Global AI in healthcare market expected to rise to $164B by 2030
The market size for 2023 was $10.31 billion
Read more...If you've ever had a long-term illness, or known someone who has, then you know that the healthcare system, as its currently set up, does not work. It doesn't provide a holistic approach to care, which means that getting the right care, from the right doctor, is incredibly difficult, time consuming and expensive.
Seeing his sister trying to navigate that system is what led Matt McCambridge to co-found Eden Health, a direct-to-employer healthcare platform that delivers care both in-person and virtually. The company announced a $25 million Series B funding round on Wednesday.
"I got passionate about the healthcare space as I watched my sister go through years of traumatic health problems. Seeing how she was just pinballed through a very complex system, to dozens and dozens of specialists and the ER a bunch of times, and having nobody to care for and no one coordinating the experience for her," McCambridge told me in an interview.
"I saw that early on the promise of healthcare right alongside the worst problems in healthcare on the other end. And that was one of the reasons we wanted to tackle this space."
First launched in 2016, the New York City-based Eden Health works with employers to provide their employees with access to virtual care services. Every member is matched with a dedicated Care Team, which is composed of clinicians who can offer digital care around the clock, same-day in-person primary care, behavioral health services and benefits navigation.
For employees who have access to Eden, they simply need to download the app on their phone, which only takes 60 seconds to register with and then they're put into a clinical encounter with one of Eden's providers right away.
"You're immediately building that patient-provider relationship, from the moment that you download the app. Most people, when they download something, they're downloading it for a reason, and so providing a very easy pathway for someone to actually utilize is something we think is really important," McCambridge explained.
Users can connect with clinicians 24/7 365, with an average of about seven minutes to a live encounter. The app is also not bot-based, meaning it is an actual clinician who they're having an encounter with right from the jump; AI and machine learning is not good enough to have a medical encounter with, McCambridge believes, compared to having a real certified clinician who knows the patient, and understands how to provide the right kind of care.
"Our clinicians are consistently providing that care for you, so it changes this transactional relationship that you see with pretty much all virtual care solutions on the market today into a patient-provider relationship that is real," he said.
"What we set out to do with this company was make a basic commitment to all of our users that, no matter what's going on in somebody's health life, we can directly provide care to them, or we're going to move heaven and earth to get them where they need to go in the healthcare system. So, it's basically a fusion of an advanced primary care model with navigation."
Along with its virtual care services, the company also operates physical primary care health offices as well, though 92 percent of all of virtual interactions are solved without anyone needing to see a doctor in-person.
For employees, Eden as been able to increase preventative care utilization by about 39 percent, and reduce the rate at which people are referred into in-person specialists, which accounts for a lot of cost and unnecessary care, by two thirds. That means the company is referring out to specialists at a rate of one in every 10 user, compared to the average primary care provider who is referring between three and four out of every 10.
"It’s about the trusted patient provider relationship because you know the person, you’ve built that relationship, you’ve spent the time and we can actually follow-up very easily, then you can easily keep people getting care in the way that’s most convenient for them and not make it uncomfortable to have to then come in again to a physical clinic when it could have been handled remotely," said McCambridge.
Going after mid-market employers
Eden's typical customer are what McCambridge calls the "mid-market," meaning they have up to 10,000 employees. Part of the reason that these companies, in particular, need a service like this, he explained, is they need an integrated model because "they haven't been served well by the market today."
"You basically have everything delivered through the carrier platform and so you end up with a fragmented system when it comes to the actual use of your benefits," he said.
What Eden winds up doing is acting almost like a Chief Medical Officer for organizations that normally wouldn't have someone like that on staff, unless they have several hundred thousand employees.
"From an HR standpoint, they're the people who are getting endless questions from their employees. I mean just imagine during COVID, how many different questions these HR teams are getting on a daily basis, and those folks, they're not epidemiologists, they need actual clinical support."
Ultimately, by using Eden Health to help navigate their employees' care, it ends up saving them a little more than $800 per employee per year.
"When we go to employers, what they're really looking to do is have their employees engage in healthcare in a simple high quality way. Get them better care, and then they're also looking to kind of control and, at the very least, offset their costs for having better health care delivered for their population," said McCambridge.
"They spent a lot of money in healthcare, they want to get value out of it. And I would say that's even more important than cost savings, because they want to get value out of this huge investment but cost savings are important."
The effect of COVID
The COVID-19 pandemic has had a major effect on Eden: the company has seen interest from employers and commercial property owners increase by more than 500 percent since mid-March, bringing its total number of employees covered to 33,000 at more than 100 organizations. The company now includes companies such as Bell's Brewery, Connell, Convene, Harry's, Kramer Levin, Newscred and Stack Overflow as customers.
Eden has also seen engagement skyrocket; even before the pandemic, 77 out of every 100 employees who have access to Eden had registered, while 66 had completed clinical encounters within the first year. That's compared to single digit rates for other telemedicine solutions. Thanks to COVID, those numbers are even higher now.
As such, Eden Health has introduced a back-to-work program for its customers, which includes COVID-19 screening, virtual primary care, PCR testing, on-site antibody testing, immediate triage and patient consults.
It works by allowing users to fill out a screener on the app on a daily basis, while also verifying their temperature with a thermometer that Eden provides. Once they do, users either get a green light, which means they are cleared and are able to go to work, or they get a yellow light, which means that there is a risk they might have COVID, though that can also be a chronic condition or another illness. If someone is sick, Eden manages their care journey until they are well enough to once again go back to work.
"Through the entire COVID period, we have not had a single one of our patients enter the hospital. We’re managing everybody at home remotely, including getting things like pulse oximeters and things that might be relevant for their care at home, which I think is a fantastic record. It’s demonstrably better than making people decide where they might need to end up," said McCambridge.
Eden reports all of the information on the employees and their health back to the employer, making it so they are able to understand what's going on in their population, and so they can manage the physical security of their office.
"This is a thing that people are thinking about, especially on the employer side, in terms of the thing that they need to deal with. It's the first time that you have CEOs around the world really waking up every single day, and saying, 'Are my employees healthy enough to work? Are my customers healthy enough to buy? It's a very different mindset in terms of health than it was previously," McCambridge explained.
A more effective healthcare delivery model
The new funding round was led by Flare Capital Partners with participation from principals from Stone Point Capital, a private equity firm that focuses on the financial services industry including the HR benefits, insurance and real estate sectors. Also participating were existing investors Greycroft, PJC, Max Ventures and Aspect Ventures.
This new funding, which brings Eden Health's total raised to $39 million, will be used by Eden it to build out more physical clinics; currently, the company's clinics are all in the New York City area, but the plan is to start building them in other cities, including Chicago.
That also means hiring more practice clinicians, including doctors and nurses; the company has already expanded the team by 111 percent since January 2020 and is still hiring quickly to meet demand.
"Everybody who interacts with our patients is employed by Eden full time. That’s really important because one, it's not somebody who's spending three hours a week on a virtual care platform. And it's somebody who's actually dedicated to having the relationship and their full-time clinical load is all about providing care and in this framework," said McCambridge.
Ultimately, he told me, the goal for Eden is to allow everybody to have a trusted relationship with a healthcare provider, which he believes is "the basis for good health care."
"I want to underscore the importance of this generation of healthcare organizations in putting high quality excellent care first in the way that they're going about delivery. The thing that gets missed a lot in that is that you can talk about all these scores and everything when somebody is providing care in the 10 minutes you have with them, but we're extending that," he told me.
"We're thinking about what is actually this person's full journey through the healthcare system from a navigation standpoint, but also all those times people aren't just sick for 10 minutes. People can be sick for days, weeks or years and so we have to really think about the way that we're delivering and providing care, and emphasize high quality care delivery. We back that up with an expanded version of how people go and report outcomes and everything like that today."
The market size for 2023 was $10.31 billion
Read more...At Culture, Religion & Tech, take II in Miami on October 29, 2024
Read more...The company will use the funding to broaden the scope of its AI, including new administrative tasks
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