[danielamitay]

I haven't started a company that needs to provide employee healthcare--does this have a short-term improvement to insurance rates? What incentivizes a company to employ HealthWiz--are there insurance providers that reduce rates as a result?

How do you convince employers that this service is in their best interest?

[shimon]

In the US, employers ultimately shoulder much of the burden of health care costs, so a tool that helps employees make cost-saving choices eventually saves money for the employer.

However, that's a very indirect path. Most employers use a separate insurance carrier (Humana, Blue Cross, Cigna, etc) and adjust costs on a ~yearly basis by shopping around. HealthWiz would probably love to go to market by integrating with these insurers, and offering an incentive to employers whose members make use of the HealthWiz product to save money.

That's a tough way to go to market because you have to convince an insurance company to trial your thing with their customers. Insurance companies have deeply risk-averse cultures. Plus you have to actually achieve significant cost savings for individuals who use HealthWiz, and wide enough usage throughout the employer, to make the insurer comfortable with offering a discount for that population.

Two other potential markets are self-insured employers and accountable care organizations. Self-insured employers are companies (or often, government agencies) huge enough that rather than paying an insurance carrier, they just operate their own, and pay for healthcare directly. These folks feel the costs a little more urgently and may be easier to pilot with.

Accountable care orgs (ACOs) are a relatively newer model, where the ACO operator (usually a hospital/health system) receives a fixed per-person amount to address all the health needs of a population. These orgs are probably the most informed about both cost and medical needs, and are making real strides in long-term cost saving measures like improving preventive care. But because they're so different from insurers and employers, they'd probably need a somewhat different product, likely one that maintains the primacy of their brand (and maybe doesn't do things like suggest that cheaper hospital a few miles away).

[anmaslak]

That's a great assessment of the space! We're focused on the midsize self-insured market for that very reason. The incentives are closely aligned.

For example, ERs frequently take in patients hoping to get a UTI treated. Much of the time, the right treatment is a prescription. But, going to the ER to get the diagnosis can cost ~$2K (split between the employer and the employee) and take as long as 12 hours of waiting in the waiting room.

In this case, if a patient uses a telemedicine provider for the same service, they're likely to get the same diagnosis and prescription but the visit will cost ~$50.

The nearly $2K in savings would go to both the employee and employer, the employee saves money and is able to get treatment faster.