Revel Health uses analytics to boost health plans’ flu shot rates

Health Data Management | November 08, 2019

Revel Health, a Minneapolis-based artificial intelligence-driven healthcare technology company, is using personalized communication to help health plans boost flu shots rates among members. Not only do improved flu shot rates impact a health plan’s STAR rating, but they also save an estimated $350 for the average person who won’t go to an urgent care or emergency department, according to Jeff Fritz, director and CEO of Revel Health, a 12-year old company that works directly with seven of the largest ten health plans as a vendor partner. Revel has 21 programs that focus on quality measures for payers, Fritz says. Annual influenza immunizations are a core objective for most health plans. The flu vaccine is recommended for all adults and may reduce flu-related hospitalizations by 71 percent. By reducing flu-related provider visits, health plans are able to drive down claims and create a healthier member base, he says.

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Example of a Lean Improvement Project and the Continuum of Care. Motivation for Lean Improvement : Reduce Emergency Room and inpatient use in Behavioral Health Setting. Goals: 25% reduction of Medicaid‐funded inpatient costs for Behavioral Healthcare for calendar year 2010. Increased collaboration between inpatient and outpatient providers. Increased financial resources for outpatient services. Availability of correct level of service when needed.


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MEDICAL DEVICES

Lark Health Builds AI-Driven Heart Health Program

Lark Health | March 17, 2022

Lark Health today announced the development of a novel AI-driven program for the prevention and management of atherosclerotic cardiovascular disease and coronary artery disease in collaboration with Roche Diagnostics. The program, named Lark Heart Health, is an AI-driven virtual care solution that provides personalized health coaching anytime, anywhere. The new Heart Health program is planned to launch later this year. Cardiovascular disease is the leading cause of death globally, and nearly half of all adults in the U.S. have some form of CVD. It's also one of the most expensive chronic conditions, with heart disease and stroke costing the U.S. healthcare system roughly $214 billion annually. Yet, provider shortages and siloed care teams leave patients with limited care options, gaps in care, and insufficient education and empowerment to self-manage their heart health. Additionally, high treatment costs and resource constraints often limit care to those with the highest acuity conditions. Built using a Cognitive Behavioral Therapy framework and designed in accordance with guidelines from the American Heart Association (AHA), Lark Heart Health will provide a cost-effective, scalable solution for continuous, person-centric remote heart health coaching intended to help users improve their healthy lifestyle behaviors, reduce stress levels, and ultimately decrease risk factors for heart disease. Through an evidence-based educational curriculum and real-time personalized coaching, Lark will provide users with the tools they need to make meaningful lifestyle changes that can help them better prevent and manage ASCVD and CAD. Earlier this year, Lark announced it had joined the AHA's Network at American Heart Association Center of Health Technology & Innovation, which is focused on building and fostering health technology relationships to develop innovative and scalable solutions. "Lark Heart Health will help those at high risk prevent and actively manage cardiovascular disease through personalized digital coaching. By leveraging our AI technology, we can deliver meaningful and engaging care at an unprecedented scale, and this collaboration with Roche Diagnostics will support the expansion of our proven tech platform into one of the costliest chronic disease markets." Julia Hu, co-founder and CEO of Lark About Lark Health Lark is a healthcare technology company aimed at delivering infinitely scalable, virtual chronic and preventative healthcare through conversational AI. To date, Lark has provided nearly 2 million people with unlimited, 24/7 personalized care delivered through an easy-to-use, text message-like interface that integrates remote patient monitoring tools and is built on a cognitive behavioral therapy framework. Lark's platform seamlessly integrates with health plans' and employers' existing healthcare infrastructure to help them scale their chronic disease prevention and management programs, boost engagement, and improve health outcomes. Lark currently works with many of the largest health plans and across four programs: Prevention, Diabetes Prevention, Diabetes Care, and Hypertension Care. Lark's Diabetes Prevention Program, which is the fastest growing and lowest cost DPP, has received the highest level of clinical recognition—Full Recognition—from the Centers for Disease Control and Prevention. The company has received numerous accolades, including having been named as one of CB Insights Digital Health 150 (2019), a finalist for the UCSF Digital Health Awards one of Fast Company's Most Innovative Companies and one of Fierce Healthcare's Fierce 15.

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DIGITAL HEALTHCARE

Walmart and Health at Scale Launch Customized Provider Recommendations for Plan Participants

Health at Scale | February 01, 2022

Health at Scale today announced a collaboration with Walmart to provide personalized provider recommendations to Walmart associates and their families who work in locations where Health at Scale is offered and are enrolled in the company's health plan. This technology will be incorporated into Walmart's health plan administrator's search engine and virtual care referrals for associates in select geographies, making it easier for plan participants to find providers that match to their unique health needs and care history. Through this initiative, Walmart and Health at Scale will establish a more personalized healthcare experience that focuses on the needs of each individual in the moment and leverages industry-leading machine intelligence to identify providers who have successfully treated patients with similar characteristics and care needs. "Finding the right provider is one of the most important health decisions a patient makes. It is also one of the hardest. What we really need to optimize is the patient-provider match. We're delighted to work with Walmart as the leader in employer health and benefits innovation and provide Walmart associates and their families in certain locations with smart, hyper-personalized provider matches that reflect a deep understanding and respect for their individual health needs." Health at Scale CEOZeeshan Syed Health at Scale's Precision Navigation™goes beyond non-personalized process-based star ratings, reputation rankings, and volume-based metrics and instead uses industry-leading AI and machine learning to model variations in provider outcomes across thousands of health factors. The service covers 25 different specialties as well as 34 procedures and imaging. "Customizing services and treatments to individual needs is the next frontier in healthcare and is a major part of Walmart's commitmentto helping associates and their family members find great doctors who consistently deliver the best value and quality care in their community," saidLisa Woods, VP, Walmart US Benefits. "We are excited to launch this collaboration with Health at Scale and are eager to see the impact that another innovative benefit like this will have on associates' healthcare experience and outcomes." About Health at Scale Health at Scale is a healthcare machine intelligence company that uses proprietary advances in artificial intelligence and machine learning to match individuals managed by insurers, employers and providers to the next best action in real-time and when needed most: whether it's the ideal choice of treatment, an early intervention, or the right provider. Founded by machine learning and clinical faculty fromMIT,Harvard,Stanford, and theUniversity of Michigan, the company's mission is to bring precision delivery to healthcare, learning from thousands of health variables from over a hundred million lives to generate personalized and precise insights for individual patients. Health at Scale's machine intelligence is deployed at scale in real operational settings -- including with some of the largest healthcare organizations in the country, driving better health outcomes and affordability for its customers. The company's software solutions service a broad range of use cases: provider navigation and network design, early targeted prediction and prevention of adverse outcomes, optimized treatment planning; and fraud, waste, and abuse prevention.

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FUTURE OF HEALTHCARE

Althea Expands Its Growing Broadband Coverage Area to Tacoma WA

Althea | March 26, 2022

Althea is proud to announce Tacoma, WA is the latest addition to its growing broadband coverage area, with installations and infrastructure investment focused in the Hilltop neighborhood. Founded in 2017, Althea’s mission is rooted in the belief that affordable broadband connectivity is a fundamental right for all people that strengthens communities, economic growth, educational opportunities, and healthcare access. Althea is a distributed Internet Service Provider which works together with local communities and network operators to provide sustainable high speed and low cost broadband access. This is made possible by Althea’s unique technology, infrastructure, and routing protocol. Althea’s routing protocol allows the service and accounting layers of the ISP to be almost entirely automated, and maximizes bandwidth utilization (i.e. delivers lower latency and higher speeds than one would typically experience from a given network connection, when compared to a traditional ISP routing protocol). This technology negates the need for contracts, late fees, and other drawbacks of traditional internet delivery. The mesh topology used to connect users also allows individuals to host infrastructure themselves, growing the network, and earning revenue share for doing so. This keeps value in the community, encourages community involvement, maintains low costs, and creates an ever more resilient network architecture. Althea uses a unique pay-as-you-go payment model, making it easy for users to manage costs. Additionally, each user has access to the always-on free tier, guaranteeing they will have access to no-cost basic internet, regardless of their financial situation. Unlike traditional ISPs, Althea’s technology does not artificially throttle bandwidth or utilize speed tiers either, so users always get the maximum speed their equipment is capable of delivering. Althea users in Tacoma can expect speeds around 100 Mbps and pay, on average, around $25/month. “Many people don’t have access to the internet, not because of availability, but costs and other barriers keep them from this vital resource.We believe internet access is a human right, which is why we provide an always-on, free tier of internet.” Deborah Simpier, Althea CEO and co-founder Hilltop, Tacoma was also one of the first proof-of-concept networks for Althea, partnering in 2020 with Tacoma Cooperative Network and the University of Washington to build and test community led LTE networks. Through this work in Open5GS, Althea developed KeyLTE, which is an embedded EPC inside an Althea home router, which provides flexibility to build and grow LTE/5G networks anywhere, quickly and affordably.

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HEALTH TECHNOLOGY

Softheon Expands to Artificial Intelligence in Care Management for Health Plans through Acquisition of NextHealth Technologies

Softheon | July 01, 2022

Softheon, a leading cloud-based eligibility, enrollment, and billing provider for health plans and government agencies, has acquired NextHealth Technologies, an AI-powered SaaS-based healthcare analytics platform. With the acquisition, Softheon will be better able to help health plans sell and deliver efficient, high-quality care through synergies in the companies' respective products and solutions. Health plans cans save tens or even hundreds of millions of dollars on medical and operational costs through Softheon's growing suite of solutions. The acquisition significantly enhances Softheon's talent density, enhancing go-to-market strategies, engineering processes, and leadership. The overall speed and capability of NextHealth's AI solutions will increase through Softheon's propriety technology. Softheon CEO, Eugene Sayan, will continue to lead the company. Eric Grossman, NextHealth's founder, has become the combined organization's Chief Commercial Officer, supporting Sayan's vision and the company's growth objectives. Sayan shared, "Artificial Intelligence in healthcare is here, and we are seeing the incredible impact it can have on both members and carriers. Our goal has been to make healthcare more affordable, accessible, and plentiful, and we see AI as a clear path forward to bring efficiencies to our carrier partners. This acquisition is a testament to Softheon's commitment to helping health plans tackle some of their biggest challenges, such as population health and the movement toward consumerism in healthcare." NextHealth Technologies, founded in 2013, offers a cloud-based platform that utilizes rigorous methodologies and standardized processes to enable health plan customers to identify impactable populations, measure which clinical initiatives work best for whom, and integrate data-driven decisions into the workflow in real-time to derive the highest ROI from their analytics investments. "We are thrilled to be part of Softheon's continued growth and expansion. This is an incredible opportunity for our respective teams. NextHealth's technical and service staff will continue to build and support cutting-edge applications of AI for carrier member populations with the support and resources of a larger company. We see a bright future for our health plan partners as we bring those tools to bear to deliver significant value and reduced costs." shared Grossman Softheon's purchase of NextHealth is expected to bring economies of scale and operating leverage to the combined company. NextHealth investors, Norwest Venture Partners and TT Capital Partners, will become investors in Softheon and expressed excitement on the prospects of the transaction. "Together, NextHealth and Softheon can provide better care at lower medical and administrative costs while advancing the application of AI in healthcare." said Casper de Clercq, General Partner at Norwest Venture Partners. "The acquisition of NextHealth will enhance Softheon's AI capabilities for health plans," said Ryan Engle, partner at TT Capital Partners, "Member data spanning shopping and enrollment through claims creates opportunities for proprietary methodologies to shape member behavior and create value for plans." Softheon has continued its growth and expansion, having completed more than 20 million enrollments since the inception of the Affordable Care Act, through public and private exchange technology. The acquisition comes after the company introduced its first foray into AI by creating a machine learning algorithm that predicts which members are at risk of letting their insurance coverage lapse, as featured in Bloomberg Law. About Softheon Founded in 2000, Softheon's Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon's solutions serve 8 State agencies and over 90 health plans. Issuers and consumers utilizing Medicaid, Medicare, and the ACA Marketplace benefit from Softheon's innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. About NextHealth Technologies NextHealth Technologies, based in Denver, is an AI-powered analytics platform that rapidly optimizes the effectiveness of health plans' cost, quality, and service enhancement initiatives resulting in significantly reduced costs and improved outcomes. Its cloud-based solution utilizes scientifically rigorous methodologies and standardized processes, enabling and promoting a culture of measurement. The platform is HITRUST-certified, scalable, and is deployed with expert services to ensure client adoption and success. Know what works™ and make it better.

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Spotlight

Example of a Lean Improvement Project and the Continuum of Care. Motivation for Lean Improvement : Reduce Emergency Room and inpatient use in Behavioral Health Setting. Goals: 25% reduction of Medicaid‐funded inpatient costs for Behavioral Healthcare for calendar year 2010. Increased collaboration between inpatient and outpatient providers. Increased financial resources for outpatient services. Availability of correct level of service when needed.

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