Latest / CareTalk: Healthcare. Unfiltered. / Food As Medicine: From Trend to Treatment w/ Spencer Pratt, Chief Growth Officer, NourishedRx

Transcript

Food As Medicine: From Trend to Treatment w/ Spencer Pratt, Chief Growth Officer, NourishedRx · CareTalk: Healthcare. Unfiltered.

• 0:07
  John: Welcome to Care Talk America's home for incisive debate about healthcare, business, and politics.
• 0:12
  John: I'm John Driscoll, the chair of the Yukon Health System.
• 0:16
  John: We're in the middle of March Madness, so please, everyone should be supporting Yukon.
• 0:19
  John: And today for Care Talk, we are talking to Spencer Pratt, the Chief Growth Officer at a company called NourishedRx.
• 0:29
  John: Welcome, Spencer.
• 0:31
  Spencer: Thank you for having me, John.
• 0:32
  Spencer: Uh, excited for the conversation.
• 0:34
  John: I think we couldn't be talking to you at a more interesting point.
• 0:38
  John: Can you, uh, talk a little bit about what NourishedRx E.
• 0:44
  Spencer: Absolutely John.
• 0:45
  Spencer: So NourishedRx is a digital health and tech enabled services companies that operates in what, what we call the food is health space.
• 0:53
  Spencer: Uh, and so what that means is we, uh, run programs on behalf of healthcare organizations that address the number one root cause for chronic disease and healthcare cost.
• 1:03
  Spencer: Which is diet and what we put into our body.
• 1:06
  Spencer: Uh, so we partner with healthcare organizations and government agencies across the country to deliver scalable programs, uh, that convert diet and nutrition from a problem, which it largely is in our country today, uh, into a solution that drives better health and lower cost for our, uh, our partners that we're working with.
• 1:25
  John: As a practical matter though, Spencer, I mean, everyone know diet's a problem.
• 1:30
  John: Why do you think it's it's, it's, it's mutable how and the we, we've been living with an America that is, you know, from a military perspective and many of the recruits are too fat to fight.
• 1:42
  John: We've got a exploding diabetes problem.
• 1:44
  John: We've got a cardiometabolic bollock.
• 1:47
  John: Problem that's growing.
• 1:48
  John: That's that the GLP ones, I mean, are, are struggling to make a dent in, although they're, we're quite optimistic about that.
• 1:56
  John: What makes you think that diet is, is changeable for Americans?
• 2:01
  Spencer: I think we we're, we're seeing growing recognition, John, that diet is the, the, the number one root cause, uh, dynamic that we should be focused on as a country to improve health and improve health in a sustainable way.
• 2:15
  Spencer: Uh, we're, we're seeing growing momentum with policy makers.
• 2:18
  Spencer: We're seeing growing investment from healthcare organizations into, uh, the number one, what we think about as modifiable driver, uh, of cost and, and poor health.
• 2:28
  Spencer: And we see that in our programs across the country.
• 2:30
  Spencer: John, we have, we have two thirds of participants coming into our programs that report to us when they come in that their diet is harming their health.
• 2:39
  Spencer: So there's that growing recognition from the public and from consumers.
• 2:42
  Spencer: I understand that what I'm eating is hurting my health, but 95% of people are motivated to make changes, uh, to take control of their health through diet and lifestyle.
• 2:52
  Spencer: What we've been lacking in this country is the, the support and momentum from policy and healthcare funders.
• 2:58
  Spencer: And, and organizations like NourishedRx coming up with a structure and the framework, uh, that really makes behavior change possible.
• 3:06
  John: Just to be clear, you're saying that people, I mean, we know that that diet is a massive problem just based on the BMI exploding and the, and the, and the growth of diabetes and, and, and, and, and how the problems of cardiometabolic disease, which used to be a problem of the elderly, are now touching ev almost every demographic, including kids.
• 3:27
  John: You're saying that people, that individual consumers understand that and want to change.
• 3:33
  Spencer: We are seeing growing recognition of that across our country.
• 3:36
  Spencer: Um, public perception and consumer interest in nutrition.
• 3:41
  Spencer: It is growing at a significant rate.
• 3:43
  Spencer: We see over 80% of consumers in this country, John, that report that they want food and nutrition more deeply integrated into their healthcare.
• 3:51
  Spencer: Um, nutrition is a foreign concept for a lot of people historically, and I think a lot of folks have not really understood what they should be consuming, how it connects to their health, how do they get started, uh, and with policy and this public perception and solutions like Nourish, DirectX converging at this moment, we we're in a real moment where this change is possible.
• 4:11
  John: How did, how did you get to Nourish Rx?
• 4:14
  John: What's your healthcare journey that got you to join the Nourish Rx team and now lead it?
• 4:21
  Spencer: I focused my entire career.
• 4:23
  Spencer: John, uh, in healthcare always focused on building solutions that address upstream drivers of health.
• 4:30
  Spencer: And so you hear about the term social determinants of health, everything happening outside of the four walls of healthcare with respect to where you live, who you live with, how you engage in your community, who you engage with in your community.
• 4:41
  Spencer: All of those dynamics are much more influential and predictive of what's gonna happen to your health than the two doctor visits that you have in a given year.
• 4:49
  Spencer: And what happens, uh, in, in the setting of the four walls of healthcare.
• 4:52
  Spencer: And so my entire career has been focused on understanding those upstream drivers of health and building solutions that really address them in a meaningful way that can change the trajectory of health in our country.
• 5:03
  Spencer: Uh, and at the top of that list, John, uh, f is, is food and diet, uh, and for a variety of reasons have gotten very, very motivated and passionate around solving this problem.
• 5:14
  Spencer: Uh, or, or you, you know, we think about it as an opportunity to, to really change the trajectory of health in our country through something as fundamental as what we eat.
• 5:23
  John: So, so maybe break down exactly what NourishedRx does.
• 5:28
  John: I mean, uh, like, like, like everything else in healthcare, I'm sure it's complicated, but how do, how do patients find, how, find you, how does the chronically ill patients find you?
• 5:40
  John: And then what happens?
• 5:42
  John: What's the process by which a, a person finds NourishedRx gets access to care and, and, and kinda what are the results?
• 5:50
  Spencer: So health plans.
• 5:52
  Spencer: Help payers as well as government agencies are motivated to improve health and lower cost, and, and they're out there every day looking for solutions that can help them do that.
• 6:02
  Spencer: Nourish RX is a solution that engages people, it improves health outcomes and, and lowers costs.
• 6:08
  Spencer: And so a lot of the work that we're doing, John, is in partnership with health plans, with government agencies that are looking to offer.
• 6:15
  Spencer: Really, really compelling comprehensive health management behavior change programs that can help them do those things.
• 6:22
  Spencer: So a health plan hires you, a health plan, hires NourishedRx.
• 6:26
  Spencer: Um, we.
• 6:27
  Spencer: So we, we understand what their number one needs are.
• 6:31
  Spencer: So let's say for example, we're really focused on improving diabetes outcomes and healthcare costs related to diabetes.
• 6:37
  Spencer: We will contract with a health plan.
• 6:39
  Spencer: Uh, they will send us eligibility files of members that they manage in their population that they want to engage in the Nourish RX program.
• 6:47
  Spencer: Uh, we then run marketing campaigns to drive awareness and promote the uh, program available to those members.
• 6:53
  Spencer: We get them into the program and we run, we run our program from there, delivering clinically guided food, telehealth, nutrition counseling and health coaching, uh, digital education, uh, things like meal planning and recipes and, and personalized tips and nudges that help people stay on the right track.
• 7:10
  Spencer: Uh, and then we report the, the impacts that we're having.
• 7:13
  Spencer: Uh, for those members in our programs on, on behalf of the health plan
• 7:16
  John: for folks who have diabetes.
• 7:18
  John: I mean a low sugar, a vegan diet.
• 7:20
  John: Like people to your point, know that this is a problem.
• 7:24
  John: Individuals have known it as a problem forever.
• 7:28
  John: What makes you think or, or, or show that you can actually change people's diet and change the way they, they, they, they consume the, the, the food that's, that's killing them.
• 7:40
  Spencer: I think one, one thing that's different about our approach, John, is historically you'd go to the doctor and the doctor would say, you need to eat better, and here's a brochure.
• 7:47
  Spencer: Go eat these foods.
• 7:49
  Spencer: And most people wouldn't know where to start, or they wouldn't, they wouldn't have trust in that process because they haven't felt the impacts of eating that way historically.
• 7:59
  Spencer: Um, so what we're doing is we're actually delivering the clinically guided food, food that's, um, guided by the dietician, working with a member.
• 8:07
  Spencer: That food shows up at the participant's home and they start consuming it.
• 8:11
  Spencer: Uh, and within a week or two, uh, we're driving an aha moment where the member says, wow, I feel better.
• 8:17
  Spencer: I have more energy.
• 8:18
  Spencer: Um, I, I trust the, the, the food that's being provided to me.
• 8:21
  Spencer: And I trust this program and I'm motivated to continue because I haven't felt this way in a long, long time.
• 8:27
  Spencer: And so through experiential learning and delivering a tangible good.
• 8:31
  Spencer: Like this clinically tailored food that we're providing it, it builds that aha moment and opens the door to meaningful engagement throughout the program.
• 8:40
  John: And so you, you give food, you're, you're guiding with a tech enabled service.
• 8:45
  John: Uh, what are the results like?
• 8:47
  Spencer: First and foremost, activation, engagement, member experience?
• 8:50
  Spencer: Uh, results are gold standard in the industry.
• 8:54
  Spencer: We're we're seeing incredible rates of engagement.
• 8:56
  Spencer: Incredible member experience.
• 8:58
  Spencer: And that's foundational to building trust and opening the door to clinical impact.
• 9:03
  Spencer: Um, from a clinical impact perspective, we, we have so many great results, John, but I'll share, uh, just one or two examples.
• 9:10
  Spencer: Within diabetes programs, we're seeing a one and a half point reduction in hba one c within three to four months.
• 9:17
  Spencer: That that's the key measure that we're looking to improve, uh, for members living with, uh, type two diabetes.
• 9:23
  Spencer: Uh, and for reference that's more effective than most diabetes medications.
• 9:27
  Spencer: I think even more compelling, John, we talk about sustainable behavior change often our goal is not to deliver food to members like we do with medications for a lifetime.
• 9:36
  Spencer: It's to use food as a, an activation tool and an engagement tool that drives immediate nourishment.
• 9:41
  Spencer: But really, um, through that as, as well as the coaching and the education, we're driving confidence and knowledge and new skills and habits that can last a lifetime.
• 9:50
  Spencer: And as we follow members up to 12 months post receiving the food from NourishedRx.
• 9:54
  Spencer: Not only are we seeing maintenance in that A1C reduction that we see in the first three to four months, we're seeing continual improvement in A1C to a 2.2 point reduction on average 12 months post starting the program.
• 10:07
  John: Do your programs go a lifetime the way drugs do?
• 10:09
  John: I mean, how, how does, how does that work?
• 10:12
  Spencer: Our goal is not to deliver food for a lifetime.
• 10:15
  Spencer: I know there's a lot of conversation in policy, John, around food being viewed as a, a social benefit or an entitlement.
• 10:21
  Spencer: That's not how we think about it.
• 10:22
  Spencer: Uh, we think about our programs as a, a time limited.
• 10:26
  Spencer: Intervention where food is used as a clinical therapeutic in that first three to four month period to drive that experiential learning drive, the immediate clinical impact.
• 10:35
  Spencer: And then we transition members into a self-maintenance phase of our programs where we want to keep them engaged, but not, not with, with the intensive coaching, the intensive food delivery, it's more of a digital maintenance phase.
• 10:47
  Spencer: And our goal is to, to keep members engaged digitally for, for life to help them continue to practice what they learn during the intensive part of the program.
• 10:55
  John: But that's a lot lower cost for the health plans.
• 10:57
  John: If you go from food delivery to then just digital delivery of messaging,
• 11:02
  Spencer: it's a lot lower cost.
• 11:04
  Spencer: Um, it is applicable to everybody in our country, not just the individuals living with high risk cardiometabolic disease, but there's significant opportunity around prevention and general wellness through a a digital forward solution.
• 11:18
  Spencer: Yeah.
• 11:18
  Spencer: But what's really exciting is as we think about the digital engagement, self-maintenance phase, that really carries members into lifelong impact, that's very well aligned with new models coming out from the administration, like the, the access model, which is a technology forward, chronic, uh, condition management, uh, type of solution.
• 11:35
  Spencer: Uh, and so what we're doing today with government agencies and health plan partners with our core cardiometabolic health programming is very applicable to some of these new CMMI models, like, uh, like access.
• 11:46
  John: And just maybe give folks a context for what these, well, first of all, I think no one will be surprised that the Make America healthy again, agenda is very focused on food, so that's gotta be.
• 11:59
  John: In an incredible change of the frame of, for how people think about healthcare.
• 12:04
  John: But maybe talk a little bit about,'cause it's not just access.
• 12:07
  John: There's a number of programs that the Center for Medicare and Medicaid, uh, is putting out to engage folks digitally in the category that would include NourishedRx and, and, and, and, and food, you know, targeted food interventions, even though it's at a digital layer.
• 12:24
  John: Maybe you could talk a little bit about what this.
• 12:26
  John: All the new funding streams might mean for you and companies in your space.
• 12:32
  Spencer: Yeah, we, um, since, since Nourish Rx was founded in 2019, John, we've been, we've been fighting the, the battle.
• 12:38
  Spencer: We've been in the trenches contracting with health plans.
• 12:41
  Spencer: As you know, it's not easy to contract with health plans.
• 12:44
  Spencer: Um, we, we've built a lot of credibility in that space.
• 12:46
  Spencer: We we're doing great work with health plans across the country and have grown pretty significantly over that time period, and we're viewing a lot of these new models from the administration.
• 12:57
  Spencer: As, uh, really an amplifying dynamic for us where the opportunity that we have to scale, what we've done with health plans over the past six years is now magnified, uh, significantly.
• 13:10
  Spencer: So we have the, the access model, which is digital first, uh, chronic condition management for original Medicare beneficiaries.
• 13:17
  Spencer: We have the, the a CO lead model that's gonna be, uh, in effect starting 1 1 20 27, which is the next, what's that?
• 13:23
  Spencer: It's the next evolution of the a CO reach model.
• 13:26
  Spencer: Um, driving a, a value-based framework for original Medicare through ACOs with, uh, financial incentives aligned kind of long term to support investment in root cause and upstream drivers of health and very excitingly, uh, food is emphasized there.
• 13:43
  Spencer: There's expanded, uh, offerings for food support as well as expanded medical nutrition therapy support under that ACL lead model.
• 13:51
  Spencer: Uh, we have the Make America Healthy again.
• 13:54
  Spencer: Uh, elevate Model, Maha Elevate, which is, uh, $100 million of funding that's gonna be going into nutrition and, and lifestyle based solutions to test the efficacy of, uh, services that are not currently covered by original Medicare, um, to, to demonstrate improvement in cardiometabolic health outcomes.
• 14:14
  Spencer: And then you also have the, the balance model, which is focused on nutrition and lifestyle support, uh, as a companion to GLP one therapy.
• 14:22
  Spencer: So across all four of those models, they're, they're different.
• 14:25
  Spencer: There's different application, uh, for, for companies like NourishedRx, but they're all pointing to nutrition,
• 14:31
  John: real money coming from the feds to actually invest in food.
• 14:35
  John: I mean, I don't think.
• 14:36
  John: I've ever heard of this many different models, uh, being dropped at nearly the same time.
• 14:44
  John: And secondly, I think this is the first time I've ever heard the feds think about funding, nutrition and food related programs.
• 14:52
  John: Is that right?
• 14:54
  Spencer: That, that that's right.
• 14:54
  Spencer: With this level of emphasis and being this deliberate about the, uh, intention to focus on nutrition and, and focus on food support as part of.
• 15:04
  Spencer: Chronic disease, uh, management and, and really spanning from prevention all the way to management and reversal, uh, of, of cardiometabolic disease.
• 15:12
  Spencer: This is as intentional as we've seen the federal, uh, government, uh, be, uh, around food, nutrition.
• 15:18
  John: Okay, so you've been at this for, uh, more than a few years now, six or seven years now.
• 15:24
  John: What are the results with the health plans?
• 15:26
  John: I mean, have you, what are the lessons learned and what are the results that you can apply to these new funding, these new opportunities to, to, and, and funding models?
• 15:36
  Spencer: Lessons learned.
• 15:37
  Spencer: Uh, you know, we, we talked a little bit about really strong engagement, leading to improvement in self-reported health outcomes, improvement in clinical outcomes.
• 15:44
  Spencer: But when the rubber meets the road, John, we need to demonstrate, uh, financial viability and we're impacting affordability.
• 15:51
  Spencer: We're driving medical and pharmacy cost savings, and across our, our programs across the country, uh, many in Medicare, some in Medicaid, and commercial.
• 16:00
  Spencer: We're seeing significant reduction in medical and pharmacy costs.
• 16:03
  Spencer: Uh, one, one example, $474 of medical cost savings per member per month in a congestive heart failure program.
• 16:11
  Spencer: That's
• 16:12
  John: massive.
• 16:13
  Spencer: Massive driving, a massive return on investment for the health plan.
• 16:17
  Spencer: And again, it, it's not an ongoing medication that you're paying for into perpetuity.
• 16:21
  Spencer: You're making an investment in A-A-A-A-A program that is addressing root cause issues and driving sustainable behavior change.
• 16:29
  Spencer: And so that impact in the first 12 months is gonna continue to materialize as we look into subsequent years.
• 16:35
  Spencer: So that, those are the learnings as we think about the continuum engagement, clinical impact, medical cost savings that we're bringing to these new CMS models and really focused on affordability given the crisis that we're in.
• 16:47
  Spencer: And we can't solve for that crisis until we go upstream and address the number one driver at Witch's Diet.
• 16:53
  John: But it feels like the, you're meeting the moment in terms of.
• 16:57
  John: We, we know that nutrition's a problem.
• 17:00
  John: You've got positive results.
• 17:01
  John: The, the funding is, uh, the funding is coming.
• 17:05
  John: It just, it's, it's gotta be an interesting time to be building in this space as the, as the, as the, as the financials are changing.
• 17:15
  John: What are the biggest challenges over the next 12 to 24 months for NourishedRx?
• 17:20
  Spencer: We think about nutrition as the connective tissue, John to physical, mental, social, emotional health and wellbeing.
• 17:28
  Spencer: There is no shortage of opportunity to apply our food as health model to solve for a, a myriad of, of challenges that are plaguing our country today.
• 17:37
  Spencer: So one thing that we're, we're continuing to focus on is like, stay focused.
• 17:41
  Spencer: Let's stay focused on the areas that can create the greatest impact for the, the business and for our, our country as a whole.
• 17:48
  Spencer: Um, we, we talked about some of those examples of Cardiometabolic health programming, the new CMMI models.
• 17:53
  Spencer: We're doing a lot of work around maternal health, uh, as well as leveraging our, our technology platform to help other organizations scale their own programming.
• 18:02
  Spencer: So we're, we're, we're staying as focused as we can be to ensure that we're driving the, the, uh, level of impact for NourishedRx and for the country as we can.
• 18:12
  Spencer: Uh, and then I think second is just.
• 18:14
  Spencer: Because of all this opportunity, because of all these new models that have come out over really over the past six months, uh, the need to move quickly.
• 18:22
  Spencer: Is, uh, really important.
• 18:24
  Spencer: Um, so we're moving quickly from a market engagement and go to market perspective, moving quickly from a product development perspective to capture some new opportunities in the market.
• 18:33
  Spencer: And we, we just want to continue to move, uh, as quickly as we can to, to drive this impact.
• 18:38
  John: How does AI play into this?
• 18:40
  John: Is it, is it a positive and negative neutral?
• 18:42
  John: I mean, it just feels like it's an overlay for any of the, any digital health company.
• 18:47
  John: How important and relevant is AI to the Nourish Rx journey?
• 18:51
  Spencer: It is, uh, it's critical, John, at this moment.
• 18:55
  Spencer: AI is critical.
• 18:56
  Spencer: It's a core part of our strategy going forward, um, in terms of how we operate as an organization in terms of how we deliver clinical care through our team of dieticians and health coaches.
• 19:06
  Spencer: Uh, in terms of the member experience within our program, ensuring that it's personalized and members feel supported throughout the entire journey, uh, with human impact that will maintain, but also asynchronously through, uh, AI tools.
• 19:19
  Spencer: And one, one thing that's really exciting, John, is we, we've spent the last six years running these programs, collecting data from a diverse set of stakeholders.
• 19:29
  Spencer: The the health plan, the, the, the participant in the program, our food supplier partners, our care team, where we're generating data.
• 19:36
  Spencer: We have a really rich data set.
• 19:38
  Spencer: Uh, over six years longitudinal engagement pathways with our participants.
• 19:43
  Spencer: Uh, and that is really gonna be under underpinning and underlying our entire ai, uh, development efforts and, and strategy.
• 19:52
  Spencer: Uh, and we believe that we're in a really unique position with that data set that we have access to.
• 19:57
  John: So maybe, uh, a, a last question, Spencer.
• 20:00
  John: What if you look at 10 years?
• 20:03
  John: What role do you think NourishedRx can play in a different world where perhaps food and nutrition are integrated into a healthcare system?
• 20:14
  Spencer: We, um, so connecting food, the food industry and healthcare is, is big, right?
• 20:22
  Spencer: The two biggest industries that we have in our country, and that's effectively the work that we've done over the past six years, John, bridging food systems and healthcare systems.
• 20:31
  Spencer: To deliver a model that aligns incentives and is cohesive and integrated.
• 20:35
  Spencer: And so looking 10 years out, our vision is we want to be supporting and enabling that model at scale across our country.
• 20:43
  Spencer: Um, we have the, the, the network of suppliers that are delivering clinically tailored food.
• 20:48
  Spencer: We have the technology platform, we have the operational blueprint for how this works, and we're gonna continue to invest in making this model, uh, scalable for all stakeholders that are delivering healthcare and related services that across the country.
• 21:02
  John: Awesome.
• 21:03
  John: Well, thank you, Spencer.
• 21:05
  John: Um, and if you like what you heard or you didn't, we'd love you to subscribe on your favorite service.