Select Page

How are new tech companies disrupting the healthcare industry in the U.S.? Hear what leaders from Oscar Health, Talkspace, Pager and Pillpack have to say about the evolving landscape of healthcare. Sara Ashley O’Brien, Reporter at CNN Money, leadsthis panel on innovations in digital health.

SARA ASHLEY O’BRIEN
Moderator
Reporter
CNN Money
@saraashleyo

Toby Hervey
VP, Strategy & Founding Team Member
Pager
@tobyhervey

Oren Frank
Co-Founder / CEO
Talkspace
@orenfrank

TJ Parker
CEO
Pillpack
@tjparker

Edward Segel
VP of Product
Oscar Health
@oscarhealth

Sara Ashley O’Brien:
Hi, thank you guys for joining us after lunch. We’re going to talk about innovation in digital health. These companies are all less than five years old, all covering very different aspects of health and innovating in different aspects of healthcare. We’re going to kind of go. I’ll have each of them introduce themselves, tell us what your company is doing very briefly, and then tell us what got you into this? What made you want to get into healthcare, which is a kind of big thing to get into and a lot of barriers to cross in the process. Oren, we’ll start with you.

Oren Frank:
Thank you Sara. Hello again. My name is Oren. I’m the co-founder and CEO of Talkspace, as we mentioned before. I think most of you were here. Talkspace was created to make therapy accessible and affordable for everyone. AS I mentioned before, we made the decision to cut the middleman and say “Guys, there’s a great service. There’s a great profession called psychotherapy. There’s so many people in need. Let’s find a way to connect those two in a much more efficient, affordable, manageable, and scalable way.

I think if we look at the economy and the way we live, healthcare in general is such a huge issue and a huge topic to discuss. I think many more people are acknowledging and learning that mental healthcare is as important, maybe sometimes more, and as relevant to this discussion as any other form of healthcare and cannot and should not be separated from the rest of the discussion. What brought us into this particular industry is our own –Ronnie and myself’s– personal history. A lot of passion of getting many of the people that are here in the crowd therapy is to actually engage with helping others. That’s, in a nutshell, our story.

Sara Ashley O’Brien:
Great

Toby Hervey:
I’m Toby Hervey. I run strategy at Pager and was part of the early founding team. Pager is a mobile app for on demand healthcare essentially. A patient who is sick or experiencing some sort of symptoms can come to our app, get triage and effectively routed to the right level of on demand care for them, whether that’s a consult over the phone or video with the doctor, an in person house call shows up at your apartment or office, or an appointment with a relevant specialist. We launched here in New York almost two years ago. We looked at a world where so many great user experiences were coming in the transportation industry or the food space. We sort of thought healthcare should work better than any other industry in terms of user experience and in terms of how people are elegantly navigated through that world. That’s why we’re here. We started this company to make the patient experience better in healthcare.

TJ Parker:
My name is TJ Parker. I’m the founder and CEO of a company called Pillpack. Pillpack is a full service pharmacy that makes it really simple and easy for folks that have to manage ongoing and chronic medications. We coordinate everything for them. We handle all their refills for them. We coordinate with their insurance company. Then ultimately, we presort and package their medications into personalized packs based on when they take them throughout the day. Rather than getting seven or eight or ten bottles that you have to sort and organize yourself, they come to your door automatically all ready to go. You just rip open the next pack. We started the company about three years ago. We launched two years ago. We are now available fully nationwide and have customers all across the country.

The reason I started the company is I actually grew up in a family that owned and operated your very traditional mom and pop pharmacy. I used to deliver people their meds in their homes, and I saw as a seventeen and eighteen year old, everybody had this pile of pill bottles on their kitchen counter; they had this Excel spreadsheet where everything was crossed out and highlighted. Everyone was trying to figure out how to manage all this stuff, so ultimately I went to pharmacy school with the ambition of trying to make that a better experience.

Edward Segel:
Eddie Segel, VP of product at Oscar Health, part of the founding team too now been doing this for about three years, no healthcare experience before that. Oscar is a health insurance company. We are insuring individuals in the Obamacare markets. There are two big stories I tell about Oscar.

The first is that we’re creating a consumer product in an industry where it really didn’t exist before. Historically, people got their health insurance from their company or the government, but you didn’t really have this marketplace for individuals to shop around and choose their insurance. Things like branding and design and modern web products and simple plans and benefits, that world was not in health insurance yet, so we introduced it.

The second thing is we are building an insurance company from scratch. We’re doing that the way you’d expect a modern technology or finance company to do it. The big insurers are a hundred thousand people spread around the country, lots of manual processes. We are leaner and more automated than that. I’d say our strategy is simple. We want to be the entry point into the healthcare system for our members so that when people get sick they don’t go to their doctor, their friends, or their family, but they come to Oscar. We can give them better care and lower medical costs at the same time. That’s how we hope to fix healthcare.

Sara Ashley O’Brien:
Great, thank you guys. Being the new guy in healthcare, there’s a lot of hurdles to jump, a lot of boulders to climb. TJ, you had a pretty big one. For the first twelve months, you couldn’t advertise your company. Tell us about that.

TJ Parker:
It was a really interesting place to be as a tech startup. We could deliver people medications to their door in thirty-two of fifty states of the United States, but there was an accreditation called VIPPS that took about fourteen months for us to get. While we were available nationwide, we couldn’t really tell anyone that we were available other than doing things like PR and much more organic ways to find customers. Frankly, I think for us it ultimately ended up being beneficial because it enabled us to really refine the product experience and get to the place where we were ready to scale, but in the middle of it it felt like a frustrating roadblock to actually start to scale the business. I think in healthcare in general, you find a lot of these nuanced regulations or accreditations are things that going into it you weren’t cognizant of how much of an issue they would be, but all have been navigable over time. It was certainly not as much fun in the middle of it.

Sara Ashley O’Brien:
Anybody else face a similar kind of hurdle?

Oren Frank:
There is a lot of concern about regulation in healthcare, and it’s good and bad. Basically, you need regulation because this is such an important service and product, and the regulation was done with purpose, which is to make sure that we’re getting quality care. Then again, our is always smaller than I, so regulation is always lower than innovation, and many of the rules and regulations that we made were written fifty, sixty years ago where telephone was very new and very exciting, and no one knew about internet, and no one knew about video conferences and artificial intelligence and so on so forth. I think every company in our category needs to make a very calculated risk versus value decision in which you want to run faster than the innovation, otherwise you’re not going to be able to change things. You want to always bear in mind that you’re talking about the health of patients and people, so be extra responsible and sensitive around that. It’s a daily battle in almost everything that we do, and I’m sure that you are very familiar with that.

Toby Hervey:
I remember an early conversation with a lawyer where I basically wanted a yes or no answer on something whether it was a HIPAA violation. The responses I got were “Well, an aggressive regulator would interpret it this way. A less aggressive regulator …” Yes or no, can I do it? I think the risk versus value decision is very accurate in terms of something we deal with every day. We want to create beautiful patient experiences that are personalized to you, and we communicate through the channels that you use every day versus some archaic login system with terrible design. The regulation doesn’t make it easy. It hasn’t been updated in a long time, and while well intentioned is an inhibitor to progress.

Edward Segel:
As a health insurance company, everything we do is regulated. At first as new to healthcare, I’d say “What about the password to our website? Are there regulations around that?” You have no idea what’s regulated. Sometimes it seems sensible; sometimes it seems fickle. When we were first getting started, there was a list of ten thousand things we needed to do as an insurance company, and we started checking those off one by one to meet the regulation. That was just starting in New York. Over time as we grew to new states, every state has their own set of regulation. We were talking before about what an obstacle that can be to scaling your business or even building a product. I look at my job a lot as understanding the constraints of the business but also the regulation, and trying to create a simple consumer product in a world where every state has its own complex puzzle to solve is hard. That’s not always well intentioned.

Toby Hervey:
Medical licensure by state, why does that make any sense if not just as a way of making money off those licenses. Well intentioned but out of date regulation you can sort of get behind and appreciate where it comes from, but something that’s just protecting the interests of the income is reprehensible and unacceptable.

Edward Segel:
One funny story there. We’re an insurance company, and we go to California. They say “Well, there’s several regulatory bodies. One regulates insurance companies, and one regulates health plans. You guys are a health plan here. We were using the word insurance in all of our welcome kits and our ID card and our website, because that’s what we are, an insurance company. We couldn’t use the word insurance, so we had to change everything to say health plan, and that’s true on everything we do from the front of the ID card to the back to what we say online. It’s amazing what that can do to a business.

Sara Ashley O’Brien:
This is a good point. You guys can’t operate in a silo. You have to be cognizant of the regulations. You have to be cognizant of the existing incumbents. You can’t just be heads down in your product and not paying attention to what else is going on around you and what has been going on for years. I think what’ interesting, Toby you had said that healthcare is not an industry that’s … Digital health is not a disruptive story or not a disruption story. Explain to me that. What is this difference between innovation and disruption. How do you see where your company is in that spectrum?

Toby Hervey:
Among the classic disruption stories are the Ubers and the Airbnbs that come in and create these great experiences with no regard for the incumbents or established regulation. In many cases, it’s not always so black and white. In healthcare, when you’re dealing with something as sensitive as people’s life and their health and their well being and their families, it’s harder to have that devil may care attitude. I think we sort of naively and maybe with a touch of arrogance had that at the beginning and thought that we could do this on our own. What we realized in meeting with dozens or providers and insurance plans across the country over the last couple of years is that we could be much more powerful at scale if we partner with these organizations.

We can help create rich patient experiences along with them. We can layer on what they’re doing, supplant the parts of their system that are broken and don’t work. I think even Oscar is a great example of taking what often existed at insurance companies –telemedicine is available under a lot of plans, incentives for exercise or reimbursements for gym plans– but the user experience was so poor and the patients were so poorly educated and marketed to in terms of what was available to them. They’ve created this really rich, great experience around that. We saw an opportunity the more we learned about the incumbents in the space to partner with them to really make an impact and change the system in the immediate term versus going at it alone.

Oren Frank:
The description of disruption, in theory the guy who coined the term is Clay Christensen from Harvard who basically said that disruptive innovation is ones that in a category offers a significantly lower cost comparable service or product to a new audience. The way I look at it is slightly different. I think most of the healthcare system in the United States is basically one huge special interest group that is made out of the insurance companies –not including our friends from Oscar–, the AMA, most of the big hospitals, and the health care plans. Their incentive is actually to make money. Let’s call it by its name. Therefore, any disruption that gets the services, the quality care faster, better, and cheaper, more affordable to consumers is not actually welcomed by most of those players. I would therefore term everything that this gang of four are doing here as disruptive because it goes against the flow or the grain of this mob, excuse my Hebrew.

Sara Ashley O’Brien:
TJ, were you going to say something?

TJ Parker:
To Toby’s point, I do think one of the fundamental reasons that as it stands today healthcare in the United States is not a great consumer experience is because you have to design with a handful of different stakeholders at play. For us, we ultimately market to consumers. We design the product and experience for consumers. You cannot ignore the interests of payers; you can’t ignore the interests of physicians, so you have to find tactical and operational ways to take those constraints and still reframe them around what the consumer wants. For however long that medication is reimbursed by another payer other than the consumer, which is probably in perpetuity as best as I can tell, you are going to have to take the way that the payer thinks about reimbursing for medications and then wrap that with a process that enables you to still make it great for the consumer. I think it is why healthcare is so challenging and complicated is that you are reliant on lots of other stakeholders in the system to act, even if you’re trying to build something for the consumer.

Edward Segel:
To add to that, the healthcare system is so fragmented. You take a simple thing like going to the doctor, and then you insurance company pays for the visit. Your doctor is part of the hospital system who orders labs for you, which is part of a lab network. You get a prescription, and you have to go to a separate pharmacy network. You have something so simple as a routine doctor visit, which isn’t just handled by one company. It’s spread out across this very fragmented system, and none of those groups are connected to each other, at least in a highly technological, seamless way. That’s a problem. When people use Oscar, for example, they say “Oh, I love Oscar. I saw the best doctor.” I go “OH great, that’s our hospital partner.” They say “Oh, it was so easy to pick up drugs.” I go “Oh, that was our pharmacy partner.” In the consumer mind, this was one experience; you went to the doctor, but in reality you have all of these different organizations trying to work together, and the gears don’t work right now. We’re all different parts of that healthcare system, and we have to find ways to basically operate together or combine the way you’ve seen in other parts of the industry.

Sara Ashley O’Brien:
This is a really important point, because a lot of this, your first interaction with it is through the web or through an app. How do you optimize for engagement and make sure that people are coming to you and coming back to you time and time again and that you’re really optimizing for that in a way? A lot of people are frustrated, and that might be why they are turning to you guys int he first place. You have to now try to keep them and to prove that you are different and better. How do you do that?

Oren Frank:
That’s a great example, because I think my friends here mentioned the difference between a consumer-grade product and a tradition healthcare product. If you were to go to your network no matter where you are insured today and ask to meet a therapist, which is what we do, the typical time for a first meeting is between two and three weeks, which God forbid something happened and I need help now. Two to three weeks is not a great service time. If you go to CUNY in New York, a four hundred thousand student system, the wait time is two to three months. Many of their campuses don’t have any counselors on campus at all.

When we build our funnel, the way we engage people, we actually work with a super team of –let’s call them– intake therapists that are available 24/7. I think most of them are in the crowd today, in the audience. Hello. The typical time if I found out something about my life that makes me want to get help now, it will be two to three minutes before I speak with a therapist. That’s exactly the difference in the experience that we all mentioned: two to three weeks versus two to three minutes.

We will do a quality match that’s another phenomena of the traditional system in which many of the matches are not really qualitative. They’re not driven by a professional match. It’s anecdotal, who is on the network, who is in the geographic vicinity, and who do we know. As opposed to we make close to ninety percent of the matches are qualitative and are done in the same day. The level of help and service that we provide in that particular segment, and it goes along and we map the entire lifetime of the patient of the therapies, and we improve each section in similar manners. That you can do while you control the funnel, you control the level of the service, and you actually disregard and do away with this entire system which involves five to six companies and organizations that their real incentive is to make a lot of money on the process and not necessarily to add value. Some of them want that as well, but it’s just too cumbersome to be done efficiently, so that’s exactly the point.

Toby Hervey:
I would disagree with the separation of being mission driven and caring about creating value and needing to make money to support that. I think aligning incentives in the right way along with who pays for the care and who is experiencing the care, which are often two different entities here, is a reality that we’re all forced to grapple with. I think we as consumers have weird attitudes around healthcare because we have this perception we don’t pay for it. It’s sort of “I pay my monthly premium, but it’s taken from my paycheck, and it’s sort of out of sight out of mind.” I’d love to see a world where companies just pay their employees more and individuals have control over their insurance plans, but that’s not the reality that we grapple with today. Balancing the interests of the patient who pays for it with the incentives of the person or the entity paying for that care is a fundamental reality we have to grapple with.

Oren Frank:
I agree with the reality, but the reality also says we are paying two and a half times the average of the OECD for the same level, sorry for lower level services. Where is the money going? Why is healthcare in the United States the most expensive in the world?

Toby Hervey:
IT comes down to incentives. The shift from fee for service to fee for value.

Oren Frank:
That’s a sanitized name for people making a shitload of money, excuse me: incentives. Why should I go to get an x-ray, and the transfer cost is three and a half grand. It doesn’t make sense.

Toby Hervey:
It doesn’t make sense, but that’s why there are companies like us trying to change that.

Oren Frank:
That’s what I’m saying.

Toby Hervey:
That doesn’t need to come with … Tackling inefficiency isn’t the same as not wanting to make money.

Oren Frank:
I never said that by the way. I am just saying that wanting to make money is fine, and I think all of the businesses here are for profit, but when you have a group of fifty people doing the work of five and making a salary and a profit that belongs to five hundred people, that’s robbery. That’s not profit.

Toby Hervey:
Right.

Oren Frank:
If you look at the expenditures of the big insurance companies and the drug companies, it’s not about R&D. It’s mostly advertising, marketing, and lobbying. This is their business model. My humble opinion is that it’s not required. It’s not a real cost. It’s a tax. That’s what it is that we’re all paying. There’s no reason for us to pay this kind of money where everywhere else in the world, countries that are less successful, less developed, and less reach than the biggest empire in human history are paying a fraction of what we do for a better service. It doesn’t add up in my opinion.

Toby Hervey:
That’s the spirit of the Affordable Care Act and all of this whole shift to engaging patients to lower cost care and holding providers accountable for reimbursement rates and all of these unnecessarily expensive practices.

Edward Segel:
That’s one of the things I wanted to ask you guys actually. What I see is we’re in this individual market. Usually, your employer is paying for your health insurance, and when your employer is paying for your health insurance, you say “I already have health insurance. I don’t want to pay extra for better care or additional services.” Then in the individual market, people are actually reaching into their own wallet to pay for health insurance. It’s several hundred dollars a month, and even that you’re still going to have a deductible, meaning you’re on the hook for the first several thousand dollars of care, literally up to seven thousand dollars of care. In some ways, that aligns the consumer’s incentive to us as the insurance company. It’s great our members want to save money. They want to shop around for care and make sure they go to places where they’re going to save money and still get a good experience, but in their head they’re saying “I’m already paying so much for health insurance. Why would I pay extra for all these services?”

We’ve incorporated a few into our product. AS one of you mentioned, we have free telemedicine. You can click and talk to a doctor. We have fitness tracking where we pay you to do things, but these things kind of work into our system and add value, because they keep people coming back to our product again and again, which allows us to be that entry point, which allows us to guide people through the system and save money, but I’m seeing –talking with a lot of healthcare companies– trouble getting consumers willing to pay more money for what they’re doing. It seems like their real customers are the insurance companies and employers, basically.

TJ Parker:
I can talk to that a little bit. I think it’s ultimately why we don’t charge the consumer an additional fee, which is different than when we first launched, when we thought there would be an alignment between someone that took ten meds and their willingness to pay a nominal twenty dollar monthly fee for the service. What we found is the folks that needed Pillpack the most were the ones that were already spending a substantial amount of their money on medication and on doctor’s visits and everything else. It actually backfired in the sense that those are the customers that we wanted to serve the most, and they had the least willingness to pay for additional things because it already costs to much. I think we have tried to fit in with that mental model and that constraint such that we’ve been able to design a service that does not cost the consumer any more. Ultimately, the payer is paying for the medications, and we can afford to deliver a higher touch service than a pharmacy customer that’s getting one or two medications a month. We saw the exact same thing. Even if it was an employee that had employer sponsored healthcare, if they consumed a substantive amount of healthcare, there was lack of willingness to pay for additional stuff out of pocket.

Sara Ashley O’Brien:
Along with the price of these services, how do you build that initial trust with the consumer? People know Blue Cross Blue Shield, whatever. They know the names of these companies. They’ve heard them for years and years and years. Their employers have worked with them. How do you guys then enter in and acquire new customers?

TJ Parker:
I’m sure you have a lot of thoughts around that, and they may be similar, but for us it’s one of the reasons we care so much about design and we care about our brand and we care about the perception of Pillpack as an entity, because for us that is how you insinuate trust. Then it comes along with lots of trust marks and some perception that what’s behind the scenes is as thoughtful as what they can see on the surface of it. Because it’s such a logistics heavy business and there’s very little room for error, the more that we care about the details of everything we put in the world, the more that that intrinsically insinuates that we care about everything behind the scenes and can deliver a great experience.

Toby Hervey:
I would argue that for us to build that trust, the technology has to be beautiful and seamless and work really well, but if you achieve that, you almost don’t notice it. The key piece for us, which I think many of the folks can probably relate to in this room, is the people behind it: the care practitioners, the nurses who are triaging, the doctors who are going on the house call. That initial reaction, which is a human one in a somewhat charged sensitive environment, it comes down to the individual behind the scenes making that experience feel great.

Edward Segel:
Trust is huge. It’s literally why do people come to Oscar to find care and allow us to do everything I was just talking about as opposed to going to their doctor. There are these great surveys about which industries are trusted the most, and consistently the top of the list is doctors and nurses. Then you go all the way down to the bottom, like thirty down, and it’s car salesmen, congress, and health insurers. What we’re trying to do at Oscar …

TJ Parker:
Pharmacists are number one.

Edward Segel:
Pharmacists are number one, there we go. We are trying to get up to the level of a doctor or a pharmacist for that matter. It really does start with the branding, and we knew that early on, so when you looked at Oscar’s site or at our ads, you said “This is simple. It’s friendly. It’s approachable. A little irreverence of distancing from incumbents.” What it does is carry over to right when you engage with the product what are you telling people. How do you use Oscar? What’s the way you start looking for care? Why are we the entry point?

One of the most important things is the people part. People say “Do you have a relationship with your doctor?” You go “Yeah, that’s a human being. He has a face, a name. I have spent a lot of time with him.” “What is your relationship with your insurance company?” There’s no analogous thing. What we’ve done is migrate our whole customer service team –a hundred fifty, two hundred people– over to what we call our concierge team. Right when you join Oscar now, you have a dedicated nurse and a team of agents with a face, with a name, with ongoing conversations calling you and welcoming you. Now, you have this ongoing relationship-based thing with Oscar in the same way you would with your doctor. Trust is huge. It’s what allows us to do what we’re doing right now.

Oren Frank:
I’m with that. It’s all about relationship. Technology is a commodity. It’s transparent. It’s not really important at the end of the day, and I think he mentions that there’s not a lot of competition. It’s like doing better than a healthcare plan or an insurance company is doing better than Enron a few years ago in terms of establishing relationships. The competition is not there. At the end of the day, you need three distinct and separate relationships.

One is the brand, and the brand is the long term differentiation and the device for trust. I think Oscar are doing phenomenal work in building a brand, and I can see the thinking and the articulation of that, which is driven by value: better services, better experiences, more seamless and transparent technology.

The second relationship is with the provider, with the carer, with the therapist in our case, which is the more valuable relationship and the more difficult to measure, engage, and maintain. This is the one that would actually determine whether you will return and be our customer in the long run. I think a good comparison is your relationship with your general practitioner. You don’t turn from your general practitioner unless they move from the neighborhood or unless they screw up massively. I think it’s part of our relationship, and it has two levels: the brand and the provider. That’s what we’re trying to build.

Sara Ashley O’Brien:
I have one more question for you guys and then we’re going to open it up for questions from the audience. Forward looking five years from now, what do you think this digital health landscape is going to look like in one sentence?

Oren Frank:
That’s it. I have one sentence. I have no clue.

Sara Ashley O’Brien:
There you go.

Oren Frank:
I think no one really knows. I think speculating and thinking about the future is very tough. Predictions are very tough about the future, but I think one theme that I think is very important is empowerment of the consumers, of the patients, of us as people to make better, smarter, more knowledgeable decisions on how we consume this immensely important and expensive product that’s called healthcare in all its aspects. I think that’s the trend, and I think in the future we’ll be smarter and more educated about what we do. Therefore, we’ll make better decisions, and actually we’ll be able to do it more on our own accord by ourselves, which I think is great. It’s a good future.

Sara Ashley O’Brien:
Toby?

Toby Hervey:
One sentence is really tough. To say something different than Oren, I think we’re going to see healthcare get way more personalized, and it’ll be about you as an individual and who you are and what you need and less a one size fits all approach.

TJ Parker:
I like to think that companies like the ones on the stage here will teach the world that if you do focus on the consumer and build a better experience, it will ultimately result in a very fast growing company and require incumbents and new companies alike to reframe how they think about growth and building a huge company.

Edward Segel:
I’m going to do three bullet points.

Sara Ashley O’Brien:
Okay.

Edward Segel:
The first is there has to be a platform for healthcare. That just doesn’t exist right now, and you have so many companies creating consumer products, but they don’t sit together in one place. I think insurance companies could be that platform because we work across all these different silos in the healthcare system, and we pay the bills I guess.

Second is you have payers and providers, AKA insurance companies and hospital systems, that have been conglomerating on either side. I think they’re colliding now, and they have to start working together or it’s never going to be a good experience.

Then third of all is payments. We’re in a new world of high deductibles. Consumers are on the hook for thousands of bucks. What other industry forces consumers to pay thousands of dollars at once? It’s not cars or furniture or whatever. There’s financing, so consumers can’t pay a thousand bucks. There has to be solutions in there as well.

Sara Ashley O’Brien:
Awesome, not as concise as I had hoped, but all good points. We are now going to open it up. Does anybody have any questions? Is there a mic? Looks like there is one there.

Audience Member:
Hi, thanks. That was really interesting. Some of you mentioned a little bit about the providers of the care, and I was wondering if you could speak more about your relationship to the providers since the care providers are kind of the talent in your industry. What do you do to attract and retain that talent, and also how do you think that these changes are going to look from a provider’s perspective?

Oren Frank:
I think that’s a great question. At least in Talkspace, and I assume that most of my colleagues here will agree, the real consumers or the real users or the real customers are actually the providers. Again, following on the theme before, I think it’s about a value exchange. If you look at our product, if you downloaded our app or visited the website, it’s pretty straightforward and pretty simple, I hope. Actually, most of the product and what most of the stuff that we build is there to help the therapists deliver better care. I would say that’s probably ninety percent of the effort that we put. The entire notion of Talkspace as a platform is something that gives a set of tools, insight, data, learnings, ability to share and to engage in clinical communities that allows every therapist that works on the Talkspace platform to be the best therapist that they can be. That’s actually the purpose of the platform that we built. It’s all driven by value, and internally that’s completely our first priority.

Edward Segel:
As an insurance company, the literal product that we sell is access to medical care and providers. The way insurance companies have approached that in the past is saying the best network is a broad network is the term. You have tons of options about where to go, but the reality is that network is disconnected. You don’t know anything about the doctors you’re going to, so a core thesis that we have is let’s focus on building deeper connections with doctors, with hospitals, and making sure that we’re focused on technology connections, seamless interactions, and super high quality and not this giant amorphous network. That’s a core bet we’re taking as a company, and it’s where I see healthcare going as well.

Toby Hervey:
Pager is at a really interesting inflection point, because until now we’ve run our own network here in New York, our own doctors, our own nurses that we’ve recruited. We’ve never done any formal recruiting because introductions have come from another provider to another provider that they’ve worked with. I’d say there are two criteria that define all of them. They’re really forward thinking and seeing the same problems that we’re seeing in healthcare and want to be part of the solution, and they share our philosophy that the patient comes first. That’s what they care about are great patient experiences, and that’s why they got into this business in the first place. That profile has been perfect for us, but we’re starting a pilot soon. It’ll be our first with an external provider group, so we’re thinking long and hard about how we can bring that ethos to a group where we have much less control. We didn’t hire these people; they’ve been working in the system for a while, so we’re thinking about training and onboarding programs that will cultivate that same spirit that we’ve seen here in New York to date. I’ll keep you posted on the results.

TJ Parker:
For us, our providers are pharmacists. We spend probably two thirds of our internal product resources building tools to make their ability to provide care better, because what we think is fundamentally missing in pharmacy is not pharmacists that care and want to provide a better experience to their consumers but the infrastructure and the tools to actually do that. We really think that providers that are technology first companies will enable the change that providers need to have to provide the type of care that they would like to.

Sara Ashley O’Brien:
Any other questions?

Howard:
Hi again, this is Howard Krumpton. I’ve worked for several different hospitals: two children hospitals one in California and one in DC, then another really big hospital in Baltimore. As a psychologist, some of the clients if they have a concern, they can get a more senior supervisor in the room, but they can’t necessarily go to the top of the chain of command in the same day or in the same week or in the same month if there is an issue. What I’ve found unique about Talkspace is that a customer can come to me or go right to the top of the chain or somebody really influential pretty quickly. That keeps the feedback loop pretty open in terms of designing the platform that holds some integrity to personalizing the experience. For healthcare companies where a customer doesn’t really get to go all the way up the chain, when you say personalized, who is coming up with the notion of it actually being personalized? Just the people in the boardroom that feel like they’re representative of the population, or is there actually an open feedback source where you guys are actually incorporating customer feedback and actively seeking it out? That was really dense, sorry.

Toby Hervey:
Certainly more the latter for us. It’s a combination of data and qualitative user feedback. You can personalize an experience based on a lot of different data points like who you are and how you live and your conditions. If you can build a relationship with a patient over time and collect those points in addition to more qualitatively understanding their experience and their needs as a user, you can build a tailored experience that makes sense for that individual. We lean on not only technologists and user design experts to do that but also practitioners in the field and medical experts. We work with a really passionate team of doctors and nurses and experienced medical practitioners who have worked with patients and continue to work with patients. For them to even participate in that design process for us, they have to be seeing our patients via the platform as well and be on the front lines. Of course, there are mechanisms within the app to rate every experience, give feedback. That’s an information goldmine for us to be collecting that feedback in real time, and it’s an important part of designing and evolving the product.

Edward Segel:
You’re talking about things escalating up, and things escalate when there are problems. In healthcare, there are all sorts of problems.

Howard:
Not always.

Edward Segel:
Not always, but the system is riddled with it. A metaphor we use is people have to project manage their own health, and anyone who has been in a hospital knows this. You say “Talk to this doctor. Go guys. Hey, I wasn’t supposed to take that medicine. Can you double check on that?” The question is who is going to help you solve these problems most? You can deal with a provider administration, but at Oscar I think a reason we’ve gained a lot of trust is that we hear about people’s problems all the time. We have customer service, and people tell us what’s going on. A lot of what we’ve proven is just smart people hustling on your behalf and helping you connect the dots goes a long way. We’ll have a member call in, and right away say “Okay, let’s talk to your doctor together” or “Hey, we’ll help you fill that prescription. Let’s have a nurse visit you in person.” That sort of stuff helps you solve problems and prevents what you’re describing as escalation to the top dog. It’s just not needed when you have that.

Sara Ashley O’Brien:
I think we are all out of time. Oh, TJ did you want to say?

TJ Parker:
No, it wasn’t that important.

Sara Ashley O’Brien:
No, but this is a good point actually. Your company does do that as well. You examine what medications somebody is taking and then see …

TJ Parker:
This is going to be so disappointing now after all that. I think we think you can use technology to bring back the personal relationship that you had with your pharmacist fifty years ago that you don’t have today with this impersonal big box retailer. I think a lot of that is enabled by smarter tools and better service, but also to your point about escalating things, we watch MPS surveys like crazy. We look at qualitative feedback. When we make a change with the product, with the work flow, or anything else, we’re constantly watching that from a user feedback and quantitative standpoint. Much to your point, that is both staying close to the user and making sure that everyone in the company understands why we exist.

Sara Ashley O’Brien:
Wonderful, well thank you guys for joining us. Thank you guys.