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Amanda DiTrolio

πŸ’‘ HTN | Community Brain Trust | 9/26

September 26, 2023
Community Brain Trust

🧡TOP THREADS OF THE WEEK

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In case you missed them, here are highlights of a few interesting conversations from different channels:

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Threads included below:

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  1. Gastrointestinal disorder digital health startups
  2. Florida Blue no longer allowing telehealth clinicians outside of Florida
  3. Eligibility data processing pain point validation
  4. Multifactor authentication apps for provider orgs
  5. Best practices for sharing product knowledge across an org

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1. Gastrointestinal disorder digital health startups

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Q: Other than Oshi Health, are there any other digital health companies that are helpful with GI disorders (a friend is dealing with a painfully long waiting list @ UCSF)? Oshi doesn't yet take his insurance and doesn't (seem to) offer a cash pay option. TIA!​
– Kusum Chanrai | via #random​

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Thread Summary: HTNers discuss digital health companies building in the GI disorders space. Top mentions include Oshi Health, Salvo, Ayble Health, Romanwell, Cara Care, Dieta Health, and AndHealth.

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Top Response:

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Dan Lesser: Not sure if these are what they're looking for, but some others in or near that space:
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β€’ Romanwell

β€’ Cara Care

β€’ Dieta Health

β€’ AndHealth

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​Check out the full HTN Slack convo here!​

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2. Florida Blue no longer allowing telehealth clinicians outside of Florida

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Q: I'm being told by a Florida Blue rep that they straight up no longer allow telehealth clinicians (ones who are not physically located in Florida) into their network (as of spring 2022). Does this seem right?​
– Anonymous Bot | via #buildersask​

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Thread Summary: A discussion about Florida Blue's policy of not allowing telehealth clinicians who are not physically located in Florida into their network. Members share their experiences with other states' BCBS plans, with several folks raising the point they have not seen official documentation communicating the changes.

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Top Response:

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Jake Powell: Have heard this from multiple blue plans β€” their blue card network appears to be wired in such a way that reimbursement is based of the state of the provider rather than the state of the patient, which messes up cross-state tele-health.

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Because they access networks across state lines, it seems like a tele-health provider located in MD would be reimbursed based on Carefirst rates instead of FL Blue rates, and only if they're in the Carefirst network, for example.

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​Check out the full HTN Slack convo here!​

3. Eligibility data processing pain point validation

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Q: Hi HTNers, as a multiple time healthtech founder and former startup studio manager, I have lived through and seen many startups underestimate the cost/time/pain of employer/payer data file processing, often via portal or FTP. Provider data is my personal nemesis, and great to finally see some good solutions here (although shockingly still not a single source of truth!).

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I’m curious to hear if others have or have had pain points around eligibility data processing. I encouraged the spin out of dart.health - they take in eligibility data from big employers like The Boeing Company and standarize it so it can be accessed by solution cos via API for a fixed fee. They want to scale their solution, but have had a tricky time figuring out the right company stage/role to sell into. Too early, and you don’t know its a pain. Too late, and your tech team is already too deep into the problem.

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Welcome any thoughts or advice about the best GTM strategy here. Paying a fixed fee to standardize eligibility data across multiple employers/payers seems like a no-brainer to me… and frees up engineering team for the more valuable innovative tech we need.

– Julia Hutchins | via #buildersask​

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Thread Summary: The brain trust jumps in to brainstorm and validate pain points around eligibility data processing - as well as suggest several startups working on related issues, including Noyo and Sohar.

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Top Response:

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Mike Radocchia: Agree this is a headache and seems like a no-brainer. Pain points include not only getting the data standardized but also getting the files in the first place (does the employer send or do they have a third party and how easy are they to work with), getting updated files at a regular cadence, etc. Money is being left on the table by the healthtech startup if they can only bill for eligible people and it is definitely a bunch of tech time and/or manual time to get it right. Seems like it might need to be a multi-sided market kind of deal since employers don't want that data just going anywhere but I could be totally wrong. Could be challenges and advantages to that (sell to the startup but scale through the employers?) Definitely not an expert but can validate there is a there there

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​Check out the full HTN Slack convo here!​

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4. Multifactor authentication apps for provider orgs

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Q: Does anyone know of a provider org that supports an authenticator app (as a 2nd factor -- e.g., Google Authenticator; 1Password; whatever) for patient login?

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I'm particularly curious for primary care.​
– John Norman | via #buildersask

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Thread Summary: The crew shares experiences with provider orgs offering multi-factor authentication for patient portal logins - the consensus is no one has seen MFA use to protect patient access.

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Top Response:

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Michael Herrick: I've never seen MFA used to protect patient access, let alone with an authenticator app. Do you mean that you know a company using MFA with SMS or something for patients?

During risk assessments, I've heard three reasons to justify not implementing MFA on patient access. Same arguments would apply just as much (or just as little) for using less secure MFA like SMS.

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1. If the patient sets a bad password or gets phished, they have no one but themselves to blame. I'm afraid that might be literally true.

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2. If a patient account is breached, total impact is exactly ONE patient record. This is a vastly different risk profile from, say, an administrator account that could allow access to tens of thousands of patient records.

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3. Patients can barely manage to remember a terrible password, they'll never be able to manage MFA, and we don't have staff to support that. We certainly should be mindful of any hurdle that could hinder access. But with the recent adoption of MFA across consumer banking, this argument is getting harder to support. We've seen consumer acceptance of MFA via SMS, but an authenticator app might be, currently, a bridge too far or too soon.

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It would be a different story if there were any kind of consumer appetite for better security, but apart from weirdos like us, I don't think this stuff is very popular.

​Check out the full HTN Slack convo here!

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5. Best practices for sharing product knowledge across an org

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Q: Any best practices for how to disseminate product knowledge across your organization in client facing roles (client success, implementations, etc.)? β€œProduct knowledge” is intentionally vague in this question - could range from how to ensure everyone can demo all parts of the product, how to understand what is a bug vs what can be solved with existing configuration capabilities, etc. Especially with a tech product that you’d consider complex or very technical.​
– Mike Sobolewski | via #topic-product​

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Thread Summary: A helpful thread of suggestions for product leaders looking for best practices to share product knowledge to colleagues in client facing roles across the org.

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Top Response:

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Bazza Gilbert: As often, it depends, and in this case will depend on your various audiences and their use cases for "the knowledge".

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For CS in one role I established monthly "lunch and learns" to demo the latest releases and roadmap updates The Head of CS loved it and heavily encouraged attendance which reduced the number of inquiries I received, and established me as a PM that understood CS needs.

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On the more technical end I worked with Dev teams to establish a Confluence Wiki and GitHub repo for hot button items.

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It's always a challenge in that most folks want "just in time knowledge" which usually means asking a question on Slack and it's rarely one size fits all, and at the end of the day will be influenced by how active or passive your coworkers are re: finding answers.

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​Check out the full HTN Slack convo here!

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πŸ€–HTN KNOWLEDGE BOT

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If you have your own question(s) to ask, don’t forget that a good place to start is our HTN Knowledge Bot. It’s our smart search tool that makes it easier to access the wisdom shared within the HTN powered by ChatGPT. You can log in and use it on the website (here) or see how to use it directly in Slack here.

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Check out the example ask below!

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Member Question:

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I'm interested in learning more about the Medicaid startup space

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‍Knowledge Bot Answer:

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Certainly! The Medicaid startup space is an emerging market with a growing number of companies aiming to transform the way care is delivered to the underserved Medicaid population. These startups focus on addressing various challenges and opportunities within the Medicaid ecosystem.

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One helpful resource is an article titled "Medicaid: Overview of The Emerging Startup Market" from Health Tech Nerds. This article provides an overview of the Medicaid program, its significance, and the market landscape for startups serving the Medicaid population. It also highlights observations and opportunities within the market, including startups expanding into Medicaid from other markets and the absence of Medicaid-focused payor innovators. You can read the article here.

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Another valuable resource is a conversation thread in the Health Tech Nerds Slack channel titled "topic-startup-funding." In this thread, users discuss their interest in Medicaid value-based care models and profitable strategies for startups operating in the Medicaid space. You can find the conversation here.

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Additionally, the Health Tech Nerds article "HTN Weekly Health Tech Reads 3/5" includes an opinion piece on investment opportunities in Medicaid, highlighting the disparity in investor interest between Medicare Advantage and Medicaid startups. The article also discusses the challenges and opportunities for innovation in Medicaid, including access to care, social determinants of health, health equity, and value-based care. You can read the article here.

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For a comprehensive market map of Medicaid startups, you can refer to the Health Tech Nerds article "Medicaid: Overview of The Emerging Startup Market" mentioned earlier. The article includes a market map that highlights several startups across different categories, such as mental and behavioral health, post-acute care, and social determinants of health.

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I hope these resources provide you with a good starting point to learn more about the Medicaid startup space. Let me know if you have any specific questions or if there's anything else I can assist you with!

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✨HIDDEN GEMS

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Here we highlight helpful resources from across the community:

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  1. ​2023 Edition: Digital Health Executive Compensation Study, Aequitas Partners via Polina Hanin – The team at Aequitas Partners is back again with their annual executive compensation survey, be sure to take 5 minutes to fill it out for a copy!
  2. ​Restructured BETOS Classification System via Austin Barrington – A database aimed at helping researchers group Medicare Part B healthcare services codes into clinical categories.