Sramana Mitra: What are you learning? What are the key areas of leakage?
Brandon Newman: We have a couple of observations. The obvious learning that we expected is there. These include an opportunity to switch utilization, go to a lower-cost medication, or help manage members.
Those are expected, but we are able to identify them sooner in a more automated fashion so that we can quickly intervene or have the health plan intervene tomorrow as opposed to six months down the road. There are some of the nuances that we have never thought we would come across like drug cost changing.
Just out of nowhere, you see the cost of medication increase by 7%. If it is highly used, your inflation on that medication is going to up to potentially millions of dollars. You would have never known if not for these daily checks that catch those changes.
Another observation is the non-stereotypical, the shifting in medication. It’s going from treating a patient with medication that is generic, then all of a sudden, something new comes to market, and you see a massive shift of drug mix.
People are going to these specialty medications because all of the sudden there is a cancer cure or something like that. We are seeing this considerable shift in utilization to much higher-cost medications. Although we expected to see some of it, we didn’t think that we would see it nearly to this degree.
Out of all the data that we have monitored, we saw this massive increase in stockpiling of medication the very moment that COVID hit. Being able to know that those trends happen, our systems can automatically inform our clients and say, “This is happening. Here are some ways that you can help monitor and manage that.”
Sramana Mitra: How well penetrated are you in the health systems?
Brandon Newman: We have been at this directly under the Xevant name for the last four years. We have tackled the market in a unique approach where we are going after the large aggravators of employer groups.
A couple of names that we work with are folks like NFP, Mercer, and several boutique firms. These are the largest consulting firms or third-party administrators, so we are touching millions of members or millions of Americans’ prescriptions.
We are not quite 300 million and I don’t think that we are going to reach 100% where we are writing every single member. Being able to get 5% of the members is a big deal for us. More importantly, being able to get integrated into the largest consultants, administrators, and health plans in America is another big accomplishment for us.
Sramana Mitra: What do you see as open problems in your general area of work that new entrepreneurs could build a business around?
Brandon Newman: I caution around a couple of buzzwords in the industry today. We hear a lot about AI and I can’t tell you how many emails I get every single week about integrating AI in everything that we do.
AI is interesting and there are elements of AI that we can leverage, but I would caution that before you get into automatic data learning and so forth, you need to do the crawl, walk, run.
My biggest advice to those getting started in trying to solve issues in healthcare using technology is, start with the more logical solutions. Think about what the client needs. Solve the problem and then find ways to be able to do that better faster and more autonomously.
That is where we went from building some amazing reporting capabilities in an automated fashion and now going towards the AI. I don’t know if that directly hits what you are seeking after, it’s more towards how to go about it and not specifically what to go after.
Sramana Mitra: Thank you for your time.