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Born from Experience: How The Care Hack Is Fixing the Caregiver Crisis · StartUp Health NOW Podcast

• 0:00
  [on-hold music] Hello. My name is Unity Stoakes, co-founder at Startup Health. Today, we have another inspiring conversation with a health transformer in our community who's part of the Caregiver Moonshot.
• 0:17
  Mitul Desai is the co-founder of The Carehack, and he's really building something extraordinary and quite meaningful to help people, caregivers specifically, who really have a great need and s- of support during their journey of helping people in their life who have mental health needs, people with dementia, people with Alzheimer's, people with behavioral health needs, and specifically building a whole platform and infrastructure for the caregivers out there who are really one of the backbones of how care gets delivered today.
• 0:55
  And there just is a huge gap in this area. Looking forward to talking with Mitul and learning about what they're building at The Carehack, what's still needed, and where we're going.
• 1:06
  So stick around for a meaningful conversation and a little bit more about the Caregiver Moonshot from Startup Health. Thank you. Hey there. How are you? Hi, Mitul. How are you, sir? I'm good. I'm good. And yourself?
• 1:20
  I'm great. I'm grateful to connect with you today. How are you doing? I'm doing, my friend. I'm doing well. I'm taking a much needed vacation later this weekend. I'm going to Barcelona, so I'm looking forward to that.
• 1:32
  So I'm really looking forward to this break. Oh, I'm so happy you're getting a break. Yeah. How long will you, will you get away? It's only nine days. It's better than nothing. Yeah. So do me a favor.
• 1:47
  Take your email off your phone- [laughs]... the news off your phone, take the social media off your phone. Yeah.
• 1:53
  Just leave your phone in your bag or, and give yourself the break and the opportunity to just totally disconnect. I appreciate that. Yes, for sure. I will try. Yeah. Um- Tell me about, more about you.
• 2:08
  You and your co-founder are building something really extraordinary and meaningful with The Carehack.
• 2:16
  I wanted to have kind of a meaningful conversation to learn more about your background, the genesis of why you and Eli cr- are creating The Carehack, and then, of course, what the mission of The Carehack is.
• 2:31
  You guys are really important founding members of the Caregiver Moonshot.
• 2:37
  I think the work you're doing is serving the world in an area where, quite honestly, there's still a huge need, a big gap, and there's these caregivers out there who, as just have not had the resources or support, it just hasn't even been a category, uh, almost.
• 2:56
  But let's start with you. Yeah. Tell us about you and your background. Yeah. Let's start with that. Sure. Professionally, I have worked across healthcare tech and policy.
• 3:08
  Spent many years on, on the business and the legal side of healthcare and, and then through some work I'd been doing on the side and kind of a, one of my life's dreams was always to serve my country.
• 3:20
  I got to serve in the Obama administration, went down to DC to do that, which was incredible. Came back to New York City, rejoined the private sector, and spent five years at MasterCard.
• 3:30
  I did three, three roles in five years, which was, like, much, much more pure kind of PNL, people management, sales, product roles, which is what I wanted because I knew eventually in the back of my mind I was gonna build something.
• 3:43
  I didn't know what I was gonna build, and that all I knew was at a high level. I was sick and tired of what my family was going through in private, which was that when my younger brother was diagnosed with schizophrenia
• 3:56
  many years ago, it was devastating for him, but also overnight, me and my parents were handed this new job. And while my brother had doctors and nurses who tried to help him,
• 4:06
  with not much success, at least he had people trying to help him. We had Google, me and my parents, that's it. And over time, you know, that elevated chronic stress with no help takes its toll. It caught up with me.
• 4:19
  It caught up with my parents. It almost broke our family, frankly, emotionally. Spent hundreds of thousands of dollars out of pocket, a whole thing, right? We're not the only one.
• 4:30
  And as I started to connect these dots, meaning the impact not just on my brother, but on my family, it started to build, if I'm being honest with you, like a rage inside of me that I couldn't, could no longer bear doing nothing about it.
• 4:42
  It would be the thing that when I allowed my mind to dri- daydream on Sunday evenings, it would always go to this, like from my ear- first job as a patent attorney, it would go, "You're gonna do something in mental health," and I had no idea, and it's, that's your soul speaking to you.
• 4:56
  Your soul knows. You just have to have the courage to actually listen and act on it, and I did.
• 5:03
  I hit the five-year anniversary, my five-year anniversary at MasterCard, and I thought another five years could go on, another five years could go on, and that'd be great, but is that really what my purpose is on this planet?
• 5:14
  And it was a very strong no. And I-- so I quit my job and- Was that like a scary moment, a scary decision? Extremely. Extremely scary. I had...
• 5:26
  I couldn't sleep for the few months leading up to the decision, and then after I made the decision, couldn't sleep for another few months. Waking up in the middle of the night, w- am I really gonna do that?
• 5:36
  And then after quitting, did I really do that? And yes, for sure. But s- something inside of me just pushed past that and was like, "This is what you, you have to do."
• 5:47
  And then eventually, I started to get little signals that it was the right decision because I had never talked about, by the way, my family struggles to anyone, and I pushed myself to talk about it 'cause I knew that was step number one, is to be authentic
• 5:59
  about it.
• 6:00
  And the minute I started doing that, I would get-Periodic responses from people who I had known for a long time who would come to me and say, "My family is also struggling with mental health," or, "My kid," or, "My partner."
• 6:12
  And that to me w- these are all things I never knew. Th- that was to me is a light bulb moment.
• 6:16
  It's like you just need to give permission to people, not just to share their story, but to seek help, because talking about it is the first step to getting help.
• 6:25
  And getting these little signals and then I knew I had to fill a gap in my experience, which was on the, quote unquote, there's interventions outside the medical system, right? As, such as it is.
• 6:37
  I knew all about the medical model. I knew all about drugs and therapy, my, through my brother and all the things we've tried.
• 6:44
  I really didn't know anything about peer support or psychosocial rehabilitation or family support or all these other things which I learned later are proven to be highly effective.
• 6:56
  And so I spent over four years working with, sorry, over three years working with an organization called Fountain House, which pioneered a community-based recovery system for serious mental illness.
• 7:07
  So they started in Manhattan, 10 blocks from my house, and over 75 years have grown to have 300 plus locations around the world, and think of it as like a Boys & Girls Club for serious mental illness.
• 7:19
  So they provide all the things that society rips away from people with serious mental illness. They give them dignity and agency and choice and hope, and it's a place where your absence is missed,
• 7:31
  which is completely unlike the rest of society with these folks. And that, these were all just...
• 7:37
  I had, like, light bulb moment after light bulb moment as I was working with them and I was there, by the way, trying to help them digitize this in-person model. Hmm.
• 7:47
  All highly relevant experience and insights w- would, for what I would go on to do next, which is I thought, "Okay, so what is... What do I wanna do?"
• 7:56
  Like, I quit this well-paying job and a corporate career track, and this is great, this consulting stuff is great, but what do I wanna do? And I found the problem that I am in love with, which is helping families.
• 8:09
  And this is so classic, right? It's the problem that's, it's the thing that's staring you in the face. It just, you just have to go on this, like, journey before you end up where you started.
• 8:17
  And so that's what I decided to do. I got connected through a mutual friend to Eli, my co-founder, who's a community psychiatrist. Was this in New York City or- Yeah. He's also in New York City, yeah.
• 8:30
  And we started to do some research, and we realized there's 30 years of evidence showing that the right kind of family support leads to better outcomes and lower costs.
• 8:40
  It just, it's just stuck in research papers and isolated kind of clinical settings and some non-profits do it. NAMI namely, I'm on the board of NAMI New York City. They're great.
• 8:51
  There's a lot more families that need to be reached. And so that was our... We were just off to the races then and we did the whole thing.
• 8:58
  We interviewed, did a bunch of customer discovery with hundreds and hundreds of families, built an MVP and, and yeah. Is there... Had you set up a company yet called The Care Hack?
• 9:09
  Or talk about kind of the genesis, and then describe for all of us what The Care Hack's mission and purpose is so we get a good understanding of what you're bringing to life. Yeah. Our...
• 9:22
  So it's the, our healthcare system could not function without caregivers, yet it gives them no support, and so our mission is to change that and to
• 9:32
  bring families closer to the center of care because it's not just the right thing, but it's the smart thing to do for all stakeholders in the system.
• 9:42
  An overwhelming majority of individuals with chronic cognitive illnesses, so think mental illness, dementia, Alzheimer's, live with their families.
• 9:51
  So these family caregivers know so much more and do so much more than the healthcare system.
• 9:58
  And so we give them the tools and the training and the support that they need so they can be more effective and efficient caregivers, which improves their lives as well as the lives of their loved ones and saves costs and improves outcomes.
• 10:10
  And, and the way I look at it is these caregivers are almost like a second healthcare system that are currently, there's no infrastructure to support them.
• 10:19
  They're operating outside of the primary healthcare system, but that makes no sense. So we provide the infrastructure and the support to integrate families into the primary healthcare system benefit.
• 10:30
  The, these, this second system, these are our brothers and sisters- Yes... and mothers and fathers and children. It's all the people in our lives around us who are taking on this role. I think
• 10:44
  y- you hear this word caregiver and you think, "Oh, it's some, someone went to college to become a caregiver or-" Yeah. "... went to medical school or..." But it's all of us. It's all of us.
• 10:56
  And it's also, whether we like to admit it or not, there's still some, there's some cultural sort of feelings around this where caregiving is seen as a private family affair. It's not seen as what it
• 11:11
  actually is, which is a clearly a healthcare and an economic activity. And so there's a sort of a, the need to change hearts and minds around this too.
• 11:21
  There's obviously underlying stigma with these illnesses as well, right? Serious mental illness, even Alzheimer's and dementia, and there's a couple of barriers that these families have to go after. Yeah.
• 11:34
  And then so you created The Care Hack, and how do you describe the mission of The Care Hack today?
• 11:41
  So our mission is to empower what we call cognitive caregivers with the expert tool, tools, and guidance they need so they can be more effective and ef- efficient caregivers, thereby improving outcomes and lowering costs.
• 11:57
  And we focus on what we call cognitive caregivers because it's the highest unmet need, but also the highest leverage point.Meaning these are the caregivers with the highest caregiver burden.
• 12:08
  Think of a, think of someone caring for their dad with dementia or a kid with a mental health issue. That caregiver burden is higher than any other caregiver burden, and so they need the most support.
• 12:18
  But again, once you support them in the right way, the ROI is outsized. So how would a family get access to this, and how does the business model work? Is it- Mm...
• 12:29
  does the family pay for it, or is it, uh, it, it provided by insurance or a- Yeah... Medicare situation? Describe that a little bit. Yeah, so we don't want-- we don't really-- we're not charging families.
• 12:42
  We don't plan to ever charge families. We're focused on selling to providers and payers, and the business case for both is very strong. We are currently, um, engaging with large behavioral health private practices,
• 12:58
  and there's a couple of reasons why they're interested. One is family support is proven to reduce patient no-shows, so it protects revenue. It also enables access to new revenue.
• 13:09
  There's these new billing codes that Medicare has put out starting in actually January 24 around where caregiver training is reimbursable, and our platform enables that.
• 13:21
  There's also a strong case to be made that when you support families, there's more patient engagement with care, and so they keep their patients, right?
• 13:29
  It's not just that they show up to the appointments, they actually stay. You know, these practices have a lot of churn. So there's a whole lot of elements to the business case for providers.
• 13:39
  And then, of course, if we're talking to hospitals, big hospital systems, they want these patients to engage with the right type of care, right?
• 13:46
  So the right type of outpatient care as opposed to going from crisis to crisis and meds to beds, meds and beds type approach, right?
• 13:54
  And then if we talk about Medicaid clinics, for example, FQHCs or CCBHCs, they actually know their mandate is holistic, comprehensive, integrated care, and you cannot do that if the families are not involved.
• 14:06
  And in fact, a certain class of these Medicaid clinics are actually required to provide family support. So that's the provider ecosystem.
• 14:12
  I should say there's also some interesting conversations we're having with specialty pharmacies.
• 14:18
  So if you think about the teachable moments where c- when families are most incentivized to seek support, picking up a new prescription is one of those teachable moments. Mm.
• 14:28
  Getting a prescription changed, teachable moment, right? So we're partnering with specialty pharmacies to leverage that teachable moment to get folks using this app. And then payers is a very clear-cut business case.
• 14:43
  Family support is proven to keep their loved ones out of the hospital. You reduce just one hospitalization, that-that's more than enough money to, to justify a contract. And so that's the case with payers.
• 14:56
  We're starting with the regional payers, as you can imagine, before we go to the big ones, and we are very excited about actually a conversation that we're having with a regional payer, where there's internal champions who get what we're doing.
• 15:08
  Well- I should say on the employer side, just to round out the class of potential business customers, we're having early conversations- It's like a huge way to help your employees and team members- Exactly...
• 15:22
  who are going through these things. It's probably a huge stressor, takes a lot of time away from work and all of these things.
• 15:28
  The more access they have to resources to un-unburden them, I think would be a driver- Hundred... of productivity. Hundred percent. Hundred percent. Caregivers are also they-- when you're a caregiver, you develop
• 15:42
  problem-solving skills, grit, empathy. Those are the skills you want in your employees, right? So these are employees you wanna keep, actually. Mm.
• 15:52
  So there's a lot of reasons why employers, I think, will eventually understand the value of caregiver benefits on this. Yeah.
• 15:59
  What do you-- what does the world need to know about caregiving today, where we still need to get to, and what you all are doing to change that? I think
• 16:14
  it's just quite clearly to me a gap in understanding, and also there's just not a spotlight that's been shined on what you're- Yeah... doing or people like you are doing. What does the world need to know? Yeah. I think-
• 16:35
  And you had to learn this with your family- Oh my God... the hard way over years and just dropped off in this new world. Yeah. Uh, like you said, you had nowhere to turn but Google at the time. Yeah.
• 16:47
  I don't know how many years this goes back, but what's-- has it- Yeah... gotten better since, since then, and where do we still need to go? Yeah.
• 16:57
  So I think it's gotten better in the sense that there's more public awareness of caregiver, family caregivers and what they do, for sure.
• 17:05
  So there's, if you think of it in terms of tailwinds, there's more public awareness. There have been some important policy discussions around this. Reimbursement
• 17:16
  is for caregiver training, is, that CMS announced is a good shift. There's, there are folks talking about and working on how to use tech to support caregivers.
• 17:29
  I've been contacted by a couple of really top-notch VC funds, so I think people are seeing it as an investable space also, which is obviously important.
• 17:39
  And there's a small but growing number of folks in the healthcare system and in the employer world that understand this. So we just need to
• 17:48
  leverage these tailwinds and keep pushing while also, I think, educating folks that it doesn't require a lot of extra work on the part of clinicians, at least the way that our platform works.
• 18:02
  A lot of times providers are provided with new solutions, and they're like, "We don't have the time to learn new app. We don't have time for any of this." We designed our solution with all of that in mind.
• 18:12
  It does not require extra time on the part of providers. And payers wanna know the economic business case, right? And so we have that too.
• 18:21
  I think-So I think it's really about capitalizing on these trends, convincing the healthcare system that it doesn't require a lot of extra work, and that there's a clear value prop. But it also
• 18:32
  will involve lifting up these caregivers so they can embrace their voice, so they can also be advocates in ways small and large.
• 18:42
  And so when they show up to the doctor's office with their loved one, they can respectfully, in an informed way, ask the right questions and provide information that shows value to the doctor.
• 18:52
  It are all-- it's all these little micro interactions that we wanna spark that we think will create a movement and realize the vision that we're trying to go after.
• 19:01
  Can families today get access to Carehap-- the CareHack app? Where do they do that? How do they find you? That there's-- I know there's a whole generation of people that need this today. They need it yesterday. Yes. Yes.
• 19:17
  Where do people go? Yeah. So they can register for our app for free at app.thecarehack.com. They can also check out our company website, which has a bunch of really useful blogs on it. That's thecarehack.com.
• 19:33
  Encourage folks to go on both and ask us questions. We're always-- We make a point to talk to at least two or three families a week. We don't wanna lose touch with the people who we are ultimately serving.
• 19:46
  And who in the industry do you want to connect with to reach out to you? We need to get this out to the world. You mentioned some funders, and VCs, and investors are already reaching out.
• 20:01
  I'm sure that's a welcome reach out. What other types of industry leaders are you trying to connect with that can really change the game? You mentioned specialty pharma. Who are you trying to meet and network with? Yeah.
• 20:15
  So, you know, we'd love to hear from beha-behavioral health private practices. We'd love to hear from large hospital systems. We'd love to hear from regional payers.
• 20:27
  Uh, these are all folks that are-- understand this, see the value, and are nimble enough to move.
• 20:32
  And I should say, we are also doing a, a bridge round with strategic angels, and so we're always looking for angels who have either some personal connection to this or some sort of experience or expertise in the healthcare industry.
• 20:46
  Yeah. We-- Any families out there who are caregivers or understand the need, please reach out to Mitul. This is something that the world needs in a really big way. Walk us into the future.
• 20:57
  D- paint a dream vision for us of, of you've-- you're dedicating your life to this. You left a extraordinary career to this really exciting, inspirational career.
• 21:12
  Paint a picture of what you will accomplish and your vision for the future here with ju- not just the CareHack, but let's say the whole movement around supporting caregivers. Yeah.
• 21:26
  So the home run version of this is, I would say, twofold. So one is our platform becomes the go-to platform for
• 21:37
  family support, for cognitive caregivers, meaning mental illness caregivers, dementia caregivers, and beyond. And in that home run scenario, families win, yes, but health systems win and payers win.
• 21:52
  And in parallel, I would love to see society reframe the way they look at families and caregiving, not as a private family affair, not something that's done by just moms, right?
• 22:09
  It's actually the diversity, the demographics are changing. A lot of people are caregivers now. Millennials, more men are caregivers. It cuts across all demographic classes.
• 22:18
  So with that awareness that it's not a private family affair, that it impacts everyone, to lift up and empower caregivers as contributing core economic activity and people that deserve respect and recognition, so that in the future, someone like me wouldn't have to hide that they were a caregiver, that they would actually feel proud to say that they're caregiving for a loved one.
• 22:45
  What more purely selfless activity is there, really? What more important activity is there? Mitul, we're just so grateful that you're one of the founding members of our Caregiver Moonshot.
• 22:58
  You, you cross over to so many of our Moonshots. In fact, our Alzheimer's and Brain Health Moonshot is relevant to this because caregiving is such an important area there.
• 23:07
  But just access to care in general, this is-- it really spans the need across our health as families and people and our healthcare system.
• 23:17
  So we're just so grateful that you're, you and Eli are dedicating your lives to this work and building an extraordinary company. We're here to support you.
• 23:27
  You're just a tremendous part of the Health Transformer community. Any parting words or of wisdom or anything you wanna make sure the world knows?
• 23:35
  This will be the first of many conversations, by the way, that we'll have, but we-- I just wanna make sure that people, A, know how to reach you and know what they need to know, so we can really speed up what you're doing more quickly because it's urgent.
• 23:53
  Yeah. Thank you. I would say our company is at a very important inflection point. We have our product. We have all this incredible user feedback and usage. We are contracting with providers.
• 24:05
  We're in discussions with payers. We are, this week, going to be announcing a partnership with
• 24:13
  McLean Hospital, which is affiliated with Harvard Medical School, which is actually the nation's top psychiatric hospital, and we're really excited about that.
• 24:22
  That's gonna just strengthen the clinical foundation of what we're doing.
• 24:27
  And so with all of these tailwinds behind us, we are really looking for not just partners, but funders to make sure that we leverage and maximize this inflection point. So that's what I would say. Yeah. All right.
• 24:40
  It's a great time to reach out and partner with us. And in the meantime, take a few days off on your much- [laughs] -time off in Barcelona. We're gonna be thinking about you and sending good vibes your way. Thank you.
• 24:53
  And sa-safe travels to you and your family. Thank you. Thank you, sir. Appreciate this. All right. See you soon when you get back. Okay. Thanks. Have a good one. Bye. Yeah. Bye.
• 25:03
  [outro music] And finally, an invitation to all of the extraordinary health transformers, whether you are a startup, someone building the future of health, or whether you are an investor, funder, or buyer of the solutions out there in the marketplace, this is an invitation to you to join the Startup Health member community.
• 25:27
  Learn more at startuphealth.com. Look forward to hopefully seeing you soon.