With the blessing of UnitedHealthcare, CEO Tom Vanderheyden left the insurance giant to create a company that puts primary care front and center. With doctors seeing fewer patients and health coaches leading the way, can the company create a healthier – and less expensive – patient population?
Ten Top Topics in this Breaking Health Podcast:
- How is this going? If you could do it all over again how would you do it?
- Started with the experience between the physician and the patient.
- What if we started a new company and went to market as a fresh clean slate and brought what we believe people need?
- What is the role of the Harken Health Centers?
- Can we put a cover sheet on the EOB form?
- What is the role of a Harken Health Coach?
- We are investing two-times the industry average on primary care.
- Why all things at a Harken Health Center are free.
- When you walk in the door they’re going to know your name. That’s how the model works.
- The Power of the Harken Health Portal.
Tom Salemi: Hi, everybody, welcome back to the Breaking Health Podcast. I’m here with our host, Steve Krupa. Steve, how’s it going there at the Psilos Group?
Steve Krupa: Great, Tom. How are you?
TS: Doing great, thank you. Had an interesting weekend of baseball.
SK: Yeah, I don’t remember what happened, so I was busy.
TS: The good guys won again, again, and again. But it’s early in the season. So Steve and I have just placed a bet on the futures of our franchises for this season at least, and we’ll see who owes whom some beer at the end of the season.
SK: Exactly. Don’t count the Yankees out just yet.
TS: I won’t, I promise. I’m a Red Sox fan; I never do. So we had a great sit down with Tom Vanderheyden, the CEO of Harken Health. Tell us a bit about Harken Health. It kind of hearkens back to –
SK: It does.
TS: – the old days of HMOs, right?
SK: Yeah, well, you know, it’s funny. It’s the one question I didn’t ask him, but maybe that’s where the name came from. It hearkens back. Well, Harken Health is a corporate venture backed by United Healthcare. But when I say corporate venture, it is really utilizing the venture model, which we’ve described here as sort of break, build, repeat, in that they’re breaking an old model of business; they’re trying to build a new model, and presumably they’ll take what they learn and break it again and rebuild it back up. But the model that they’re trying to solve for is how to provide better care experiences for members of health insurance plans. And where they’re hearkening back to, so to speak, is the first real model for HMOs, when the HMOs came on in the 80s, which was the idea that staff model medical clinics would be the point of contact for all members, and that by containing the care as much as you can in those clinics, you can afford at that point to underwrite first dollar health insurance. So that’s where the idea came from. And Harken Health is utilizing that structure with a little bit of information technology and some new ideas like health coaching and things like that in an effort to improve the member experience for health insurance membership.
TS: Excellent. And you had a very great conversation. Sounds like you guys knew each other from some previous stint in healthcare?
SK: Yeah. We knew each other from just general interaction between us and United Healthcare. I knew him when he was back sort of at the parent before he got started doing this. And I think this is kind of interesting, that he got this opportunity, as we’ll learn from the discussion. They just said, you know, Go off, do some work and come back to us with a new model. And it’s not a staff model exactly, but it has the initial flavor of that, which is this idea that you would get your care initially from a clinic.
TS: Terrific. Well, let’s start her up. Have a listen.
SK: Welcome to the Breaking Health Podcast. I’m here with Tom Vanderheyden, CEO of Harken Health. Welcome, Tom.
Tom Vanderheyden: Thank you. It’s great to be here, Steve.
SK: Yeah, glad to have you. We’re going to talk a little bit about corporate venturing here, right? You’ve got a new idea backed by a health plan. And I think it’s worth just sort of giving a little bit of your background as to maybe how you got involved with Harken. How did they talk you into this?
TV: Sure. Yeah, the early formation – so I did spend a dozen years prior to Harken at United in a variety of roles, very few of which had anything to do with healthcare or health insurance. But the last few of those years I spent a great deal of time in the innovation space within the industry, so looking at where venture capital was going, and what new emerging trends were occurring within the industry. And as part of that, had the opportunity to put a small team together to reimagine healthcare from the start. So literally, just a white board activity of how’s this going. And if you could do it all over again, how would you do it?
TV: That was the beginning. So we spent a bunch of energy focused on the experience within the industry and the experiences specifically between payers of parties.
SK: So did you start with a list of complaints, or did you start with just sort of saying, How would I want it to be?
TV: You know, we started looking at current state. So we started by looking at the experience between a physician and a patient, like in the moment, in those minutes in the room, what are the characteristics and attributes. How’s it going between those two? Like do people – has the doc got his or her back turned to the patient? And how quality are those 8 minutes? And how does the patient feel? How does the doctor feel in that experience? So we started there, and then we said, OK, now that’s one set of experiences. How about the experience between the physician and the payer, the insurer? What are those characteristics and attributes? How’s it going when those 2 parties are interacting? Generally not great.
TV: And then we looked at the patient.
SK: Yeah, the experience when they get the bill, for example.
TV: Exactly. So the experience when they get the bill, which is not very fun either. So we went through, spent all our first weeks of energy going through the experiences of may the top ten or twelve relationships within the industry, and then candidly sat back, and as I refer to it, because it was on one wall in our room, and I refer to it as the yarn matrix. And it looked like a detective’s office. The the yarn stretched between the parties and how unattractive each of those relationships were. And we sat back at a classic innovation moment, and said What do we do with that? What do we do about that? What’s the opportunity in that? And then we started – go ahead.
SK: No, and I’m curious. You were looking at it presumably with a fresh set of eyes, as though you weren’t tainted by any presuppositions about what it ought to be, right? So where did you focus first? Something must have hit you first, right?
TV: Yeah. Well, a couple things hit us. One was there were so many experiences that were negative that we had difficulty reframing to positive. And so then we started to just look at what experiences did the collective dozen or so of us enjoy having. Like what brands, companies, experiences do we like spending time with? And we spent a fair bit of time assessing those. And these are great companies: Trader Joe’s and Zappo’s and Dollar Shave Club and a couple of others. And really started to dissect what are the characteristics and attributes. Why do I like going to Trader Joe’s? What are the things about the experience that they create that draw me to want to participate with them? And I’m kind of distilling down six months’ worth of work in two minutes. And where we got to was what if we could start a health company that focused on the experience people were having, and focused on creating experiences that people actually would want to have, or would find pleasure instead of pain in having those experiences, across many dimensions, by the way, but really focused on experience first. And that was the genesis of Harken. That’s what’s we said on that day. What if we started a new company and we just went to market as a fresh, clean slate, and brought what we believe people need? And we distilled all of that kind of work into three core tenets. And the first was around culture. And we just said the culture of the enterprise, if we’re talking about healthcare, the culture of the enterprise at its core must be care. So as we say, 60% of our waiting in hiring criteria for every single employee, top to bottom in the organization is care and empathy. That’s what we screen for. Then we’re going to figure out if you can do marketing or sales or process a claim or take a phone call or do strategy.
SK: You know, I’ve probably met all of the other 40 – well, I don’t want to say 40%, but I’ve met all those other people, right, that don’t have care and empathy. And they’re in the healthcare system right now.
TV: And they’re in the healthcare system. They are.
SK: They’re usually the ones answering the phone, by the way.
TV: And the reason that they’re not empathetic is because they’re getting motivated, they’re being driven to try to get you off the phone. And measured.
SK: Right. It’s like I need to see the doctor, and they say, Yeah, I can fit you in in about four weeks. Right. And you’re just like, Well, wait a second, four weeks from now I’m going to feel fine. I mean if I don’t see any doctor I’ll figure out a way to feel better in four weeks.
TV: Which they know that, too, right? They know that, too. So we really focused on the culture of the enterprise, and combining that culture with this human-centered, design-led thinking. So back to the original work of the experience that a person was having.
TV: So we want high care and empathy focused around the experience that a person’s having. The second thing that we discerned from that yarn matrix is really the need for an integrated care model. And that is we believe people want and need care. They don’t necessarily want insurance. They may need it, but they certainly don’t want it. And so the observation and discovery was all of us on care journeys – I was just talking to a woman this morning, in fact, who was diagnosed with a brain tumor a few years ago, and she’s healthy and well and fine. But she was sharing with me she went through six doctors to begin with, all of whom had slightly different opinions on what she should do next, none of whom were coordinating her care, or in essence acting as a consultant or, as I use the term, quarterback for her. So she’s this 23-year-old trying to navigate, as she described, words she couldn’t speak much less understand for her own care. So we discerned this need for a quarterback in your life as it relates to journeys of care. And more importantly, prior to that, to just allow you access to care. So that’s where the idea for the Harken Health Centers, so we built 10 Harken Health Centers in combined Atlantic and Chicago. These are primary care on steroids, as I like to say. So you‘ve got primary care, behavioral health, health coaches, and these care teams are available to our members, to you 7 by 24 for free. So no charge to our members. I like to say it’s unfettered access in a relationship between you and a care team. So that is absolutely core to our model. So if you buy Harken Health Insurance, you go to a Harken Health Center, the only people that can go to a Harken Health Center are those that buy Harken Health Insurance. So a closed system that is then supported by presently the largest network available in the country. So 850,000 physicians and 6,000 facilities, etc.
SK: So United let you borrow the network?
TV: United let us borrow the network as part of the deal.
SK: Thank you very much. Good deal.
TV: Yeah, it is. It’s part of the deal: if you get access – they have access to enough of your equity, you get access to their assets. So yeah. So we wrap it with the big United network. So that’s the second differentiator. So again, culture number one, and this fully integrated care model that is central. And the last is around administrative simplicity. And this is related to my background, which is not insurance or care. And I tend to get irritated by things that don’t make sense to me, and things like the explanation of benefits, the EOB form to me is like Exhibit A in the industry. It’s this document that comes to your house and says it’s not a bill, so don’t pay it, but you owe $500. That one.
TV: And so I asked the team to recraft the new Harken EOB, and they did. And because we’re design-led, it’s the most beautiful EOB you will ever see.
SK: Send me a copy, will you?
TV: And it’s terrible. And it’s terrible. It was terrible, I should say. It was terrible. This was last summer. So I said, Why is this so bad? Because it says things that I don’t understand on it, like coinsurance and other stuff that 99% of the world doesn’t know what it means. And then my team informed me, because I’m not a healthcare guy, that it’s a regulatorily required document. So we have to produce it. And I said, Well, can the regulator keep us from putting a cover sheet on it like to mask it? And they’re like Hm, no, they can’t keep us from doing that. So that’s exactly what we do. We put a simple 1, 2, 3 on that cover sheet just to say, Hey, here’s what this thing is, here’s how you can use it, and here’s if you need to keep it or not keep it, etc., etc. We try to put it into language that I, Tom, could understand, versus a smart regulator.
SK: Document that follows is something that you will not be able to discern nor understand, so let me explain to you exactly what it says in this letter. It’s required by the government and healthcare regulations to be provided to you.
TV: That’s exactly right. And that’s just the sample of an administrative simplicity edge, a point of friction, a point of abrasion in the system that we are very, very active in trying to take the edge off. We try to do that from a plan design also, just make it really simple.
SK: You know, my family, we got 2 little kids, right? So and I’m old, and I go to the doctor, and my wife goes – so one of my wife’s jobs is to collect the EOBs and then collect the bills, and then match the bills to the EOB, pay the bills. And then when the bill comes again, after we’ve paid it, call the provider and tell them that we’ve already paid the bill.
TV: Belt and suspenders.
SK: And she does it. Because I mean honestly, if we just paid the bills as they came in, we’d double, triple pay everything. They keep billing you. They forget. They didn’t get it in the billing system. And –
TV: You have a better system than I do. Yeah. Because we do double, triple in my house.
SK: That’s the system. We have like a little filing cabinet, and that’s the way it all comes together into one. And I say to her, This is the value add of having a husband that knows a little bit about the healthcare business. We won’t double [?]
TV: You’re going to laugh because what we did also do with the EOB is we created a checkbox portion to do exactly what you’re referring to. So that when people get the bill from the facility, they can go to the EOB and literally check off that that bill was paid. So we’re trying to match literally what happens in your life with the forms that we are forced to send to you.
SK: My wife writes “paid” on the bill. That’s how she knows. And it happens more when we’re out of network. Like I went to a couple of providers when I was traveling, and man, they just keep firing me the bill. She’s like, I paid this bill. All right. So administrative simplicity, and then of course you’ve got just this whole idea of why should I have to figure out what that damn thing says. It starts out with a list price, and then a discount, and this is how much you’re covered, and this is your deductible, and this is how much you pay. And at the end of the day, it’s very, very hard to tell what’s going on.
TV: It is. And that’s a key part of what we are trying to do and be for people. It’s that translation agent and again, your quarterback to help you through the journey.
SK: So yeah. So let’s talk about the model. You’ve already sort of hinted about the health clinic and the health coach and the primary care clinic on steroids, care teams and so forth. So if I sign up, and I would urge to think about whether you could call this something other than insurance, because that would blow everybody’s mind. But essentially, I’d buy my insurance from Harken Health. I don’t have to buy it from United Healthcare, right, and then I become a “member.” And I’m –
TV: You are a member. Yup. In fact, you, the membership part, so when we send you a bill, it is your membership fee. And we call them membership cards, not ID cards. Because at Harken, you, unlike the vast majority of the competitors, you get something for your membership, which is you get access to the Harken Health Center, just as you would get access to a gym membership, right? So we’re trying to change not only the experience but the language of the experience as well.
SK: I like that.
TV: So that people start to realize, yeah, I do send you $350 a month or $950 or $1450 a month, but it is for a membership, and I get legitimate value out of that membership. It’s 7 by 24 access. So we know if you live in Wicker Park and your health team is quarterbacked by Dr. Jones, you can call Dr. Jones daytime, you can call Dr. Jones night time. Dr. Jones may not answer, but one of Dr. Jones’ Harken Health peers is going to answer 7 by 24. That’s whether you’re at home or not. So if you’re on the road and you’re on vacation in LA, it’s 3 a.m. on Saturday, instead of going to urgent care or the ER, you just call back to the doc who has your record, has your medical record, knows your family. Unfettered, no bills, no EOBs for that visit, by the way. No paperwork for your wife to have to reconcile. So that’s why we’re trying to really change the way people think, not only experience it, but think about it is I’m not going to hesitate to pick up the phone and give my doc a call for any question at any time because it’s a relationship.
SK: Yeah. I think that now once I get there, look, I have a primary care doctor, and I know what that experience is like. I think that she means well. I think she cares about me. But at the end of the day, most of the time they don’t recognize me because I don’t go that much.
SK: So they recognize me by looking into the file, they pretend like they know me and they spend 15, 20 minutes maybe with me.
SK: And then I’m either referred out or I’m given a prescription. And from there it’s up to me. You go figure it. I just gave you two names of a cardiologist, or I just gave you the name of another type of specialty, whatever you can think of, and give him a call and go see him, and I hope it all goes well. And that’s it.
TV: Yeah. So let me just maybe walk through the same scenario that you would have in a Harken Health Center. So each doc at a Harken Health Center has three to five health coaches strapped to the doc. OK. This health coach role doesn’t exist in any fee for service model, and you’ll understand why. These health coaches are people that are hired for two skills: they’re hired for care and empathy, and they are hired for relationship development. Relationship – they love people. They love building and maintaining relationships with people. So why and how are they central to the role? In the visit you just described, that health coach is going to be the one that comes and greets you in the lobby when you arrive. That health coach is going to bring you back to the consult room or the exam room. We have two very different types of rooms in the Harken Health Centers. And they’re actually going to start the visit with you, and they’re going to stay with you through the visit with the doc. And by the way, our docs – average primary care doc sees 30 to 33 patients a day. Ours see 15. OK. So that’s just in terms of number of minutes you’re going to get with a doc. It’s 2 to 3x. That health coach stays with you through that visit. The doc finishes up, the health coach stays with you after the visit and does the wrap up. And the health coach is the one, the next day or the day after, may call you, may call your wife, may call your child or friend who was with you in the visit to see how you’re actually doing. These health coaches are also people who would literally come to your house and help you understand what parts of your house might make you less or more healthy based upon your conditions. They will come with you grocery shopping to teach you if you’re diabetic how to get better and live healthier. So and candidly, it’s that person, like you just said, the doctor would pat you on the head and wish you well. The health coach is the one who’s going to ensure that you’re taking the actions to be well and hold you somewhat accountable. And it is that person with whom you are likely going to create the most significant relationship. In our model, we say people come for the doc and stay for the coach. Because they’re the ones who are going to quote-unquote stay in your business, right? Stay in your business in a way that’s productive and helpful for you. And if you want to go do a 5K, they’re going to be the one that’s help you build your plans, stick to your plan to get you to your 5K. Keep you within that spectrum, right?
SK: Are they licensed nurses?
TV: They are unlicensed, no. The point of this role is this is on top of all the other roles you would normally have in a clinic. These are non-clinical roles.
TV: They are solely to develop and build relationship with you and to ensure that you’re cared for and to coordinate with the docs, the behavioral health specialist, to ensure that you’re getting everything that you need to be well. If that’s managing, seeking the right referrals, ensuring that you did in fact take your meds, Steve, etc. So it’s a new role. It’s a new role.
SK: Yeah. And not to sort of break the good feeling that I’m getting from what you’re doing, because it sounds awesome, all right, but is it then from a business objectives point of view – of course you’ve got the idea of being able to provide the care on a fixed fee basis for the membership in aggregate, right? The whole insurance model holds.
SK: So is it your goal to try to deal with – well, obviously I think your goal would be first to try to identify chronically ill people so that you can get them on some sort of regimen to keep them well.
TV: That’s right.
SK: And I would imagine you’d also want to try to contain, given the model you just described, as much as the care delivery within the clinic setting as you can. Is that a business objective from just the insurance point of view?
TV: Clearly, that’s a business objective. And through plan design, we incent that behavior. So that’s why all things at a Harken Health Center are free. So anything else, you know, you go out into the network world, and you’re going to deal with the industrial healthcare system. And there’s going to be some charges associated with that. Even in our plan design, some people have to pay for things. You know. So having at the core of our model, having this be free is central to try to get people to not only try it; the good news is even in our first four months here, the feedback, the daily letters that we get are off the charts in terms of the impact we are having on people’s lives, and the things that they say around I can’t believe this is real.
TS: Hi, everyone, Tom here. Just taking a moment from this conversation to ask you to go to healthegy.com. That’s the world health followed by EGY.com. Healthegy.com to sign up for the Breaking Health Newsletter. You’ll not only get this Podcast and future Podcasts sent to your inbox, but you also get our own exclusive reporting on the healthcare space as well as videos from our healthcare events. So go to healthegy.com and join the Breaking Health family. Now back to this conversation.
TV: Because a lot of times I suspect you may be thinking this, even, Steve.
TV: Sounds too good to be true, Tom. How are you able to do this? And from an economic standpoint, you headed down the business path. We are over-investing in primary care.
TV: I mentioned the health coach role. There is no way in fee for service for anyone to bill for that person’s time. It’s why it doesn’t exist. So we are investing over two times what normal insurers would pay for primary care to provide what we are providing within the robust set of services within the Harken Health Centers.
SK: Well, I mean it’s –
TV: And we do that knowing if you’re in LA on Saturday morning, you’re not going to go to the urgent care center. You’re going to call your doc in Wicker Park and you’re going to get the script delivered to you in LA. If that’s the right course. And that is cost – it’s not only cost avoidant, it’s a better experience for you as a member. So this is not cloak and dagger insurance behavior to try and divert you from care. This is actually creating a better experience for you at every turn and virtuously reducing the cost.
SK: I mean there’s probably pretty good data on over-utilization of specialty services and ER services, right? So I mean at the end of the day, you’ve got people that are coming and getting a better experience from a health coach and primary care doctor for most of their ordinary, if you will, healthcare needs, right, than you’re able to not only give a better service, but you’re containing the care to a particular group, and avoiding people going off on their own to sort of a fee for service world and getting – over-seeing specialists.
TV: That’s right. You mentioned your relationship with your doc, who pretends to know you, and my doc certainly pretends to know me, too. And what’s different in this model is that that doc and those set of health coaches only care for a thousand to 1,500 people max. that’s it. Now that may sound like a lot, but in terms of active populations, that’s a very small number.
SK: Yeah. I can see that.
TV: So they are going to know you. The whole point is when you come to a Harken Health Center, you don’t present your membership card because they already know who you are. After your first visit, they’re going to have a photo of you, and when you walk in the door, they’re going to know your name. That’s how the model works. It’s very personal.
SK: Yeah. Where’s your membership coming from, Tom? Are you embedding this into a corporate group model? Are you pulling people in off the individual markets?
SK: Where are you hoping to get your membership?
TV: Two places. Yeah, so we went live January first this year. So available on and off exchange in Atlanta and Chicago and to small group in both markets. So all ACA compliant plans, predominate bulk of the membership is individual on and off exchange this year.
SK: That’s cool.
TV: Thirty-five thousand members across two cities.
SK: And did you pick Illinois, Chicago and Atlanta for a reason? Because I know you’re a Minneapolis guy. So –
TV: I am a Minneapolis guy. But what we believe – the most important thing to us – I shouldn’t say the most. A very important thing to us when building the company was that this plays across America. That it’s a model that works for all people. And when we looked at Chicago and Atlanta, we looked at the top 50 metros, and things like competitive participation, regulatory environment, all those factors played in. But when we looked at cultural aspects, we felt that those two cities were really, really different culturally, and represented a fair cross-section of America. And those were the primary reasons that we picked them, in addition to the fact that our model, given that it’s kind of a neighborhood health center based value proposition, we need density. And those two cities of course have great density. So that within 20 or 30 minute travel time of any given address, where a Harken Health Center is located, we can capture enough of that population to make a business viable and viable not only financially, but viable from a member experience standpoint. Because we don’t want you to have to travel 90 minutes to get to a Harken Health Center. We want it to be 20 to 30.
SK: Yeah, absolutely. That makes sense. And so how are you doing? How’s your membership doing? Has it – are people understanding the value proposition that you’re offering when you go out and market the product?
TV: They are, they are. I will tell you last fall, when I had the opportunity to meet with hundreds and hundreds and hundreds of brokers in training events, they were just struck by how different this model is. In fact, I had a broker this morning. We were doing new employee orientation, and we had a new health coach start. And she was here, and I didn’t realize that she had been in one of those broker sessions. She worked for a broker. And as she was doing her introduction this morning, and I unfortunately I didn’t remember meeting her late last summer, she was describing how impactful the presentation that we were giving was about Harken Health. And she said this morning, she’s like, that meeting, that presentation changed my life, she said.
TV: Because the impact on her in terms of what she wanted to bring to the world was that significant. She was like she had been on the broker side for a long time; she was frustrated by, you know, the tough things the brokers do. And she was looking for a way that she could care for people. And this health coach role fit her perfectly, and she just started. And –
TV: – it is awesome. It’s absolutely awesome.
SK: So are you thinking about technology as a big part of improving the experience for your members? I know you mentioned being able to give them an overlay on their EOBs or administrative simplicity.
SK: There’s a lot of technology innovation, or attempts at innovation, to act on consumer engagement. And I kind of look at what you’re doing, to be honest, as a very sort of direct and significant member engagement model, basically.
TV: It is.
SK: Because you’re getting them to come to your clinic. That’s A, you’re getting them to come there, and then when they come there, you’re not messing around. You’re giving them good service, you’re informing them, and then they go out and they leave. But when they leave your clinic, they begin to interact with the rest of the world. Their parents start to ask them questions, or in my case, I always ask my parents when they go see a doctor, What did he say to you? What’s going on? I want to know what’s going on.
SK: Are you looking at ways to incorporate our new technology infrastructure into your model?
TV: Yeah. So I’d make two points. The first, 50 to 70% of our clinical interactions are outside of the Harken Health Centers.
SK: Interesting. OK.
TV: So and the reason I bring that up is you’re right, and the model is centrally developed around the experience in a Harken Health Center. But candidly, it’s developed around the relationship that’s created in the Harken Health Center. Because Steve, you’re a busy guy, right?
TV: And if you’re not feeling particularly well, do you really want to take that afternoon to go sit in a waiting room and blah, blah, blah?
TV: Or do you want to just call your doc and have a conversation, describe the symptoms, and then figure out if you need to get blood drawn or you need a script or you just need to wait three days and you’re going to feel better? Right? So I think that’s a really important aspect of the model. And as it relates to technology, a couple points. One is everything that occurs in the Center, when you sit down with a doc and a health coach, you’re going to look at a large, flat panel screen with your medical record on it. We have these half-round tables. You sit and look right at it together. So you see every word the doc writes, every piece of data about you. Everything that you see is available to you verbatim on our member portal. So if you want to call and ask your mother how her visit went and what did they say, we have the ability literally, your mother could take you into her Harken Health portal and show you exactly what the doctor said, and exactly what her conditions are, and exactly what she is supposed to be doing.
SK: I love that.
TV: The other thing that’s critical is let’s say, Steve, you’re a healthy guy, you’re a Harken Health member, and you’ve never been to a Center. OK. Which is a fair bit of our population. Like me. I don’t go to the – I’m blessed. I don’t go to the doctor very often. Years in between, often. So let’s say, though, that you have a cardiac event on Saturday night, and you end up in a facility, and it’s Monday morning. Every health plan in the country has to call you. They have to get engaged in case management, disease management activity. Most health plans outsource that to 1-800 Nurse in the Sky to meet the regulatory requirement to get engaged. We don’t do that. We delegate that to the doc in Wicker Park, do your doctor in Wicker Park. So Steve, if you end up in a facility Monday morning, you’re getting a call from Doctor Jones in Wicker Park, who even if you didn’t have a relationship previous, you’re gonna have a relationship now, and that doc is going to be in your business in a good way, and you’re going to have a relationship going forward. So that’s a little bit on the tech side to round out the tech side. We think – we don’t necessarily believe that Fit Bits are the answer to fixing all healthcare.
SK: No, no.
TV: What we tend to believe is to use the data, as you mentioned, go identify your chronics, go identify the people who need you, and there’s lots of ways to do that, not just through claims data, but there’s other sources available to figure out who really needs us, who has social determinant issues, etc. So we’re trying to use technology to identify the populations and to engage with them proactively, especially those who have not engaged with us for any particular reason. But we are very focused on solving the last mile problem, which is touching you. And I mean that very broadly. It’s getting to you. It’s caring for you. It’s helping you learn to care for yourself as well, and how can we participate with you to get you better. But it’s being done on a one to one, voice to voice, face to face basis, versus you having to log into an app to do something, take some action, track something, etc. And I’m not dismissing any of that, because there are certainly in the behavioral health world and some others, there are a few categories of conditions that are well served by technology and we’ll adopt and adapt those as we think appropriate. But otherwise, out of the gate we’re using a very high touch model to get after care management.
SK: Yeah. You’ll adapt as you go along, right? Figure out what works and what doesn’t work for you.
SK: Are you doing this inside of the corporate structure of United? Are you a separate company? Separately funded? Partially owned? Wholly owned? How did you guys figure out how to do that together?
TV: Yeah. We are – I refer to us as an independently operated affiliate. So they are our sole source of funds. We are an independent legal entity. So we bear our own risk.
SK: And do they provide the insurance overlay for you? Or is that you’re a separate insurance company too?
TV: We are a separate insurance company.
SK: OK. So you’re going to figure out if this works –
TV: We do our own separate filings, we take our own risks. Yeah.
SK: All right. And as I think about this, and of course we talked about this in our sort of pre-interview discussion, the old group model. I remember Signa was a big model company. They would build clinics at manufacturing facilities or corporate centers and things like that. And that was really the beginning of the HMO, first dollar health insurance product.
SK: And you were nice enough to remind me that you don’t remember that. And I don’t know that I remember it that well, other than it was described to me. Because when that was around, I was never going to the doctor anyway. So this is a little bit of going back to get some of the essentials that people thought were in place in that model, which was the idea of the relationship with the doctor, the idea of the clinic. How big do you think the demand for this is going to be? I mean what are the ambitions for a product in a company like this?
TV: Yeah, the ambitions are significant. The beauty of the model is that it is to serve people. And so it turns out people come through a lot of channels. You mentioned, and we’re serving the individual exchange and off exchange buyers as well as small group. But the asset itself, and the core value of the asset has a lot of value to all people. So we like our position in that regard. At the moment, it’s a density required play. So we’ve got where there’s enough people within 20 or 30 minutes to carry the infrastructure of a Harken Health Center. Having said that, the Harken Health Centers themselves are built for a very discrete population. So again, focused on the experience, I always liken our market position – I’m talking about our geographic market position – to Starbucks, which is you never go to a mega-Starbucks, right? They don’t build huge ones. They want you to have the same, consistent experience.
SK: They’re everywhere.
TV: From store to store. They’re everywhere. So if that one gets busy, they build another one two blocks away, etc. And that is exactly what we are doing because the intimacy of the care team themselves within the Center is critical in insuring that the population is cared for in the way in which the population wants to be cared for. So we can’t have a care team staff of 30 people because they’re not going to fit around one table every morning, which is what they do in the Centers is they meet for an hour before open as a full team every morning to talk about the people, a few of the people who are coming in, but most of the people who aren’t coming into the Center. It’s the people who need to be cared for, and who need outreach to care for them.
SK: Very good.
TV: So that is central also to the model is this geographic concentration. And so as we think about what other populations could you serve, we’re still going to require some density to it, but it turns out there’s a lot of density in the US. So we feel good about our future prospects and opportunities.
SK: Well, this is very cool. I’m talking with Tom Vanderheyden, CEO of Harken Health. My traditional question is to talk about – ending question, if you will, is to talk about the development of an entrepreneurial culture. And most of the time I’m speaking with people that are not really in a corporate venture. And I hope you don’t mind if I categorize this as a little bit like that. I mean you’re getting your funding, obviously, from United. You’re getting their network.
SK: But my question is more along the lines of are you able to separate the culture? And you’ve done a great job in outlining that in fact the business was built around a cultural idea. But are you able to separate the corporate culture, the culture of the company itself to have it feel entrepreneurial and unique alongside the fact that you’re somewhat affiliated with – you’re very affiliated with United in terms of funding and so forth?
TV: Yeah. I would encourage and invite you to come visit, Steve.
SK: I’m going to be in Minneapolis this summer. I will come visit.
TV: Seriously. Stop by. I think you will be nothing but pleased in terms of the facility that we have, the way in which we – there isn’t a cube to be seen. There are no offices in our office. So we are all seated at 4-foot desks next to each other, and the culture is very, very interactive and non-corporate. And this is a pure, jeans-wearing, music playing, soft seating, and yet aggressive, high energy, collaborative culture that has got its basis in care and empathy. And that care and empathy doesn’t necessarily mean you’re just playing a powder puff game. It’s care and empathy that’s got to be defended.
TV: So how are we going to get aggressive on plan design or pricing or marketing approach? We’re going to get aggressive at these things to the end of insuring we can deliver care and empathy to our members. That’s the experience that people deserve.
SK: Hey, how about this for an outcome? Very high customer satisfaction scores, right, and competitive medical loss ratios. Is that possible? That’d be pretty cool, right?
TV: We think it’s possible. We think it’s possible. And when you come this summer, we’ll let you peek under the hood.
SK: If there’s a ping pong table and a keg there, I’ll definitely be there.
TV: I have stories on both.
SK: It’s great to catch up with you again. Congratulations on your new venture, and I can’t wait to come see you. Thank you very much for being with me.
TV: Thank you. Yeah, appreciate it, Steve. Be well.
TS: Would like to thank Tom Vanderheyden for joining us today on the Breaking Health Podcast, and of course big thanks to Yankees fan, Steve Krupa for not only keeping the faith for his local nine, but also for leading a great conversation and hosting this Podcast. Thank you also to our Breaking Health Podcast listeners. Join us next week for another tale of healthcare innovation.