Health+Benefits Technosavvy the March 2018 issue

Data-Driven Care

Q&A with Jim Meadows, M.D., Chief Medical Officer at Narus Health
By Michael Fitzpatrick Posted on February 28, 2018
Tell us about how Narus Health coordinates care for employees and individuals.
We built our business model around monitoring the population, looking for leading indicators that identify individuals who are trending toward or already experiencing a significant illness. When someone gets the rug pulled out from under them, they have multiple issues they must deal with at once. What are my options? What is covered by my health plan? How do I coordinate all these medical visits and remain working if possible? Are these symptoms I’m having to be expected?

Right or wrong, many people feel like they are passive participants in their medical experience—relying on the structure of the health system, the recommendation of their providers, the permissions of their benefits, and the influence of their caregivers—all while dealing with the illness or disease itself. For most, it’s an overwhelmingly exhaustive task.

Great care-management organizations understand the importance of delivering clinical support. The differentiating value of Narus Health is our deep understanding and our ability to manage the non-clinical issues people have. Do they have a caregiver? Can they get to a doctor? Can they afford their medication? And are they compliant with it? All of these things are significant contributors to total medical costs.

We capture these issues, along with their clinical profile, in a personalized care plan. We’ve developed a proprietary, structured-data format both to provide the attending physicians new insight and to build predictive analysis of the psychosocial issues—the soft drivers—and to superimpose them on the clinical drivers of care, painting a fuller picture of each individual and their unique care needs.

We’ve learned over the years the best way to help support people through complex care management is an informed and engaged multi-disciplinary team. Every person we enroll is assigned a dedicated team based on their unique needs: a registered nurse, care coordinator, social worker, chaplain and nutritionist. We’re available 24/7/365 for our patients. We know that, to really help people with complex issues, we’ve got to be available at two in the morning to triage and potentially avoid an ER visit.

Who are Narus’s clients?
We began our business by offering a direct-to-consumer service in March 2017, enrolling individuals who wanted to subscribe to our service. We quickly received recognition from self-insured employers who saw our service as a much more relevant way to provide great support for their employees. Employers have a lot of reasons to work with us, including an enhanced employee experience, full coordination of both chronic diseases and complex illnesses, and total cost savings. We make the healthcare benefit actually feel like a “benefit” again. The employers we’ve worked with say, “Our employees are part of our family, and we want to take care of them.” So they’re replacing outdated disease and case management with Narus Health’s services.

One example of our value-add offering—especially for employees of a self-insured employer—is benefits guidance. We’re able to connect patients and their families to employer resources they may not realize are available. Employers really appreciate that because right now a lot of those benefits happen in silos. There’s not much transparency. We connect people to benefits already being offered and offer insight into their efficacy.

For employer clients, which patients does Narus work with?
Our care-management services are tailored by the employer. For the most part, we provide a core set of services. Number one is population analytics and evaluation of the top 10% of employee claimants that account for 70% of the employer’s healthcare spend. Regardless of what their condition is, they need help. We typically find the top 2% of claimants represent nearly half the medical spend. They desperately want our help. Number two is evaluation of claims data to identify other employees who may benefit from our help—for example, people newly diagnosed with a condition that is likely to be chronic and require extensive treatment, follow-up, lifestyle adjustment and encouragement. Without engagement, many people in this situation will progress to far more complex conditions. Number three is 24/7/365 mobile support for all eligible employees to use for as-needed assistance, such as explanation of benefits, finding a new doctor and general medical education.
How does Narus use technology to coordinate healthcare?
At the center of our technology strategy is our proprietary care-management platform, Compassion. This platform provides our team an optimal way to develop care plans, share data and reports with physicians, schedule appointments, collaborate as a team and deliver a highly personalized care plan.

A second piece of technology is our mPower app, which renders in four different versions, depending on whether the user is the patient, the caregiver, or a friend or family member. mPower is available to all employees and offers a mobile messaging feature that allows any employee of one of our clients to start a secure, confidential conversation with our team. Even if they’re not one of our active, enrolled patients, we can help solve as-needed problems for all employees. We’re able to connect the majority of a company’s employees on the same platform and communicate with all of them, simultaneously. We can send out reminders of flu shots, annual appointments, whatever the case is, through mPower.

How does Narus use data analytics?
Our data analytics team combines numerous sources of data, such as medical claims, pharma and demographics, to help us engage with the right person at the right time on their own terms. That’s a game changer in the care-management space.

Prior to onboarding an employer, our team focuses on clinical and demographic data. We seek to identify co-morbid conditions and patterns of use of the healthcare system for that employer. By understanding patterns specific to an industry, a service line, a geography, we better know what’s happening to individuals in their day-to-day lives. This way, we can identify how we can be most helpful to them and their family.

Once they’re enrolled, we monitor relevant activity while adding new data we’re collecting—psychosocial needs, community resources, the patient’s goals and expectations. Often, we see patterns or similarities not only with individuals but with other employees. For example, if employees living within a community in Tennessee are having problems getting certain medications filled, is that a problem with that employer, the health plan, the supplier or the pharmacy? Knowing this, we can solve for problems before they even occur for other individuals.

Where does Narus fit between patients, doctors, employers and insurers?
We’re partners to the patient, the physician and the employer. We’re in lockstep alignment with the patient, completely and without bias, advocating for them and their family. We work collaboratively with their physician and other providers to better coordinate care with the patient, the caregivers and available employer benefits. We help employers understand the health status of their workforce and the benefits that are most meaningful to the workforce during an illness or injury. We make a significant improvement in the employee’s experience while affecting total cost. We’re one of the few places in the health system that can actually say that—with research and data to support it.
How has Narus been growing?
We are having a substantial burst of growth within the self-funded employer market. Benefit brokers are realizing our services offer a significant enhancement beyond the legacy disease-management and case-management programs currently available. Employees we’ve supported are telling their co-workers, you need to talk to Narus Health. More and more employers are choosing to take control of their own destiny with regard to their health benefits and are becoming self-insured. We also have a strategic partnership with Lucent Health, which is delivering additional customers eager to integrate progressive solutions such as Narus Health.
Why was Narus founded?
We formed this business because we saw an unmet need in the patient experience that required an innovative approach. Each of us, in various roles, has lived the problems we now solve every day as a company. For every one of us, it was a highly personal decision to join a startup opportunity. We all were established in successful careers. We left our former jobs not out of necessity for employment but out of necessity to solve something we had lived.

So many people are in serious need of help, serious need of navigation and serious need of support. The system is not improving fast enough. We’re trying to make people’s lives better and a bit more simplified so they can focus on the things most important to them. We measure our business value in the data we analyze and the savings we generate. But we see the true impact of our care in the cards around our office and the photographs and paintings on our walls—all gifts of appreciation from those we are fortunate enough to serve.

It is for those patients that Narus Health was formed.


Michael Fitzpatrick Technology Editor Read More

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