Sramana Mitra: Is there an example of what cannot be done without technology?
Chini Krishnan: Absolutely. Let’s take a couple of examples. A big part of what consumers need to navigate is decision support. If I’m eligible for the Affordable Care Act in California, I’ve got to figure out two things. One is the amount of the subsidy that I’m eligible for. That’s not possible without technology.
The second is, once I’ve determined the amount that I’m eligible for, I still have to figure out if the right plan for me is a Blue Cross or a Kaiser plan. That type of consumer need fundamentally requires an online support tool.
It is not possible to achieve that decision and help that consumer without having an online support tool where I can go in and say, “I see Dr. Jones.” What I’m looking for is a plan that meets those criteria.
I hope that gives you some very specific examples – online shopping experience, quicker enrollment processing, faster access to care, getting onboarded. That can only be achieved with technology. Sometimes you’re eligible for Medicaid. Sometimes, you’re eligible for subsidies in the state. Many consumers toggle back and forth.
The process of toggling back and forth depends on the underlying changes in income and is something that can only happen through the establishment of standard APIs, standard web services, and standard tools and notification systems that make it easy to transition people out of these programs.
Sramana Mitra: What you’re selling is a white-labelled marketplace. It could also be technology that is not necessarily a marketplace where all these examples that you gave are technologies that could be used, but not necessarily in the marketplace setting. What are the great advantages of a marketplace setting that you’re discovering?
Chini Krishnan: Even 10 to 15 years ago when the Affordable Care Act was framed, it was somewhat possible for it to be framed in a way where consumers could figure out what subsidy they would be eligible for. Thereafter, they are on their own and maybe talk to a broker.
What people realized over time is that the greatest good is achieved by presenting to consumers, in real-time at the point of determination, an apples to apples comparison between the plans. What that achieves is, in one integrated way, I’m able to go in and say that I live in whatever zip code, see a certain doctor, and require Statin.
I can input those and get a very personalized online marketplace recommendation for the plan that I need. It’s not very different from saying that I want to fly from San Francisco to London and that I want a coach class window seat. I want it to be a non-stop flight. Tell me what my choices are. The discovery problem is what an online marketplace facilitates.
Sramana Mitra: Let’s talk about open problems. When you look around in this general space that you have been in for a long time, what do you see as open problems? I’m talking more broadly but within your segment. What are some possibilities where new entrepreneurs should dig to find problems to solve?
Chini Krishnan: Healthcare is a huge problem. It’s a huge problem because the underlying basket of goods and services that the healthcare system has is taking up more and more of our GDP. There are a range of new business models that remain to be solved.
Just one quick example would be, nobody has figured out how to do a Netflix model for generic prescriptions. Imagine a set low-cost monthly fee where consumers could have access to any kind of generic prescription medication they want. That could be made available to an entire population. Nobody has figured out how to do that yet.
Another problem is, there is a persistent issue where the price of prescription medication in the United States tends to be higher than the rest of the world even for drugs that have been around for a very long time. If you look at insulin, it costs way more in the United States than it does elsewhere. It was invented over 100 years ago.
For any entrepreneur out there, if you have the patience, tenacity, determination, and creativity, there are enormous problems that are waiting to be solved.
Sramana Mitra: Before we close off, tell me a bit about the company. Is it a bootstrapped company?
Chini Krishnan: We’ve been around since 2005. We are backed by institutional capital. We were founded in Bessemer’s offices. We are fortunate to have supportive institutional investors. We’re very fortunate to be in the Valley and to have access to the kind of capital and support that Bessemer and others provide.
Sramana Mitra: What is the business model that you’re using?
Chini Krishnan: We’re SaaS.
Sramana Mitra: That’s a function of users on the system?
Chini Krishnan: Not quite. It’s oriented towards what is classically considered as enterprise pricing. It tends to be fixed-price contracts.
Sramana Mitra: Great. Thank you for your time.
This segment is part 2 in the series : Thought Leaders in Healthcare IT: Chini Krishnan, CEO of GetInsured