Collective News

Announcing CareX™

by Dr. Rajaie Batniji, MD, PhD,
Chief Health Officer, Collective Health

A lot has changed in three and a half years here at Collective Health. We’ve grown our membership 500x since welcoming our first client onto our integrated health benefits platform in 2014, with 70,000 employee and dependent lives across 15 enterprise clients. We’re setting new standards for NPS (Net Promoter Score) in the industry and expanding our leadership bench with our first CFO and industry experts from national consultants and carriers. This idea of ours—it’s working—but this is just the beginning.

In order to understand where we’re going next, I want to go back to where I started.

Healthcare at its best is a team sport—CareX can be the foundation for that team

Before I co-founded Collective Health, I was a practicing physician. In fact, I still do rounds at Stanford Hospital twice a month. I think there’s an old, stereotypical view that doctors are all-powerful individuals, single-handedly saving each patient. Reality is very different.

Healthcare, at its best, is a team sport. You see this all the time in the choreographed hustle of the emergency room, the handoffs in an operating room, and the longer-term partnership of doctors, nurses, and other specialists working together to support a patient with a chronic disease.

In the future, healthcare will be even more collaborative, with a much broader set of players. Traditional providers will be supported by newly specialized roles, digital tools and programs, innovative communication and collaboration platforms, and other ideas we haven’t even thought of yet.

From where I sit at Collective Health, I’m already seeing glimpses of this future. We’re working with organizations like Ovia Health to improve maternity care, Omada Health and Livongo to transform treatment of prediabetes and diabetes, and Lyra Health to redefine what behavioral healthcare can be. I’m incredibly excited by these partners and the thought of a truly connected healthcare system—one where provider organizations, health plans, and innovative programs work together to deliver the best possible care.

There are no greater champions of this vision than the employers that we partner with at Collective Health. Organizations like Activision Blizzard, Cloudera, Counsyl, and Red Bull have been at the forefront of weaving together traditional and new resources in order to surround their members with amazing care options. However, all this employer energy and optimism has to confront a challenging reality: programs can’t make an impact if people don’t use them. Employers and consultants alike know all too well that poor engagement undermines the best intentions.

Programs can’t make an impact if people don’t use them

In a recent interview, the president and CEO of the National Business Group on Health, Brian Marcotte, called employee engagement the number one challenge facing employers: “I think the fundamental engagement challenge employers have had is: How do I keep programs in front of people at the time they need them? …Employees will never be sophisticated consumers of healthcare. We want them to be, but we’ve come to the realization they won’t. The system is too complex and they don’t touch the system enough for them to become a sophisticated consumer…”

To make matters worse, it is often the most vulnerable employees—the ones most in need of care—who are most confused and most lost. These individuals are facing massive clinical and financial decisions, but are in the dark to all the helpful resources around them.

And so we’re stuck at a crossroads. Healthcare and health benefits are full of more incredible programs and resources than ever before, but an individual’s ability to navigate those resources hasn’t kept up. As a result, great programs sit unused, members are confused (or unaware), and the healthcare system seems more complicated than ever.

And it matters to all of us—especially those of us who like my co-founder Ali four years ago, face the confusing, frustrating, and overwhelming with dozens more questions than answers.

Collective Health can help solve this problem.

Today, after nearly two years of development, I’m thrilled to announce the beta release of CareX™, our new patient identification and engagement product that uses artificial intelligence (AI) to help members navigate the many different treatment options they have available to them.

For us, CareX represents the missing piece in the engagement puzzle—one that can unlock the potential of connected healthcare.

Here’s how it works:

Integrated into Collective Health’s existing platform, CareX is an intelligent system that integrates population data and member-specific claims and queries with high-touch, personalized care navigation to simplify care journeys for members. It comes down to three core steps:

  • Learn: An employer client creates a thoughtful benefits program with robust health plan options and an array of point solutions such as maternity, behavioral health, and/or second opinion programs. Together with Collective Health, that employer works to identify the target profiles for which types of members would benefit from those programs.
  • Find: CareX uses patent-pending artificial intelligence (AI) and a vast set of data streams (including medical and Rx claims, search queries on Collective Health’s Member Portal, third-party wellness program engagement data, etc.) to identify members who fit those target profiles. Our machine learning-based algorithms enable our CareX algorithms to continuously evolve and improve based on observed results in the field.
  • Connect: CareX uses multiple digital tools and a team of Care Navigators to connect members to the right program and fuel relevant engagement, with more precision and speed than ever before. The exact approach is based on employer preferences, member preferences, condition/program specifics, and real-time engagement analytics.

In the last three months of its beta, CareX has already fueled a 2x increase in program engagement

Each new cycle combines utilization results, experience feedback, clinical impact data, and artificial intelligence to refine our ability to connect the right person to the right program at the right time. For more complex conditions, a primary goal of CareX is to connect members with a Collective Health Care Navigator who personally helps members navigate their coverage, programs, and unique care needs, using the intelligence within the CareX system. CareX also gives employers a more powerful set of tools to analyze and optimize their benefits ecosystem, member impact, and associated investment.

In the last three months of its beta, CareX has been live with 15,000 members and has already fueled a 2x increase in program engagement, thanks to Collective Health’s unique, technology-enabled approach that utilizes data from disparate sources combined with personalized, premium member support. The CareX private beta will continue with select clients and their populations through 2017 and will become more widely available to Collective Health clients in January 2018.

Personally, I’m extremely excited about this work and the early results we’ve seen. I passionately believe that healthcare at its best is a team sport—and I believe CareX can be the technology foundation for that team.

Stay tuned, you’ll be hearing much more from us about CareX in the coming months.

Our customers include: