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How Health Innovation Startups Can Partner with Anthem · StartUp Health NOW Podcast

• 0:00
  [on-hold music] You also need a certain level of detachment from your product as well.
• 0:10
  If you're too in love with your product or your solution, it's going to be very difficult for you to, one, receive feedback, but two, also to be able to pivot and make changes to your product so that you can ultimately, you know, drive greater uptake, uh, and success in the marketplace.
• 0:27
  [upbeat music] Welcome to Startup Health Now, the podcast where we celebrate the entrepreneurs and innovators reimagining the future of health. I'm your host, Logan Plaster.
• 0:40
  In health innovation, you can have the most amazing idea and a rock solid business plan, but in order to scale, you might still have to collaborate with the right enterprise partner.
• 0:50
  Topping this list for many entrepreneurs is Anthem, which serves forty million people and is ranked fifty-seven on the Fortune five hundred.
• 0:58
  It's safe to say that if you're a startup and you can get distribution through a network like this, it's gonna put you on a whole new trajectory.
• 1:05
  In order to find out how Anthem works with startups, we invited in Omid Toloui, Anthem's Vice President of Innovation.
• 1:12
  Anthem has had a range of programs in recent years aimed at collaborating with nimble, forward-thinking startups, like their innovation studio in Atlanta and their digital incubator program.
• 1:22
  But we wanted Omid to pull back the curtain on exactly how Anthem thinks about innovation, and then talk about how startups can partner with them.
• 1:30
  This episode was excerpted from a fireside chat held in front of a live audience of founders from the Startup Health portfolio. Enjoy. Omid, let's start big picture.
• 1:44
  Uh, you run a whole innovation team, a whole division there at Anthem that looks for promising startups and, you know, helps them come to market and grow utilizing Anthem's various-- very large pools of patients and consumers.
• 1:57
  So just start by telling us how that innovation ecosystem works within the organization and, you know, more specifically, how you partner with startups. Yeah, for sure.
• 2:07
  You know, there's a mantra that I learned, um, when I was standing up a product management division, uh, at a, a previous role that I had.
• 2:16
  I went through this, uh, this training w-with a company called Pragmatic Product Management, which I'm sure some of you have, have heard of.
• 2:22
  And, uh, the mantra was, you know, your opinion, although interesting, is irrelevant. Your opinion, although interesting, is irrelevant.
• 2:33
  And to me, you know, this is something that I think we all need to adopt, uh, in the healthcare marketplace, and I think it's really central to, um, kind of the-- our ethos, um, as, as a, as an innovation team within Anthem.
• 2:47
  You know, I think all too often within the innovation space, innovation teams suffer from an-- and qu- and, and organizations suffer from what I call shiny hammer syndrome, which is the-- there-- you know, the, the teams, the organizations are quick to fall in love with the shiny object, the, the, the shiny new solution, and then they turn to the business, you know, looking for the nails, right?
• 3:08
  And in the process, you end up hitting a lot of thumbs and pissing off [chuckles] a lot of people and, and, and creating a lot of frustration. And what we've done as, as part of our team is we've really...
• 3:17
  our operating model flips that on its head. So we really start by understanding what the nails are. You know, what are the challenges that our business units are having?
• 3:24
  You know, what is-- what are the corporate priorities?
• 3:27
  What is the data telling us, um, in terms of where we have the greatest opportunities to innovate and the greatest-- where, where we have the greatest opportunities for impact?
• 3:35
  And then from there, you know, we apply our human-centered design. We have a dedicated human-centered design team, um, that goes deep on the problem. They understand it from the di- various components.
• 3:45
  They understand it from the perspective of the member, the provider, um, the various stakeholders that we have, the business units.
• 3:51
  And we emerge from that process with a much better understanding of what an idealized solution could look like. Now, sometimes that idealized solution is kind of what our opinion said it was going to be. Sure.
• 4:03
  And it's, it's validating, right?
• 4:05
  But that's, um, more often than not, it's, you know, a, a deriv-- it's, uh, it's some aspect of that, um, or, um, it's something completely different, or there are certain insights that we uncover that, um, that are, uh, kind of change our point of view or our perspective.
• 4:20
  And what that process helps us do is it helps us-- helps inform, like, what an idealized solution is going to look like. And then from there we have to make a decision. Is this something that we should build in-house?
• 4:30
  Is this something that we should partner with, you know, a, a vendor, um, or an established company or a researcher to, to, uh, procure?
• 4:38
  Um, or should we go out into the marketplace and identify, uh, you know, an early stage startup that can help us, you know, um, ha- gain this capability?
• 4:47
  And then I think, you know, the other piece where I think a lot of, um, innovation dies, um, is, like, post-pilot.
• 4:54
  So, you know, the next phase is pilot, uh, and I, I think a lot of companies are really good at doing pilots, um, certainly we are, um, and, and studying them to see if there's impact.
• 5:04
  But I think a lot of the times where, you know, I've seen challenges, uh, in the industry and in my own work is post-pilot. Um, what then?
• 5:11
  So you've identified value, how do you then go and extract, you know, that value across an-- the enterprise or across an organization as large as Anthem?
• 5:19
  So, you know, we focus a lot, and we have a dedicated team that's focused on, um, you know, taking the innovations and the, and the value that we've found and expanding that across the enterprise.
• 5:29
  So these are what I like to call my innovation bulldozers. So they bulldoze the path to scale. Because at the end of the day, innovation is tr- really only truly innovative if it leads to impact at scale.
• 5:40
  If we're just doing pilots and patting ourselves on the back, you know, we're, we're doing experiments. We're not really doing innovation.
• 5:47
  Innovation is when you can take the value that you've identified in a pilot and then expand that so the broadest set of, of consumers can take advantage of those, of those innovations.
• 5:57
  And so we're very much focused on, on driving things through from pilot, um, and through to scale. So through from seed, um, to scale.
• 6:05
  Got itLet's get a little more specific about, uh, some of those drivers and some of those areas of focus.
• 6:11
  You said that the, the antidote to the shiny hammer syndrome, which I like 'cause it kind of, it combines the shiny object idea with everything's a hammer, uh, well for... If you have a hammer, everything's a nail.
• 6:21
  So two- That's right. Two, two great images pushed together. Um, the antidote to that is really to understand the true problems that an organization has.
• 6:28
  So let's talk about what those are, uh, because those are the, the kinds of problems that the founders on this call might be trying to solve.
• 6:35
  You know, I think the, the wonderful thing about the healthcare industry that is that there's never a shortage of, you know, problems- [laughs]... to solve.
• 6:41
  Um, and I think, uh, I think the challenge, um, that, that we all face is the, the discipline that we need to be very focused on the, on the problems that really need solving the most.
• 6:52
  I could go into kind of a, a laundry list of things that we're focused on.
• 6:56
  Um, and, and certainly, you know, we, we make, we try to make sure that the work that we're doing is very much driven by the needs of the business units- Mm-hmm... um, by what the data is telling us, right?
• 7:07
  And what our strategic priorities are as, as an organization.
• 7:10
  Um, you know, some of the things that are kind of top of mind for me, and maybe this is just a, a fact that, a virtue of the fact that I've been talking about this recently with my teams, is that, um, you know, I think too often in healthcare, we, we look at problems kind of in a very kind of like an individualistic point of view.
• 7:29
  Um, or we look at... We, we think about members, um, or individuals or consumers or patients, whatever term you wanna use, um, as, um, you know, uh, defined by the illnesses that they have or a compendium of illnesses.
• 7:44
  And I think that the opportunity that we have is to think more about, um, you know, members or consumers, uh, from a whole health perspective, um, really looking at them holistically from a behavioral, social, uh, and physical point of view.
• 7:59
  And I think within each one of those buckets, there's a lot of room for innovation. There's a lot of room for advancement.
• 8:05
  So when we think about, um, you know, behavioral health, we've seen, uh, the burgeoning of, of digital behavioral health solutions, um, over the last three years, especially, you know, um, kind of catalyzed by the pandemic, um, and, and the, and the tremendous need for, for digital BH and virtual BH.
• 8:23
  Um, but what we're not seeing is, you know, um, solutions that are helping members identify what the right behavioral health intervention or solution is for them, right? That level of customization.
• 8:35
  Uh, and we can be doing more to be predictive and proactive in identifying behavioral health needs and getting folks connected to, um, the right s-services and solutions for them.
• 8:45
  Um, we're also seeing, uh, a tremendous rise in adolescent BH, behavioral health issues.
• 8:52
  Um, we're seeing a, a rise that's, um, in, in, in, uh, depression and anxiety within the adolescent space that's two times as, as great as what we're seeing in the adult space. Mm.
• 9:04
  Um, on the social, you know, side, you know, I think there's, I think we still have work to do as an industry, um, in, in closing a lot of, um, and addressing a lot of the gaps, um, as it relates to health equity.
• 9:16
  Um, you know, uh, areas that we're focused on are helping folks with, with transportation, you know, getting the care, getting to the care they need. Um, we're seeing, um, a lot of need to bridge the digital divide.
• 9:29
  Um, so all of us, you know, on this call are probably digital natives. Um, throughout the entire pandemic, we've had smartphones and access to high-speed connectivity.
• 9:38
  Um, and as, you know, the virtual and digital solutions in the world have, have grown, we've been able to benefit from, from that, right?
• 9:45
  Because we have access to internet, we have access to smartphones that, um, that let us participate in this, in this new reality that we have.
• 9:52
  But, um, sadly, that hasn't been the case, um, for a lot of folks, um, that don't have access to smartphones, um, or ad-adequate internet connectivity. That's an area that we're focused on addressing as well.
• 10:04
  And then on the physical, you know, side of, of care, you know, we see a lot of care moving into the home. And obviously, we've seen a lot of that as a result of, um, you know, the pandemic.
• 10:14
  You know, we were forced to, to, to be at home. Uh, and, uh, I think we've, we've seen and we've, we... We're seeing more and more models of, of care in, in chronic disease management being done at home.
• 10:24
  And so we see a lot of that moving into the home, not only for, um, you know, folks that have chronic conditions, but folks that, you know, are elderly that wanna age in place, uh, that wanna, uh, receive more of their care, uh, in the place that's the most comfortable to them, which is, which is their home.
• 10:40
  I saw a video that you posted recently, um, about how Anthem is sort of shifting their mindset from being a, a health insurance company to what I think the video's called a lifetime health partner, that I just, uh, I find it interesting that's really in line with what you just described as sort of the type of innovation that you're looking for.
• 10:58
  And also, it's probably worth mentioning that that, that's also seems to be part of the ethos of the Anthem name change.
• 11:04
  I don't know if you have any, uh, anything, uh, any sort of color commentary you can give us about the announcement in March that Anthem, uh, intended to change its name to Elevance Health, and if that has something to do with this changing perspective.
• 11:18
  We're really excited about the name change and, um, you know, hope our, uh, shareholders will approve, uh, it. Uh, and, um, you know, I think, I think you're right.
• 11:26
  I think this idea of being a lifetime trusted, uh, partner in health, um, is a big part of, you know, what drives us as a company.
• 11:34
  Uh, when you think about it, you know, your health plan has every incentive to make sure that you're healthy, that you're getting the care that you need. Um, they also have the ability to see things end to end, right?
• 11:45
  Um, where y-when you go to the doctor, your doctor has the EMR. They understand, you know, one aspect of your care. But you know, what about...
• 11:51
  But we have the ability kind of at, from our perspective to see every, all the care that you're receiving, um, to then take all that data, leverage it, um, to draw insights, um, and to find the right, you know, types of solutions, uh, both in person, virtual, digital, uh, that can ultimately benefit, um, benefit you and, and your health,
• 12:12
  um, and, uh, make sure that you're able to live a, a happy and healthy life.Let's get really specific about how you actually work with startups. We've got dozens and dozens of- Yeah...
• 12:20
  startups on this call, um, and they might really have no idea kind of what Anthem's innovation ecosystem is like, how the, how you run pilots, how you talk to startups, how you work them into your system.
• 12:33
  So, ja- let's get, let's get, uh, tactical about it. Yeah, for sure. So, you know, innovation is a team sport. Um, we can't do it alone.
• 12:41
  Um, and so we, we oftentimes, uh, you know, partner with, with, uh, innovative, you know, startups and companies, uh, such as yourself.
• 12:49
  Um, you know, I think, you know, working with a health plan for a lot of startups, especially early stage startups, can be somewhat daunting.
• 12:57
  Um, you know, uh, they maybe have never worked with a payer, they haven't had a payer contract, they don't know what the process is like.
• 13:04
  Just even the, the basic, um, fundamentals of it, like what does it take to get a contract? What are the security approvals that you have to go through? What are the legal approvals that you have to go through?
• 13:14
  So, you know, part of what we can do in order to, as an innovation team, is just to make that process as easy as possible, um, for the companies that we're working with.
• 13:24
  Um, but, you know, to go back to my earlier, you know, comments, what really matters, um, to us the most is, you know, whether that startup that, you know, we're working with, you know, ha- one is solving the, the problems that we've identified, the, the true needs that we have, right?
• 13:40
  And whether they have the capability to scale.
• 13:43
  Um, because I think that is one thing that, you know, you mentioned at the beginning, you know, we have over 40 million members, about 45 million members, that's one in eight Americans, um, across, you know, more than 14 states.
• 13:55
  So we, you know, when you're working with a company of that size and scale, you know, you need to have, um, what it takes, uh, to scale.
• 14:04
  And, you know, and, um, our jobs as an innovation team is, one, to help, uh, not only identify companies that, that are solving kind of some of our needs, but to have the ability to do that scale.
• 14:16
  And if they don't, um, you know, provide them with the feedback they need in order to, um, in order to get, you know, to plug those gaps and be able to come back and work with us in the future.
• 14:26
  Omid, let's go in on that a little bit- Yeah, for sure...
• 14:28
  deeper because there's probably folks on the call who are thinking, love to work with Anthem, um, wondering whether I have the ability to scale the way he's describing.
• 14:38
  And we've talked to folks from Walmart, and we've talked to folks from CVS with similar language.
• 14:43
  You know, you gotta be ready to, to scale, um, and it's a bit of an unknown if you're an early stage company and you're like, "Well, what does, what does that mean?"
• 14:50
  So what are the mark- marks that you're looking for, uh, in a, in a particularly early stage company that hasn't done it before, that s- tells you that you can have confidence? Yeah, that's a really great question.
• 15:02
  Um, I think there's a few different ways I can answer that. I, I think the first is, like, honesty. I think that just being honest about what your capabilities are, um, and- I love it...
• 15:14
  um, like, whether or not, you know, you have, um, certain, you know, concerns. Uh, if we're working with a startup, um, there's clearly interest that we have in that company.
• 15:24
  I think at that point, it just makes sense to be open and honest about what your capabilities are, and maybe some of the, the challenges that you may have.
• 15:32
  Oftentimes, we'll work with a, we'll work with a company and, um, and we, we realize the fact that they're early stage. We don't expect you to have everything figured out, right?
• 15:41
  I think part of the, some of the value that we provide as an innovation team through either our Anthem Digital Incubator program or our Fast Track, Fast Track to Scale accelerator, is some of the hand-holding, um, that, that's, that's needed, you know, to scale within Anthem.
• 15:57
  So we try to do as much diligence upfront, you know, before we enter into a relationship to make sure that, um, you know, the, the company has what it takes to, to, to work and be successful within Anthem.
• 16:09
  And then, you know, through a, a small scale pilot, we then validate that.
• 16:13
  And I think it's during that pilot that we really see whether or not they have what it takes, and if they don't, uh, and we think that there's value, we try to keep that relationship strong, and we try to provide as much feedback and sometimes even investment to help get them to where they need to be, uh, and then to invite them back, you know, once they're ready to, to, um, to then start scaling with us.
• 16:32
  Omid, you said a minute ago that, you know,
• 16:35
  a company that you work with has to have the ability to scale, but there's certain things that you can sort of hold their hand on, and I think there's, you know, the devil's in the details.
• 16:44
  You know, what are the things that you gotta have, and what are the things that you can grow into?
• 16:49
  And something I like to ask guests is, um, for sort of non-intuitive wisdom around that, because I'm guessing people come in and they think, um, that they have it nailed, kind of what they need, what's table stakes, and what they can grow into, and yet there are probably some common, uh, misunderstandings that folks have.
• 17:07
  So I, I wonder if there's any trends that you've seen, maybe folks putting their emphasis too much in the wrong area, and you realizing, like, "No, this is a place where we can help you grow," uh, versus you gotta come with this already set.
• 17:19
  Is, is there sort of non-intuitive wisdom there? Yeah. I think, like, um... That's a great question. Um, I think one is, like, just assumptions. Like, are you making, are you making the right assumptions?
• 17:31
  What are your assumptions based off of? A lot of times, those assumptions are driving, um, the, the model, the clinical model, the s- you know, you know, various aspects of the solution.
• 17:40
  Uh, and oftentimes, you know, they're making those assumptions because they don't have access to, you know, data, or they don't have access to a patient population as large as ours.
• 17:49
  So, um, yeah, I think being, again, the whole i- i- idea of honesty, just being upfront about the assumptions that you're making and whether they're accurate or, or inaccurate.
• 17:58
  I, I think also just, just, uh, data security is, is really important to us, so we take, you know, the privacy and security of our members' data, like, incredibly, um, seriously. Yeah.
• 18:10
  And, um, I think that oftentimes is an area where, I know companies that are, they're smaller or earlier stage get tripped up.Uh, because there are certain standards that you have to meet.
• 18:20
  Um, and so, uh, I think doing a little bit of prep and, and research on, on what those things are, I think is, is certainly helpful.
• 18:27
  Uh, and you know, we, we walk through that process with the companies that we work with. Um, and oftentimes it's, you know, it can be a painful process sometimes.
• 18:35
  We try to not, not to make it as painful, uh, as, as possible. But there are certain, you know, standards that need to be met in order to, you know, work within Anthem.
• 18:44
  Something we talk about so much at StartUp Health is just the role of the founder mindset, uh, and how you think being as important as really kind of what you're building.
• 18:53
  And, and I, and I wonder if you could speak to the mindset of the founders that you're looking to invest in at Anthem. You know, I think people often ask, like, what, what do you look for, um,
• 19:07
  for folks that are joining the innovation team? And I think that it's, it's oftentimes the same answer I'd give to a question about, like, what do you look for in a, in a founder? And I think that's a high level of grit.
• 19:20
  Um, I think the, the thing you need to be successful, I think, in the healthcare system, and I, you know, Jamie's on the, on the line, you know, very successful entrepreneur, um, is, is grit.
• 19:30
  You have to have determination. You have to have tenacity. You can't give up, because there are going to be a lot of roadblocks and obstacles that are thrown your way.
• 19:40
  Um, but you have to, you know, stay focused on the impact that you're trying to generate, um, and those lives that you're trying to, to improve. I think that's, that's, that's number one.
• 19:51
  I think number two is also, um, again, it comes back to s- a certain level of honesty and humility with yourself, um, and with your product.
• 20:00
  I think that there's a lot of confidence that you can show in being open and honest about, you know, where the gaps are in your product and, and how you can work with a partner to fill those gaps.
• 20:11
  Uh, and, you know, I think that's something that, that we look for a- as well. Um, and I think, you know, there's als- you also need a certain level of detachment from your product as well.
• 20:22
  If you're too in love with your product or your solution, it's going to be very difficult for you to, one, receive feedback, but two, also to be able to pivot and make changes to your product so that you can ultimately, you know, drive greater uptake, uh, and success in the marketplace.
• 20:39
  Um, and so it's, uh, I'd say those are the probably the top three things that I look for.
• 20:45
  Uh, I, I love that last note because, uh, that kind of goes along with that counterintuitive, uh, wisdom idea that I mentioned before.
• 20:52
  The w- the willingness to be a bit detached makes me think of, uh, S- Stephen King's writing tip of being willing to kill your darlings.
• 21:00
  Uh, you have to be w- willing to, to extract yourself from, from the, uh, from the situation. Yeah. Another way of saying it is that you gotta be able to call your baby ugly. Mm.
• 21:09
  A parting piece of advice for a, a founder, uh, navigating, uh, the healthcare landscape today. Uh, what, what, what's your last word?
• 21:18
  You know, the, the insight is, you know, just to remember the impact that you're trying to generate.
• 21:25
  Like, every day when you wake up and you, you go to work, like, think about the lives that you're trying to change, the impact that ultimately your work is going to, is going to lead to.
• 21:35
  'Cause I think that so often we get tied up in the day-to-day, right?
• 21:39
  There's a lot of stuff that we have to deal with, like you're, you're fundraising one day, the next day you're trying to, you know, secure a deal, the next day you're trying to apply to get into an am- amazing program like StartUp Health.
• 21:50
  Um, there's so much, you know, practical stuff that we get tied up in. So just at the end of the day, at the, at the beginning of every day, you know, focus on, you know, what your, the end goal.
• 22:00
  Um, that's certainly what I do.
• 22:02
  Uh, and, uh, that, that should help you, you know, get through the challenges of, uh, of, um, uh, of working with, you know, of navigating the healthcare system and trying to, you know, achieve scale.
• 22:12
  [gentle music] Beautiful. Well, Omid, I, I echo all the thanks that are coming in on the chat right now and say thank you so much for taking the time with us today. We know you're busy as well.
• 22:22
  Thanks for the opportunity. Take care, everybody. Thanks for listening to StartUp Health NOW. StartUp Health invests in health transformers from around the world who are committed to achieving audacious health moonshots.
• 22:35
  If you want to learn how you can join this community of entrepreneurs, or if you want to connect with one of our 380 companies, go to startuphealth.com.
• 22:43
  If you'd like to learn how you can invest in our Health Moonshot Impact Fund, in collaboration with AngelList, go to healthmoonshots.com. Thanks for listening to StartUp Health NOW. We'll be back next week. [outro music]