RockHealth (late 2013) - EngageCare

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EngageCARE Connecting Healthcare with Customers Date: 10/31/13 Contact: Evin Ollinger, CEO & Founder [email protected]

Transcript of RockHealth (late 2013) - EngageCare

Page 1: RockHealth (late 2013) -  EngageCare

EngageCAREConnecting Healthcare with Customers

Date: 10/31/13

Contact: Evin Ollinger, CEO & Founder [email protected]

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EngageCARE TeamEvin Ollinger – CEO. Fourth startup, two successful exits (DistribuPro,

Chronos Software). 30 years in high-tech and online services in B2B and B2C markets. Led marketing at ATT Language Line ($68M - $146M rev growth, $720M spinout) serving 84% of US Hospitals, 8 of top 10 Insurance Companies and US Government CMS, HHS and CDC.

Brent Daugherty – Dir Dev. M.S. CS, EE, UNC. Lead Mobile Web Application Developer at Eveo, #1 Digital Healthcare agency. Clients include Johnson & Johnson, Merck, Pfizer, Bristol-Myers Squibb, Novartis and Roche. Expertise in front-end, UI and transactional platforms. Previous, Wells Fargo and Lending Tree web and mobile apps. Second startup

Mary Stanton – VP Care, MSW, LCSW, Smith College, BA Nonprofit Management, Amherst. Medical Case Manager at VNA for in-home chronic and senior care clients. Previous, Senior Web Architect at startup HealthCommunities.com, grew to 28 websites, 3,000 doctors.

Note: All co-founding team members are committed to working full-time out of Rock Health’s office in Mission Bay.

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EngageCARE – Overview

EngageCARE has a revenue generating LOI with Blue Cross Blue Shield (Wellmark) to develop an app for post-discharge and chronic care Members.

• These Members comprise 11% of BCBS’s population, but account for 81% of the spend.

• Post-discharge, at home and often alone, these Members are at high risk for hospital readmissions, low medication adherence and cascading health problems.

• To date, BCBS and other Payers have provided little support and lots of complex claims forms and service disputes.

• EngageCARE provides BCBS with its HOME suite of apps for connecting Members with caregivers (F&F and formal), an integrated chronic CarePlan for medication adherence and behavioral support, and with a BCBS Case Manager all on a mobile/web platform.

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Targeting the Payer’s Market Problem

The ACA has changed the healthinsurance marketplace.

Introduced major risk factors for Payers:

1. Population Risk – aging, more chronic care, can’t exclude.

2. Cost Risk – 11% of population accounts for 81% of spend.

3. Competitive Risk – customers can now compare and choose plans.

4. Value Risk – Payers are seen as “claims processors” who don’t care about their customers.

Payers provide health insurance for 195M Americans and their business model is at risk.

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EngageCARE – Solutions for MembersConnecting Members with F&F caregivers, chronic care planning tools and online Payer services.

EngageCARE

HOME

CareCircle – connecting F&F caregivers in a social care network

CarePlan - hronic care support

Medication adherence

Social F&F care support

Payer Case Manager integration

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Pay for HelpPay for Help Government ResourcesGovernment Resources DiseasesDiseases AssessmentsAssessmentsPay for HelpPay for Help Government ResourcesGovernment Resources DiseasesDiseases AssessmentsAssessments

Status UpdateStatus UpdateReminderReminderAppointmenAppointmentt

Find help for Mom

Find CaregiverFind CaregiverCreate TaskCreate Task

SeniorServe HOME

Caregiver Accepted

Elizabeth T. has accepted your request.

Tuesday at 10am

Task for Handyman

Your task has been created and has received a response.

Completed

Hi honey, I need the gutters cleaned for winter, some boxes moved from the basement and some light bulbs changed.

Handyman Task CompletedYour mom enjoyed looking through the boxes. She found some pictures from your childhood.

2 hours ago

ApproveApprove Dispute

Weight: 110lbsPicture: View Picture

Payment: $60Time: 3 hours and 22 minutesMom’s Care Plan

My CaregiversMy Caregivers

DoctorDoctor’’ss

MedicationMedication

Care CircleCare Circle

Care ChartsCare Charts

Care NotesCare Notes

Review

My Dashboard for Mom

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EngageCARE – Market Opportunity

Target Population

Payer Population

Growth Factor

Average Spend

Discharged Patients 8M 1.7x

Chronic Care Patients

14M 2x

Supporting Friends & Family

36 Average CareCircle and ConcernCircle F&F engaged to care for 1 Member

Connecting Payers with their Members – partnering with Payers to target the 11% of Members accounting for 81% of Payer’s cost.

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SeniorServe Revenue Model - Building into an $80B Market

Revenue Categories: Pricing Model 10,000 100,000 1M 10MTransaction Platform: (Initial & Primary Revenue Source)

Service Fees 12% - 33% of task/shift $450,000 $4,250,000 $40,000,000 $375,000,000

CarePlanner & Assessment (online) $20/month fee $48,000 $480,000 $4,800,000 $48,000,000

CarePlanner & Assessment (in-person) $100/month fee $120,000 $1,200,000 $12,000,000 $120,000,000

$618,000 $5,930,000 $56,800,000 $543,000,000

Industry Eco-System Partners: (National Scale Accelerators)Discharge Partners (Hospitals & Rehab Centers):

Increased Service Usage 0% to 15% over time $0 $212,500 $4,000,000 $56,250,000Medicare Penalty Reduction Bonus Annual rebate from Partner $0 $0 $500,000 $5,000,000

Senior Care Partners (Assisted Living & Senior Living Homes):Increased Service Usage - Leads In 0% to 15% over time $22,500 $212,500 $4,000,000 $56,250,000Referral Commissions - Closed Leads 1/2 - 1st mo. rent $2k - $10k $300,000 $3,000,000 $30,000,000 $300,000,000

Long-Term Care Insurance Partners (In-Home Care Provider): Increased Service Usage 0% to 10% over time $0 $0 $2,000,000 $37,500,000Cost Reduction Bonus Annual contract rebate $0 $0 $0 $2,000,000

$322,500 $3,425,000 $40,500,000 $457,000,000

Senior Channel: (National Scale Accelerators)Home Safety & Alert Products Install & Monthly Fees $0 $300,000 $3,000,000 $30,000,000

Remote Medical Monitoring Devices Install & Monthly Fees $0 $60,000 $600,000 $6,000,000

Discount Coupons (Groupon for Seniors) % of Sales $0 $10,000 $50,000 $1,000,000

National Brand Partners Referral Promotions/Ads $0 $0 $50,000 $1,000,000

Big Data on Seniors Unknown $0 $0 $0 $0

$0 $370,000 $3,700,000 $38,000,000

Totals $940,500 $9,725,000 $101,000,000 $1,038,000,000

User Base / Revenue Projection

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Today: Team in place, Closed Alpha, 30,000 Home Helpersonboarded, 100 Seniors field survey & case management

Next 12 months:Angel Funding (Q3 closed)Release Beta MVP (early Q4, 2013)Lean MVP buildout to full platform release (Q1, 2014, ongoing)Demand Connection: - Test & Launch: Landing Pages, Online SEO, FB/Google

adwords, Blog (Q3, ongoing) - PR, PR, PR campaign (start Q4, ongoing) - Pilot program with senior living home for prospect management

and referrals (Q4 kick-off) - Caregiver client referral program (Q3 w/onboarding caregivers)100 Seniors field study (ongoing)

Current Status & 12 Month Focus

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Members interviewed view BCBS as providing less than 4% of their support versus F&F at 76%, whilst Payers cover 76% of the cost of care.

targets Payers to connect them with their Members.