to the employee to make the right choice. Once they have the information in hand, the trusted guidance will come. They will provide access to someone seven by 24 within 60 seconds who can help you to evaluate your choice.

Those choices can be those negotiated rates within your existing plan or even options outside of your plan. They can look at local care surgery centers or even centers of excellence that are just a short flight away. Finally, they close the loop. This is one of those things I think is really powerful and really interesting.

They will line you up for care and provide you an experience across the care journey to connect you with follow ups, rehabs, and the like. I. . This provides a powerful feedback loop that will make them even smarter with each new employer. They sign up. So I think the power of this really comes down to the fact when you look at what they're providing, unbiased information, trusted guidance, easy access, they're closing the loop and they've aligned themselves with the employer.

So this is a group of people that will, . Side with the employer, side with the employee, give them the information, the quality, the outcomes, the, the, the information that they need to make the right choice. This will get down to the individual level, the individual provider level. So you'll be able to take a look at that and, and decide which provider do I want to go with?

And. Do I want to stay within my plan or do I want to go outside of my plan? If I have the means to make that kinds of transaction, they're gonna provide me with trusted guidance. That person who I need when I'm trying to make that decision, or my wife needs when she's trying to make that decision. Right?

The trusted guidance, 7 24, 365, 60 seconds or less, you're talking to somebody that's gonna help you to navigate healthcare and then closing that loop. The easy access to care, the scheduling and all the complexities of that. And then scheduling the rehab and the follow-up. You know, with each one of these stories, I do a So what?

Why does this matter? This is a well-funded startup by a company that has deep healthcare experience and background, and they have had proven success in doing this before. They're not gonna try to find a market. They're not going to spend the bulk of their time raising money. They're not going to have a hard time attracting the best talent, and they know where the money is hidden in healthcare and how to find it.

They will extract value at the point of waste. They will create a market at a point of frustration with the existing system. This is yet another example of where next year's margin pressure will come from for your health system. If I were a healthcare CIO today, I would be waging a war on inefficiencies, automating as much in everything that I possibly could, and working diligently to make our health system easy to partner with, easy to plug into.

I used to think that health systems . Would be able to stop the disintermediation that was occurring. The consumer decision is being influenced less and less by the healthcare providers. This is a scary place to live. If this is the future, if we assume that this is the future, quality matters even more than it does today, this will become true at the individual provider level, and this is a really hard place.

For health systems to address. But as a technologist, how I would be thinking about this is I need to make our health system an easy place to do business with. I. . Think of our health system as an enterprise service bus. People need to plug in, connect to our scheduling, connect to our providers, easily connect with us to do business with us.

Think of it as a set of APIs. If you wanna be more modern than your enterprise service bus it, it has to be easy to get access to your health system, to partner with you, and to really become a partner on cost savings, and that is the future for health system. All right, that is all for today. If you know of someone that might benefit from our channel,

Please forward them a note. They can subscribe on our website this week, health.com or wherever you listen to podcasts. Apple, Google Overcast, Spotify, Stitcher. . You get the picture. We are everywhere. We wanna thank our channel sponsors who are investing in our mission to develop the next generation of health leaders, VMware Hillrom, Starbridge Advisors, McAfee and Aruba Networks.

Thanks for listening. That's all for now.

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