Here’s Clover Health’s Secret to Winning Over Healthcare Providers – The Motley Fool
Posted: January 25, 2021 at 1:52 pm
What's Clover Health's (NASDAQ:CLOV) key to success? Its technology. However, that key won't open any doors unless physicians and other healthcare professionals use the company's technology. In this Motley Fool Live video recorded on Nov. 16, 2020, Bill Mann, director of small cap research for The Motley Fool, talks with Clover Health co-founder and CEO Vivek Garipalli about how his company wins over healthcare providers to use its platform.
Bill Mann: Every single medical device company I've ever talked to, when they talk about the objections to getting broader adaptation, it hinges upon one thing. Well, is Mayo Clinic using it? Is Cleveland Clinic using it? Is Harvard using it? How do you go from a system in New Jersey to much broader adaptation? How do you get that customer adaptation in a fairly conservative audience?
Vivek Garipalli: Yes, interestingly enough, Clover Assistant, for the most part initially scaled in our New Jersey markets and then the 200,000 lives are bringing on to direct.
Bill Mann: That's not Mayo though.
Vivek Garipalli: Correct. Then the 200,000 lives that we're bringing on April next year, half of them are non-New Jersey and that these are physicians adopting Clover Assistant. Who were not familiar with Clover Assistant prior, so when you think about what primary care physicians care about versus interventional cardiologists, orthopedic surgeons, there's a huge body of data appropriately on device efficacy, I think it's some of what you're referencing.
Whether it is a certain implant or whatever it may be that relies heavily on, do you have the right orthopedic surgeons as part of your clinical trial advocating for the device or product, primary care. When we think about chronic conditions, which drives over 90 percent of costs and Medicare, and unfortunately, any one of us at some point in a life will probably end up with one or more chronic conditions. They range from diabetes, congestive heart failure, chronic obstructive pulmonary disease. These are conditions that are really around appropriate treatment or management of conditions while you have them.
A lot of the organizations you described are hospitals, they are managing your care once you've hit the emergency room and now you are an inpatient. The condition has exacerbated. You are now in need of a complex surgery, and a very specific type of surgery ensuring quality surgeon. When you think about hospital care, that's a narrow segment of care, very high a cost of it as well. When you think about managing primary care, that's really around presenting to physicians not Mayo protocols or not Mount Sinai protocols. It's actually presenting peer-reviewed, evidence-based protocols, and that is not necessarily tied to brand, is tied to evidence, it's tied it's already been published.
Even when we think about surfacing diagnoses -- when we're surfacing diagnoses it's tied to rules entrants. EGFR result between 30 and 60, which means that the particular patient may have chronic kidney disease, but Stage 3, asymptomatic. Only really denoted by a lab result, but at the same time that's how the literature lays it out. If that data point is not presented to a physician the point of care here, she's not going to diagnose that condition and it's going to end up progressing probably about a third of the time elicits elevated thyroid hormone levels and your bone breaks down and you fall in your break your hip.
That's healthcare today. That's where data paired with evidence presented to a physician where the physician can now make a better decision. We're not in the business nor will we ever be telling the position what to do or not to do, it's really presenting evidence to take that 10-20 minute visit and make it more valuable, whether it's assessing a condition that wouldn't have otherwise been assessed, presenting machine learning algorithms that will generate what a potential diagnosis may be without actually saying it does or doesn't exist, but just what are data's shows could be present and that prompts a conversation, that may or may not lead to a condition being captured.
But to your point of how the space looks at software and technology, when organizations are building technology for physicians within healthcare, it's almost as if they throw away the software playbook that has worked for successful companies outside of healthcare. If we take businesses like whether it's Amazon (NASDAQ:AMZN) or e-commerce company like that, they have to one, make sure that the data that they're presenting to consumers is trusted and can be relied upon.
Two, in terms of the product picture is accurate and their shipping time is accurate, two they need to make sure that payment construct's accurate. Is the price you are being told to pay actually the price, if you're saying it's ranked from low to high in prices that the truth is that how it plays out. Then in terms of features and consumer value, is that continuing to improve rapidly over time, but in healthcare, that's not how software is built. When we, when we thought about building great software, only one aspect was, we need to make sure this can add value to physicians and drive rapid feature development, that was key.
For the first part was we need to make sure that the data we're presenting to physicians can be relied upon, it's accurate it could be sourced, whether if it's evidenced-based protocol, that that could actually be brought up at the point-of-care in terms of what evidence are we citing over to lab result, where do we get that lab result? If it's based upon a claim that led to a chart that we pulled that had conditions on it which positioned to that come from, and then in terms of the payment side, our positions penalized for not agreeing with the Clover Assistant.
Are they rewarded for agreeing with the Clover Assistant? We don't do either of that. From our perspective is a physician went to medical school for four years, fellowship, residency, practice for many years, took the Hippocratic Oath, really cares about his or her patients. We believe, fundamentally, that if we pay physicians fairly and more obviously for now using additional piece of software, the point-of-care, and give them better and more accurate information, actionable data, and as Andrew described, a true real-time conversation, their decision-making is going to improve for the benefit of the patient, and we do not modularly payment up or down tied to what buttons they're clicking on in Clover Assistant, and just that very simple construct, that is not accepted philosophy in incumbents.
That you cannot get them to agree to pay physicians the same amount for using software irrespective of what they're clicking, irrespective of acuity, because there's an obsession in value-based care down to paying for everything that what agree with as a payer or penalize if we don't agree with it, and the intent is proper, but that is not how you build trust with physicians on the payment side.
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Here's Clover Health's Secret to Winning Over Healthcare Providers - The Motley Fool
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