May 1, 2025 • 43 mins
“We exist to solve prior authorization so patients can get the care they deserve,” says Dr. Jeremy Friese, founder and CEO of Humata Health. Friese joins Bloomberg Intelligence health-care analyst Jonathan Palmer to discuss how Humata’s AI-driven technology is transforming one of health care’s most notorious administrative headaches. They cover how Humata connects deeply into medical records, helps both providers and payers streamline approvals and is expanding into specialty pharmacy. Friese also shares his journey from Mayo Clinic radiologist to serial entrepreneur — and why he believes solving back-office burdens can unlock better patient care.
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Episode Transcript
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Speaker 1 (00:17):
Welcome to another episode of Boomberg Intelligence Vanguards of Healthcare podcast,
where we speak with the leaders at the forefront of
change in the healthcare industry. My name is Jonathan Palmer,
and I'm a healthcare analyst at Bloomberg Intelligence, the in
house research arm of Bloomberg. We're very happy to welcome
doctor Jeremy Freese, founder and CEO of hum Out of
Health to the podcast today. He's an interventional radiologist by training,
(00:40):
and he had a storied career at the Mayo Clinic
before setting out the tackle industry, where he's been a
serial entrepreneur ever since. He previously served as a president
at Olive after selling one of his earlier ventures to
the company in a successful exit. I'm really excited to
learn about his latest foray into the intersection of healthcare
and technology. Humant of Health, thanks for joining us.
Speaker 2 (01:00):
Today, Jeremy, Morning, Jonathan, great to be here.
Speaker 1 (01:02):
Well, why don't we dive right in? I mean, maybe
a simple way to summarize what humanity does is what
is your mission statement? In a couple of sentences, we
exist to solve prior authorization so patients can get the
care they deserve, and to do that you've you've got
to be on what we like to say, on both
sides of the fax machines, sofully helping solve this problem
for both providers and payers. All right, So let's define
(01:23):
prior authorization. I'm thinking about my mom listening to it
the way person. Where does prior authorization fit? I guess
in the grand ecosystem of our very complex, tangled web
of healthcare.
Speaker 3 (01:34):
Yeah, so prior authorization has been around for decades and
it's this process where you and your doctor decide what
needs to be done, either an imaging test or a
surgery or something, and then for a certain list of
those items you have to get quote prior authorization, so
(01:55):
permission payer. You need to get permission from the payer
in order to be able to do that. See if
it falls within the covered benefits for that you know,
for that particular patient, And you have to do that
before you deliver the care, because if you don't do
that and you deliver the care, then you, as the.
Speaker 2 (02:13):
Provider and the patient get stuck with.
Speaker 1 (02:16):
You're on the Coppy bill on the maybe talk about
the evolution of primary authorization. You know how common was it?
I don't know what the right timeframe, is it ten,
twenty thirty years ago? And why is it such a
sticking point today?
Speaker 2 (02:29):
So it's always been a sticking point for providers.
Speaker 3 (02:32):
It certainly has sort of you know, gotten to the
forefront of the you know, the of what the public
is seeing. So it's always been around and it's always
you know, been an issue. It is one of the
key levers that you know, that insurance companies can use
to help control costs. And so while I don't have
a stat to say, you know, ten years ago there
(02:53):
was this many and you know last year there was
X times that it certainly is more common. And the
other thing is true is that the reason it's become
so much more complicated is because there's so many players,
uh and and so and so many different ways of
(03:15):
going about doing this. Historically it was usually solved by a.
Speaker 1 (03:18):
Phone call or the facts or the facts machine. Facts,
the ubiquitous facts machine of healthcare, I mean.
Speaker 3 (03:23):
The only industry where it still exists. And so it
really has you know, it's become a really difficult web
for providers and patients to to try to try.
Speaker 2 (03:33):
To deal with.
Speaker 1 (03:34):
So if we rewind a little bit, you know, a
doctor fills out this prior authorization, sends it into the
insurance company. What happens at that point, you know, I
assume they either pass it or they reject it. What
are some of the common reasons for some of the rejections?
Speaker 2 (03:50):
Yeah, So, so.
Speaker 3 (03:53):
The process is just as you've said. Sometimes it's you know,
me as a doctor. Usually it's you know, my nurse
or some some administrauble chinstrative office person that would send
it in. And then you know, you either send it
through a fact you go through a portal, sometimes you
make a phone call. Once it gets shipped over to
the payer, then an army of humans on the payer
(04:15):
side also has to review that information that was sent
across and compare that with their medical policies, so with
that particular patience policy to say is this covered? And
if the answer is yes, then you know, what are
the sort of rules of the game. And that's a
human that's reviewing medical policy and reviewing the clinical information
(04:36):
as well as the other information that's been submitted like name.
Speaker 2 (04:40):
Day to birth.
Speaker 3 (04:41):
Just makes you know, make sure you know the you
know the you know who the member is. And so
the main I mean, there are lots of different reasons
for these to get denied. I'd sort of put them
into two main buckets. The first bucket is the right
information hasn't been sent over to the payer.
Speaker 1 (04:57):
And so that seems like an easier one to solve that, and.
Speaker 3 (05:00):
You know, that's what that's what we solve with technology,
making sure the right information gets over to the pay
or either clinical information or the non clinical information.
Speaker 2 (05:10):
Or it could be the REA.
Speaker 3 (05:12):
I mean, the reason it would be denied is that
all the right information has come across, but for that
particular patient doesn't meet the medical policy criteria to say
it's within this person's plan to get approved.
Speaker 2 (05:26):
And so it could be.
Speaker 3 (05:27):
Denied because you don't have the right info, or it
could be denied because you don't have the right info
because the patient just doesn't meet the criteria.
Speaker 1 (05:34):
Understood, and then I understand that. You know, the following
process to that is typically an appeal from the provider
usually or maybe they just drop it. I don't know.
Often is there any rules of thumb around how many
go to appeal versus just get dropped.
Speaker 3 (05:49):
More often than not, it just gets dropped, really and
the and the physician will say, you know what, instead
of doing the CT I'm going to do the ultrasound
or you know, instead of doing the surgery, well, we'll
do some kind of conservative therapy.
Speaker 2 (06:00):
But if you know, if.
Speaker 3 (06:02):
The doctor and patient do feel strongly this is the
path they want to go down, you know, then then
it goes through an appeal process, and that usually means
sending back more information if it's available, and then the
you know, the pair would review that additional information, often
oftentimes requires again going.
Speaker 2 (06:19):
Through facts portal or some other way.
Speaker 3 (06:22):
Oftentimes also requires a phone call, and then if if
the appeal isn't approved, then that would lead to the
next step. It's called a peer to peer and the
peer to peer means me as doctor talks to doctor
on the other side, So a doctor on behalf of
the insurance company, and then you have a conversation and
(06:44):
say this is why I think it should be done.
Doctor on the other side says, well, you know it
doesn't meet criteria because of a B or C or Yeah,
I understand, and let's end, and you know I'll approve it.
Speaker 1 (06:55):
Yeah. So I think we're assuming that everybody has the
best intention in those in those conversations as well, and
I think we know there's a lot of friction and
conflict in the system as well, which maybe we'll talk
about waiter. But so we set the table around prior off,
you know, where does Humota come in to maybe help
solve this problem or bring it into the next era.
Speaker 3 (07:14):
So solving this problem requires a lot of blocking and
tackling connectivity because every every payer has a different way
of submitting SURE, and every provider houses all of their
information in a system of record, a medical and an
electronic medical record. And so what we do is we
(07:38):
connect deeply into the medical record so that we really
an or whatever it might be, you know, whatever whatever
the system might be, and then we help the provider.
We say, we're in the business of yes, okay, so
we help the provider understand the information that the payer
needs so that we can then on their behalf, using technology,
(08:00):
pull the right information from the medical record and using technology,
submit that information over to the payer whatever way the
payer needs to get it, through a portal, through a
fact through a through a direct API connection. And because
we've done millions and millions of these, we understand what
is the information that the payer generally needs in order
(08:21):
to get to a yes if it's available, and so
if it's available in the medical record, we use artificial
intelligence to comb the medical record, find the right information
and then ship it over to the payer using technology
instead of that process today is mostly done by humans.
Speaker 1 (08:36):
Got it? And when did you decide that you wanted
to tackle this problem? You know, let's let's maybe talk
about your origin story a little bit and your journey
from being a radiologist into being an entrepreneur and deciding
PA is the place I have to go?
Speaker 2 (08:51):
Yeah, I'm so.
Speaker 3 (08:53):
I say that I'm a recovering radiologist, maybe a radiologist
with a with an entrepreneurial problem. So I I would say,
I've been on this journey around prior authorization for a decade.
So I had their you know, I had the great
fortune of practicing medicine at the Mayo Clinic, first training
for ten years it takes a long time, and then
practicing for ten years, and during that process ended up
(09:13):
helping run our radiology business. And so where there's a
lot of half of all prior authorizations are imaging related,
and so we were doing you know, literally hundreds of
thousands of these every single year, and so it was,
you know, partly my problem to try to try to solve.
As a provider at you know, running this large group,
(09:36):
I would also say, so I was an interventional radiologist,
every single patient that I would do a procedure on
required prior authorization. And so yeah, you know, from the
earliest point, I've been dealing with this with my nurses,
you know, since the beginning of my practice days. And
I would say, nobody teaches you that stuff in medical school,
(09:57):
like that's kind of what the on the job training
is about being doc. And you know, frankly, we tried
to hire a bunch of consultants and other folks to
help us improve the process, and it just became very
very clear to me that it is a problem that
requires technology, not more humans.
Speaker 1 (10:15):
So if you go back to those days when you're
working at Mayo, were service providers helping you? Were there
companies who were coming in with services or solutions to
help you manage this.
Speaker 3 (10:26):
So this was now nearly ten years ago, and the
answer at that time was a very clear note. And
so you could hire consultants to try to help you
improve your processes, but honestly it was done by post
it notes, really Excel spreadsheets, large folders where you would
keep track of this CPT code needs a prior off
for this payer, this one doesn't need. And so that
(10:47):
just reams of paper and frankly armies of humans that
were trying to keep track of all of these rules
and all of the yes' is you know what requires
what doesn't because there wasn't a technology solution. It was
it was really that impetus that led to the realization
that wow, this is this is a problem that if
we can solve this back what I would say, this
(11:09):
back office BS problem, doctors could be doctors, and nurses
would be nurses, and patients could get the care they deserve.
And so that's we've been on this mission.
Speaker 1 (11:17):
I mean, is there if you think about it, is
there amount of time that you think of the average
doctor spends on PA or maybe his staff or her
staff spends on spends on PA.
Speaker 2 (11:27):
It's hugely variable because.
Speaker 1 (11:29):
Depending on what you're treating, right.
Speaker 3 (11:32):
Depending if you're a primary care doct or a specialist
or whatever. But you know, industry data would say doctors
spend on average eleven hours a week dealing with this,
which is pretty insane. I'm not I'm not sure that
I well, yeah, you're not practicing at the top of
your license for those eleven hours, not at all. And
(11:52):
I mean, I'm I would say my practice, I didn't
spend eleven hours, but whatever it is, I mean, and
if it's an hour or two, that's an hour or
two that you should have been either taking care of
your patients or at home with your kids.
Speaker 1 (12:08):
No makes sense. So we have the technology, or I
think we have the technology to solve this problem. Can
you talk about building that technology stack and what you
actually have to build to tackle this problem?
Speaker 2 (12:19):
Yeah? You know.
Speaker 3 (12:20):
So the way I think about the problem is if
you're really going to solve it, a provider wants a
solution that's going to help with all my specialties I say,
all my ologies, Okay, cardiology, orthopedicxology, radiology, et cetera. And
you want it to be a solution for all your payers.
And so you don't want to have one technology that
(12:42):
works for United but doesn't work for the Blues as
an example. So you want it to you want it
to handle all your payers. And then this process of
prioritization involves you know, ten different steps, and so you
want it to help with all of those steps. And
so that you know there are a bunch of things
that you can do where you could, you know, just
help one specialty, or just help with certain payers, or
(13:02):
just help piece of the puzzle. The way we think
about building, the way we've built our solution is to
help with all ologies, all payers, and from beginning to end.
And so to be able to do that, there's a
lot of really kind of mundane blocking and tackling, connecting
into payers, interfacing with portals, connecting into the medical record.
(13:24):
That's sort of the blocking and tackling work. And then
there's the sexy artificial intelligence stuff where you've got to
comb through massive amounts of unstructured data, both clinical data
and non clinical data, and understand what pieces of information
the payer actually wants so that they can make an educated,
(13:47):
knowledgeable decision. And so we use AI to comb through
the medical record, comb through all of that information as
well as historical yeses and the information that led to yes,
and then we submit that right information through all those
pipes that we've either partnered with folks.
Speaker 2 (14:05):
Or built ourselves.
Speaker 1 (14:07):
Maybe just a quick question therese I think I understand
the unstructured data from the provider side. I'm thinking about
notes and all that sort of stuff that could be
in any sort of form. And all these disparate data sources,
is it also instructored on the provider or the payer
side as well?
Speaker 2 (14:24):
Absolutely?
Speaker 1 (14:25):
And so and what's an example of that.
Speaker 3 (14:28):
So they're really sort of two pieces of mostly unstructured data.
There's the there's the medical clinical information as well as
the metadata around the patient. And then there are these
policy the policies, and so you know, a pair will
usually you know, show to a provider, make available to
a provider for this CPT code for this patient member.
(14:51):
Here's a twenty page document that.
Speaker 2 (14:55):
It could be a few pages.
Speaker 3 (14:56):
There are some that are up to one hundred pages
long that are these that a provider would need to say,
you know, does my patient meet this criteria? And that's
the work that the human on the payer side is doing.
They're they're reading this medical policy and they're looking at
the unstructured clinical information that's coming across the facts or
(15:18):
however it comes, and then they're saying, does the clinical
information submitted match this unstructured medical policy that we have
on our side?
Speaker 1 (15:25):
Okay, gotcha. So you guys are a relatively new company
twenty twenty three. I think as you're founding, how have
you what have been some of the milestones in your
relatively new journey, you know, what have you had to
build and what are some of the early successes you've
had with with clients on either side.
Speaker 3 (15:41):
Yeah, so we you know, we our focus has been
on solving the problem for providers and so we've you know,
we've been building for a couple of years. We also
bought some assets, bought some technology that allowed us to
jumpstart some of this work as well. And so you know,
we now have north of two hundred hospital is using
the system to help them. For most of them start
(16:04):
in certain specialties and then and then expand.
Speaker 1 (16:06):
There's a way and and expand you start in cardiology
or imaging, whatever the big buckets are, and then.
Speaker 3 (16:11):
Exactly and so that you know, we just feel really
really proud of the work that we're doing with these
with these provider customers to help them, you know, submit
millions of these things every year, and that's millions of
patients that we're turning the prior ofth out dramatically faster
then would be done if it was a human And
we're you know, like I said before, we're in the
(16:32):
business of yes, and so we're getting the right information
over so that are our provider customers. You know, they
usually don't know what their success rate is before we
show up because it's very difficult to track. But you
know what we see as we start to work with
them over the first several months is they start to
get approval rates in the very high nineties up to
ninety nine percent. Oh wow, which which means that there's
(16:53):
no more of that back and forth that we're talking
about at the beginning. And it also means that patients
are getting you know, they're getting the s and they're
getting the care that their doctor thinks they they should.
Speaker 1 (17:03):
No, that's great. I mean, I'm sure it's everything under
the sun, But what what sort of solution are they
most of your current customers, what were they using before
they started using Hamada? Were they using another provider? Are
you displacing somebody or was it still this very manual
process for most of them?
Speaker 2 (17:18):
For the most part, it's a manual. Yeah, it's it's
a they're all using the old post it notes, you know, spreadsheets,
et cetera. There.
Speaker 3 (17:26):
You know, there are some groups that do outsourcing for
prior authorization as well as a bunch of other sort
of reb cycle back off of stuff for healthcare providers,
and so some of them, you know, use those outsourcers,
but for the most part, either you know, it's done
by a human that they've outsourced it to, or it's
a human that they you know, pay and have as employee.
Speaker 1 (17:49):
So is the competitive landscape fragmented or or is it
still just this legacy legacy workflow? Yeah, maybe I'm not
asking the question right, but I I guess what I'm
trying to wrap my head around is are there a
lot of people who are kind of competing or coming
into the market with the technology solution or who are
competing against each other or are they really just competing
(18:11):
against the legacy workflow and that's where most of the
turnover is going to be.
Speaker 3 (18:15):
Yeah, I mean, I just want to see the problem
solved for patients and providers and frankly for payers as well,
because you need to solve it for payers so the
patients get faster.
Speaker 2 (18:25):
Decisions as well.
Speaker 3 (18:26):
So if you look at the competitive landscape for the
most part on the provide on the provider side, you're
you're looking at outsourcers, and many of those outsourcers are
now bringing technology across everything, across everything as well.
Speaker 1 (18:40):
You mentioned rep cycle, a whole bunch of other things,
I'm sure.
Speaker 3 (18:43):
And then you know, and then there are certainly a
couple of others, you know, wonderful companies that are also
tackling this on the provider side as well. There's a
lot more folks that are trying to tackle it on
the payer side.
Speaker 1 (18:52):
Oh interesting both you.
Speaker 2 (18:55):
Know, existing companies and startups.
Speaker 3 (18:58):
Because it's all, like I said, once the information gets
sent over the payer, they have to do the exact
same work on their side. And it turns out it's
even more expensive on the on the payer side. And
you know, payers can take up to thirty days to
turn around a decision. And and so if you can,
you know, if payers are very interested in implementing technology
(19:20):
so that a they can remove their friction and you know, well,
certainly there are some some historical bad actors in trying
to make it friction lad And you know, in my experience,
that's not the mentality that that payers have. And they
really want they really want to get they want to
get to the right answer as fast and cheaply as possible,
(19:42):
now understand, and that's doing it with technology.
Speaker 1 (19:45):
So one of the things you mentioned was that it's
more expensive on the payer side. Why is that we're
humans and so or is it just the complexity of
those big organizations.
Speaker 2 (19:57):
It's probably it's probably a combination of both, Jonathan.
Speaker 3 (19:59):
But you know, so on the provider's side, we know
that it's anywhere from ten to twenty dollars for a provider.
Speaker 2 (20:04):
To do the work of submitting it off. Okay, pretty expensive.
Speaker 3 (20:08):
On the payer side, that number ranges from twenty dollars
to one hundred and twenty dollars. And so again that's
because of you've got a whole army of nurses, doctors
and other.
Speaker 1 (20:19):
Humans that are deal medical directors that.
Speaker 3 (20:22):
Sort of exactly that are doing that work. And so
if you think about solving it for the patient, for
the member, you got to get the right information out
the door, and you want you want the payer to
give a faster decision so that care can be delivered.
And so that's you know, that's the ecosystem today.
Speaker 1 (20:39):
So maybe that's a good segue into your business model.
So you sign up a provider or a hospital system
or or I don't know, a surgery center. How do
you guys actually make money for the service you provide.
Speaker 3 (20:51):
Yeah, we're a you know, we're an artificial intelligence SaaS
based solution, and so we you know, we sell them
software that connects into their medical record. Most our customers
are Epic and Oracle, but certainly others as well, and
you know, then they're for a bulk of their prior authorizations.
Our computer can do the work from beginning to end,
(21:13):
ship it out the door. Human doesn't even have to look.
Speaker 1 (21:15):
At it, okay. We also know that it doesn't happen
every time.
Speaker 3 (21:18):
It doesn't happen every time, and so you know, then
in that scenario, then the humans that you know at
our hospital customers would use our software okay, to pull
the right information to understand the medical policies and then
you know, be the final, you know, the final approver
of the information that we've pulled together.
Speaker 1 (21:39):
And then ship and then ship it over. Got it?
And to how long when you sign up a new customer?
Is that a year week contract I imagine or maybe
longer a couple of years. Yeah, we're you know, imagine
it's kind of sticky. You don't want to be pulling
this sort of thing in and out of the system.
Every year.
Speaker 3 (21:52):
Yeah, it's you know, they're they're multi year contracts, and
you know, like like I said earlier, usually you know,
starting a couple of specialties.
Speaker 2 (22:02):
And then and then you expand throughout the entire hospital system.
Speaker 1 (22:06):
No, it sounds good. So maybe a very basic question.
But I'm thinking about what you're saying about technology on
one side and then technology on the other side. How
do you guys think about maybe the bias from each
of the two parties and the conflicts that they have.
Because I'm thinking about AI from the provider wants to
make sure the procedures approved. I will assume that the
(22:28):
AI on the payer also does, but at the same
time might also have a little bit of a bias
towards cost. And how do those two things come together?
And is there this conflict of like the AI agents
being in conflict of each other.
Speaker 2 (22:45):
Yeah, I mean I would.
Speaker 1 (22:47):
Or maybe we're not there yet.
Speaker 3 (22:48):
I don't know the way I describe it as we
are in an arms race. Okay, we're in an AI
arms race prior authorization, one agent on the provider side
and agent on the payer side. And having said that,
you know, I we feel very strongly an AI should
never say no. On the payer side, Okay, that is
(23:12):
just inappropriate. So you know, the way we think about
AI being utilized effectively on the payer side is how
do you understand that unstructured data so that you can
take this process that today takes thirty sixty minutes for
a human and turn that into something that they can
evaluate that clinical information within and.
Speaker 1 (23:32):
Get to that yes.
Speaker 3 (23:32):
To get to the yes, because everybody understands on both sides,
the vast majority of prior oss end up at yes,
and so let's just get to that answer quickly. And
if the answer is it's unclear or you know, maybe
it should be no, then let's streamline that process as well.
Speaker 2 (23:52):
But that part needs to be done by a human.
Speaker 1 (23:54):
Got it, No, that makes perfect sense. I don't think
I want I don't want machines deciding yeah my care
at the end of the day. I mean, maybe we'll
get there, uh, I hope, but we'll see what happens.
That's for a future podcast. There you go. You know,
if I think about your business model, so your software
as a service, you know, what are the levers to
to reaching profitability? Is it just volume? Getting more customers
(24:17):
on the on the platform for the most part, and
at that point, you know, the numbers work themselves out.
How do you think about the longer term? I guess
horizon from a financial perspective, Yeah, I mean.
Speaker 3 (24:29):
I very much believe in businesses that have you know,
long term uh longevity.
Speaker 1 (24:36):
Sure.
Speaker 2 (24:36):
To do that, you need to be you need to
be a profitable business.
Speaker 3 (24:38):
And so, you know, we worked very hard with our
with our partners too, you know, to build something that
delivers our ali straight out of the gate for them
and is delivered in a way that we can you know,
be a profitable business. And so I'm you know, I'm
proud to say that last year we were we were.
Speaker 1 (24:56):
Break even excellent yep uh.
Speaker 3 (24:58):
And you know, I think that that's us up very
well for you know, for being being a thriving business
so that we can really solve this patient, for solve
this problem for patient.
Speaker 1 (25:09):
Well. So that's a good question. I mean, if you're
profitable or near profitability, now, you know, as your business grows,
you're gonna have to continue to invest in the business.
What do you have to invest in over the next
couple of years to be successful on that trajectory?
Speaker 3 (25:24):
Yeah, We're we are, you know, we're we're a one
trick pony. We're only solving prior authorization here. There are
a lot of other pieces, like prior off fits into
a lot of the other pieces of the rev cycle
for providers and similarly other aspects claims, et cetera on
the payer side. So, having said that, there are lots
of different pieces of pri authorization, there's in patient, there's outpatient,
(25:47):
there's the physician side, there's drugs, there's medical. So we
are very much investing in in product expansion in twenty
twenty five. And so you know, there's both product expansion,
but then there's also you know, investing in new you know,
(26:08):
new AI tools and ways of doing this even better, faster,
cheaper than we already are today. And so our product
is AI. We use AI to you know, to build
our software as well. And so you know, we've seen
even just in this last year, dramatic efficiency gains in
our engineering team just from you know, just from some
of that investment that we've we've done on that side.
Speaker 1 (26:29):
I probably should have asked this earlier in the discussion.
But within that world of PA you mentioned medical pharmacy,
are you primarily being used in one or the other.
Speaker 3 (26:39):
Yeah, we've historically focused exclusively on what we would call
medical benefit, so medical problems, that's imaging, surgeries, things of
things of the like. We I'm really excited to say
that all of our customers have said, listen, we really
really need your help on pharmace, interesting specifically in specialty pharmacy.
(27:03):
And so if you look at all of the well
if you look at something like seventy percent of the
drugs coming down the pipeline are all specialty.
Speaker 1 (27:11):
Pharmacy, we're over fifty percent of spending is specialty, that's exactly.
And so most of that goes through the medical benefit.
Speaker 3 (27:16):
Though it's I think we're at about fifty to fifty today,
but increasingly.
Speaker 1 (27:23):
It's going to go through the pharmacy sid it's got.
Speaker 3 (27:25):
Well, increasingly it's going to go through the medical even
more through the medical kind. And so consequently our provider
customers saying please please please help us with the specialty drugs.
And so it's you know, excited that we're starting to
do that now as well.
Speaker 1 (27:38):
You're probably going to have to go up against some
big incumbents in that space. I mean, I'm thinking of
cover my meds and that sort of thing you how
do you think about how you're going to compete against
some of these bigger players.
Speaker 3 (27:49):
Part of the reason that we didn't do pharmacy benefit
is there are some wonderful companies that have solved this,
or I would call it basic drugs basically pharmacy drugs.
There really isn't a great There aren't great solutions out there,
especially in the special side, because the problem so normal
pharmacy prior offs.
Speaker 2 (28:07):
It's usually just send the script.
Speaker 3 (28:09):
You don't need to send a bunch of other information
or get it or clinical information. But with specialty drugs
it's more like a surgery, and so you do need
to submit clinical information all.
Speaker 2 (28:19):
This other stuff.
Speaker 3 (28:19):
It looks and feels virtually identical to getting approval for
a surgery. And so consequently, you know, we feel really
like we're in a great position because of the capabilities
that we have doing for surgery and imaging. To take
that exact same capability and now deliver that for specialty
drugs is actually a very good I.
Speaker 1 (28:38):
Just had this epiphany while you were saying this. I'm like, oh, yes,
especially oncology, drug could be hundreds of thousands of dollars,
but I could probably get my knee done for forty thousand.
I don't know whatever the number is, So you know,
a fraction of hat.
Speaker 2 (28:50):
That's exactly right.
Speaker 3 (28:51):
And so consequently, earlier I was talking about these medical
policies that range from twenty pages to one hundred pages.
If you look at the specialty pharmacy drugs, they tend
to be on the longer.
Speaker 1 (29:04):
Side of that.
Speaker 3 (29:05):
It's because there's they're they're very, very expensive, and the
problem for a provider is you deliver that drug, you've
administered it, patient already has the drug. If if the
payer then says, wait a minute, we're not paying for that,
that's a really big hit.
Speaker 1 (29:21):
Somebody's got to pay for it.
Speaker 3 (29:22):
That's a really big bill that that patient and provider
on look for it. So solving this problem the specialty
side is really important.
Speaker 1 (29:28):
One maybe taking another tack at the problem the overarching problem.
Are there any is there anything coming out of Washington
or on the regulatory front that is pushing for more
transparency or less friction.
Speaker 3 (29:43):
Yes, And I mean this has been because this this
has been such a lightning lightning ride issue on the
in the physician community for many years.
Speaker 2 (29:54):
Sure, but then.
Speaker 1 (29:56):
You know, we've got a couple of them in Congress, it's.
Speaker 3 (29:58):
Got a couple of them. And you know, the AMA
has done a lot of work to really highlight you
know what the you know, patient delays and just the burdens,
you know, the burden on providers and so it you know,
even you know, even before Brian's murdered last year, there
was a lot of attention on the hill in DC,
(30:18):
but then also in state legislatures and so yes, there's
a lot of energy at federally as well as in states,
and you know right now, specifically North Carolina and a
whole bunch of others, there's a lot of work being
done to try to you know, ranges from you know,
some states trying to say, hey, you can't do prior
(30:38):
off at all, which.
Speaker 1 (30:40):
Most you know, most might be one extreme.
Speaker 3 (30:42):
Yeah, most people in the industry think that's a you know,
an impossible like that can't happen.
Speaker 1 (30:45):
Because it is it is we need a couple of
bad actor, Yeah, exactly.
Speaker 3 (30:50):
And you know, it turns out that not all physicians
are delivering care that are that are meeting guidelines, and
so there does need to be some kind of check
and balance. So on one hand, you know, the idea
of prior off going away, but really what you know,
there's a new CMS not new, there's a CMS mandate
out that goes live for payers first and then for providers.
That a brings some level of transparency, but also requires
(31:14):
certain turnaround times that players have to meet. And so
for urgent ones within two days and for non urgent
ones within seven days, which is dramatically faster. Yeah, thirty
days that historically been the case.
Speaker 1 (31:25):
And almost forces them into a technology solution. That's exactly right,
because that's good for you guys. You just get it.
Speaker 3 (31:32):
Better to be lucky than go And I would say
that the regulatory landscape is only heating up more, you know,
it's it's definitely not a problem that's going to go away.
Speaker 1 (31:42):
So maybe asking you to put back on your physician
hat or your entrepreneur hat, maybe a combination of both.
But you know, if we take a broader view outside
of PA, you know, i'd love to hear your views
on what's been kind of driving the cost crisis and
maybe what you if you were in charge, what would
be one or two solutions you might have or thoughts
you might have to really improve the cost crisis that
(32:05):
we have in this country. How long do we have
pod just do it in a couple of minutes.
Speaker 3 (32:10):
A couple Well, the really short answer is it's very
it's very very complex, of course, and there's no like,
there's no simple magic silver bullet.
Speaker 1 (32:18):
I'm putting you on the spot hereably.
Speaker 2 (32:19):
Yeah, no, I love it. The drive is really on.
Speaker 3 (32:24):
You know, the increase in costs is really on all fronts.
Labor costs are going up, that's you know, it started
before COVID, but really accelerated with COVID, So labor costs
on the provider side are going up, all the durable
good costs are going up. And then we also have
all of these really expensive drugs and as we were
(32:45):
talking about earlier, you know, almost all the new it's.
Speaker 1 (32:49):
Really wonderful that the is fantastic.
Speaker 3 (32:52):
The innovation is fantastic. And patients that previously you know,
couldn't get problem A B or C treated now have
treatments for it, and all those are expensive. And so
you know, if you looked last year, commercial fee for
service insurance rates went up eight to nine percent, and
for you know, for a family.
Speaker 1 (33:10):
That's that's meaningful.
Speaker 3 (33:13):
That's a meaningful amount of money. And so you know,
I don't know exactly what the average family for is
spending on a commercial insurance rate, but it's in the
twenty thirty forty thousand dollars a year, and that's just
that's just not sustainable. And so increasing labor costs, increasing drugs,
increasing devices, all of these things, and then there's just
an enormous amount of waste. And so you know, up
(33:35):
to some studies would say a third of care delivered
doesn't you know, necessarily follow a guideline, could be in
a gray zone. Some of that you know, as a doc,
I'd say some of that gray zone is appropriate and
some of that gray zone isn't appropriate. And so couple
that with all of the paperwork that hospitals need to
deal with. If you look at providers thirty years ago,
(34:00):
they had ten administrative staff per physician. If you look
at it today, it's forty to fifty administrative staff per physician.
And that's just dealing with all this back office bs
so that the doctor and nurse and care providers can
deliver care. And so most people in healthcare would say
those forty to fifty people per physician are not making
(34:21):
the service. You know, it's not a Ritz Carlton experience, right,
There's just a lot of stuff that's happening behind the scenes,
and that's cost interesting guys.
Speaker 1 (34:30):
I think a lot of people come out on the
administrative side as the one area to really focus on
that we could make a real material change.
Speaker 2 (34:37):
There's no doubt in my mind.
Speaker 3 (34:39):
You know, even when I started, you know, building companies
to try to solve back office problems for healthcare, we
are at a at a vanguard moment where we now
have technology available to us that that was just not
available even two years ago, that we can solve some
of these problems. And so that coupled with frankly, a
(35:00):
cost crisis on both a provider and payer side. You know,
healthcare is slow to innovate in many ways, especially around
this administrative stuff.
Speaker 1 (35:08):
And so you know, it's all the regulations and exactly
it's difficult clients, it's it's it's hard to move the ship.
Speaker 2 (35:14):
You know.
Speaker 3 (35:14):
Yes, And now I can say, you know, very favorably
that c suite leaders on both the provider and payer
side recognize that this is this is unsustainable and we
have all of these back office costs we need a technology.
We need technology solutions to do this, and and prior
off is one of those. There's also, you know, a
(35:36):
whole bunch of other back office things that are very
well sell, very well suited for technology. And I would
say the immediate thing that I could see and should
that we should expect to see over the next couple
of years here is that providers and payers are going
to adopt artificial intelligence to handle this back office stuff.
(35:57):
And they're going to work on the fringes around what
you using AI for care, but for the most part,
it's going to be in this back off of stuff.
Speaker 2 (36:04):
And you know, I just I.
Speaker 3 (36:06):
Just hope that that is a huge step in the
right direction to actually reduce costs, not just add costs and.
Speaker 1 (36:13):
System I have a ton of questions, but I'll try
and keep it to one or two. Are there one
or two technologies or improvements in AI that you're looking
forward to, because I think when I listen to the
in videos or whoever it might be, they talk about
these waves and I don't know that I could even
define what the waves are because I'm not a technologist.
But is there are there any that you're really looking
(36:34):
forward to that you know, we'll have this, we'll drive
an inflection in either your business or the healthcare sector
in general.
Speaker 3 (36:41):
What we're going to see in the next twelve to
twenty four months in new care that's so new capabilities
around generative AI and in traditional AI, it's going to
be mind boggling. And we're going to we're going to
see it implemented in non healthcare frankly before we're going
to see it implement in healthcare. But you know, around voice,
around video, around unstructured data, around agents that are i
(37:07):
mean even today but increasingly so over the next year
or two, able to do autonomous work that humans did
in the past. It's just remarkable. And then if you
look at what we're seeing advanced in the robotics field
and what what some of these robots, these AI driven robots.
Speaker 1 (37:27):
Can do again with all the sensors and everything, I.
Speaker 3 (37:30):
Mean, it's just remarkable. And there's so much movement of
people and movement of stuff within healthcare. How those you know,
how those technologies can be used to frankly make hospitals,
which are generally inefficient places, be more efficient and sort
of less requiring people to do some of those things.
It's gonna be it's gonna be pretty pretty amazing.
Speaker 1 (37:51):
So maybe I'll dovetail that into a little longer time
span than twelve to twenty four months. But where do
you want humanity to be in? I don't know, five years,
ten years.
Speaker 3 (38:00):
There are hundreds of millions of prior authorizations every year,
hundreds of millions, and that means hundreds of millions of
times patients are having to wait to get care or
it's not being done well, and so they're getting stuck
with a bill on the back end.
Speaker 2 (38:16):
And so what I you know, what I.
Speaker 3 (38:18):
Would love to see is that we're tackling the majority
of those prior offs for providers all across the country.
Speaker 1 (38:26):
Well said, you mentioned it before. You've been involved with
a number of companies. I mean that's all. We've mostly
been talking about Humata, But you also are working with
a number of other different entities. Maybe you want to
touch base, touch on a couple of those that you
find the most exciting and where you're doing some other
work outside of PA.
Speaker 2 (38:42):
Yeah.
Speaker 3 (38:42):
I love all my children equally, So there we've got
five wonderful kids. I love all my children equally. Am
involved in a variety of other things, really proudly, my
wife and I have launched a new venture fund focused
on female founders called Simana, called the Donna Fund, named
after my mother, and you know, we're on a mission.
(39:03):
Two percent of all venture dollars go to female founders,
both in healthcare and outside of health care.
Speaker 2 (39:10):
And if you look at if you look at you know.
Speaker 3 (39:14):
The attendance rate, the graduation rates in both undergrad grad
school and med school predominantly women.
Speaker 1 (39:22):
And so there's this huge guests to disconnect there.
Speaker 3 (39:25):
Huge gap of you know, women that are getting funded
in in you know, in their entrepreneurial ventures. And and
I've you know, I've been very fortunate that have been
able to raise money from really wonderful people and really
wonderful firms and just excited to put some of our
capital to work to help these these force of nature
(39:45):
women do really amazing things. The other point there is
eighty percent of all health care decisions are made by
the woman.
Speaker 1 (39:53):
And now it's interesting, we've had a couple of female
founders on the show, but mostly in the women's health arena,
and they always point to that that statistic as well.
Speaker 2 (40:03):
Yeah, it's just fact.
Speaker 3 (40:06):
So it's you know, it's not only the right thing
to do, but it's also the right thing to do
from a business standpoint, that women should be leading more
of these companies, and so we want, you know, we
want to help make that happen. So not just women's health,
but you know women that are tackling healthcare and technology. Yeah,
building healthcare into.
Speaker 1 (40:21):
Now understood anything under the sun, anything under the sun.
So if you're a female or a woman founder, reach.
Speaker 2 (40:26):
Out to the Yeah, we'd love to hear from you.
Speaker 1 (40:29):
So one of the ways I like to wrap up
these conversations is to focus on a life lesson that
that drives the guests to Jeremy, is there something that
you're comfortable sharing for me to your personal life or
your business experience that really drives you on a day
to day.
Speaker 3 (40:43):
There are lots There are lots of things that my
team would you know, my team and share. I've got
lots of silly little sayings that I like to use.
Success comes from failure and life is a team sport.
Entrepreneurship is a team sport. That's not the one I
want to share, but a good motto, you know, and
(41:04):
and a bunch of similar ones, but you know, the
one that comes to mind.
Speaker 2 (41:07):
I remember earlier in my career, I.
Speaker 3 (41:09):
Had the opportunity to meet Doug Leoni, who you know,
the famous venture capitalist with the Ransiquia Capital for a
long time, and you know, I was asking him, what
are what are some of the things that you look
for in your you know, in people that you back,
and his answer was failure.
Speaker 1 (41:28):
Interesting.
Speaker 3 (41:28):
And so, you know, one of the things that I
think about in both you know, personal life, but also
definitely in building companies is you've got to make failure
acceptable and and maybe even celebrated, because it's those failures
that allow you to build something great on the other side.
And so embrace failure and don't shy away from it,
(41:50):
and great things will happen.
Speaker 1 (41:51):
That's excellent. Thank you for sharing that story, and thank
you for giving us a great lesson on prior and
humut of Health and the Donna Fund. I'm looking forward
to your continued success. So with that that's Jeremy Freeze,
founder and CEO of Human of Health. Thank you so
much for joining us on our latest episode, and please
make sure to click the follow button on your favorite
podcast app or website so you never miss a discussion
(42:13):
with the leaders in healthcare Innovation. I'm Jonathan Palmer, and
you've been listening to the Bandguards of Healthcare podcast by
Bloomberg Intelligence. Until next time, take care,
Welcome to another episode of Boomberg Intelligence Vanguards of Healthcare podcast,
where we speak with the leaders at the forefront of
change in the healthcare industry. My name is Jonathan Palmer,
and I'm a healthcare analyst at Bloomberg Intelligence, the in
house research arm of Bloomberg. We're very happy to welcome
doctor Jeremy Freese, founder and CEO of hum Out of
Health to the podcast today. He's an interventional radiologist by training,
(00:40):
and he had a storied career at the Mayo Clinic
before setting out the tackle industry, where he's been a
serial entrepreneur ever since. He previously served as a president
at Olive after selling one of his earlier ventures to
the company in a successful exit. I'm really excited to
learn about his latest foray into the intersection of healthcare
and technology. Humant of Health, thanks for joining us.
Speaker 2 (01:00):
Today, Jeremy, Morning, Jonathan, great to be here.
Speaker 1 (01:02):
Well, why don't we dive right in? I mean, maybe
a simple way to summarize what humanity does is what
is your mission statement? In a couple of sentences, we
exist to solve prior authorization so patients can get the
care they deserve, and to do that you've you've got
to be on what we like to say, on both
sides of the fax machines, sofully helping solve this problem
for both providers and payers. All right, So let's define
(01:23):
prior authorization. I'm thinking about my mom listening to it
the way person. Where does prior authorization fit? I guess
in the grand ecosystem of our very complex, tangled web
of healthcare.
Speaker 3 (01:34):
Yeah, so prior authorization has been around for decades and
it's this process where you and your doctor decide what
needs to be done, either an imaging test or a
surgery or something, and then for a certain list of
those items you have to get quote prior authorization, so
(01:55):
permission payer. You need to get permission from the payer
in order to be able to do that. See if
it falls within the covered benefits for that you know,
for that particular patient, And you have to do that
before you deliver the care, because if you don't do
that and you deliver the care, then you, as the.
Speaker 2 (02:13):
Provider and the patient get stuck with.
Speaker 1 (02:16):
You're on the Coppy bill on the maybe talk about
the evolution of primary authorization. You know how common was it?
I don't know what the right timeframe, is it ten,
twenty thirty years ago? And why is it such a
sticking point today?
Speaker 2 (02:29):
So it's always been a sticking point for providers.
Speaker 3 (02:32):
It certainly has sort of you know, gotten to the
forefront of the you know, the of what the public
is seeing. So it's always been around and it's always
you know, been an issue. It is one of the
key levers that you know, that insurance companies can use
to help control costs. And so while I don't have
a stat to say, you know, ten years ago there
(02:53):
was this many and you know last year there was
X times that it certainly is more common. And the
other thing is true is that the reason it's become
so much more complicated is because there's so many players,
uh and and so and so many different ways of
(03:15):
going about doing this. Historically it was usually solved by a.
Speaker 1 (03:18):
Phone call or the facts or the facts machine. Facts,
the ubiquitous facts machine of healthcare, I mean.
Speaker 3 (03:23):
The only industry where it still exists. And so it
really has you know, it's become a really difficult web
for providers and patients to to try to try.
Speaker 2 (03:33):
To deal with.
Speaker 1 (03:34):
So if we rewind a little bit, you know, a
doctor fills out this prior authorization, sends it into the
insurance company. What happens at that point, you know, I
assume they either pass it or they reject it. What
are some of the common reasons for some of the rejections?
Speaker 2 (03:50):
Yeah, So, so.
Speaker 3 (03:53):
The process is just as you've said. Sometimes it's you know,
me as a doctor. Usually it's you know, my nurse
or some some administrauble chinstrative office person that would send
it in. And then you know, you either send it
through a fact you go through a portal, sometimes you
make a phone call. Once it gets shipped over to
the payer, then an army of humans on the payer
(04:15):
side also has to review that information that was sent
across and compare that with their medical policies, so with
that particular patience policy to say is this covered? And
if the answer is yes, then you know, what are
the sort of rules of the game. And that's a
human that's reviewing medical policy and reviewing the clinical information
(04:36):
as well as the other information that's been submitted like name.
Speaker 2 (04:40):
Day to birth.
Speaker 3 (04:41):
Just makes you know, make sure you know the you
know the you know who the member is. And so
the main I mean, there are lots of different reasons
for these to get denied. I'd sort of put them
into two main buckets. The first bucket is the right
information hasn't been sent over to the payer.
Speaker 1 (04:57):
And so that seems like an easier one to solve that, and.
Speaker 3 (05:00):
You know, that's what that's what we solve with technology,
making sure the right information gets over to the pay
or either clinical information or the non clinical information.
Speaker 2 (05:10):
Or it could be the REA.
Speaker 3 (05:12):
I mean, the reason it would be denied is that
all the right information has come across, but for that
particular patient doesn't meet the medical policy criteria to say
it's within this person's plan to get approved.
Speaker 2 (05:26):
And so it could be.
Speaker 3 (05:27):
Denied because you don't have the right info, or it
could be denied because you don't have the right info
because the patient just doesn't meet the criteria.
Speaker 1 (05:34):
Understood, and then I understand that. You know, the following
process to that is typically an appeal from the provider
usually or maybe they just drop it. I don't know.
Often is there any rules of thumb around how many
go to appeal versus just get dropped.
Speaker 3 (05:49):
More often than not, it just gets dropped, really and
the and the physician will say, you know what, instead
of doing the CT I'm going to do the ultrasound
or you know, instead of doing the surgery, well, we'll
do some kind of conservative therapy.
Speaker 2 (06:00):
But if you know, if.
Speaker 3 (06:02):
The doctor and patient do feel strongly this is the
path they want to go down, you know, then then
it goes through an appeal process, and that usually means
sending back more information if it's available, and then the
you know, the pair would review that additional information, often
oftentimes requires again going.
Speaker 2 (06:19):
Through facts portal or some other way.
Speaker 3 (06:22):
Oftentimes also requires a phone call, and then if if
the appeal isn't approved, then that would lead to the
next step. It's called a peer to peer and the
peer to peer means me as doctor talks to doctor
on the other side, So a doctor on behalf of
the insurance company, and then you have a conversation and
(06:44):
say this is why I think it should be done.
Doctor on the other side says, well, you know it
doesn't meet criteria because of a B or C or Yeah,
I understand, and let's end, and you know I'll approve it.
Speaker 1 (06:55):
Yeah. So I think we're assuming that everybody has the
best intention in those in those conversations as well, and
I think we know there's a lot of friction and
conflict in the system as well, which maybe we'll talk
about waiter. But so we set the table around prior off,
you know, where does Humota come in to maybe help
solve this problem or bring it into the next era.
Speaker 3 (07:14):
So solving this problem requires a lot of blocking and
tackling connectivity because every every payer has a different way
of submitting SURE, and every provider houses all of their
information in a system of record, a medical and an
electronic medical record. And so what we do is we
(07:38):
connect deeply into the medical record so that we really
an or whatever it might be, you know, whatever whatever
the system might be, and then we help the provider.
We say, we're in the business of yes, okay, so
we help the provider understand the information that the payer
needs so that we can then on their behalf, using technology,
(08:00):
pull the right information from the medical record and using technology,
submit that information over to the payer whatever way the
payer needs to get it, through a portal, through a
fact through a through a direct API connection. And because
we've done millions and millions of these, we understand what
is the information that the payer generally needs in order
(08:21):
to get to a yes if it's available, and so
if it's available in the medical record, we use artificial
intelligence to comb the medical record, find the right information
and then ship it over to the payer using technology
instead of that process today is mostly done by humans.
Speaker 1 (08:36):
Got it? And when did you decide that you wanted
to tackle this problem? You know, let's let's maybe talk
about your origin story a little bit and your journey
from being a radiologist into being an entrepreneur and deciding
PA is the place I have to go?
Speaker 2 (08:51):
Yeah, I'm so.
Speaker 3 (08:53):
I say that I'm a recovering radiologist, maybe a radiologist
with a with an entrepreneurial problem. So I I would say,
I've been on this journey around prior authorization for a decade.
So I had their you know, I had the great
fortune of practicing medicine at the Mayo Clinic, first training
for ten years it takes a long time, and then
practicing for ten years, and during that process ended up
(09:13):
helping run our radiology business. And so where there's a
lot of half of all prior authorizations are imaging related,
and so we were doing you know, literally hundreds of
thousands of these every single year, and so it was,
you know, partly my problem to try to try to solve.
As a provider at you know, running this large group,
(09:36):
I would also say, so I was an interventional radiologist,
every single patient that I would do a procedure on
required prior authorization. And so yeah, you know, from the
earliest point, I've been dealing with this with my nurses,
you know, since the beginning of my practice days. And
I would say, nobody teaches you that stuff in medical school,
(09:57):
like that's kind of what the on the job training
is about being doc. And you know, frankly, we tried
to hire a bunch of consultants and other folks to
help us improve the process, and it just became very
very clear to me that it is a problem that
requires technology, not more humans.
Speaker 1 (10:15):
So if you go back to those days when you're
working at Mayo, were service providers helping you? Were there
companies who were coming in with services or solutions to
help you manage this.
Speaker 3 (10:26):
So this was now nearly ten years ago, and the
answer at that time was a very clear note. And
so you could hire consultants to try to help you
improve your processes, but honestly it was done by post
it notes, really Excel spreadsheets, large folders where you would
keep track of this CPT code needs a prior off
for this payer, this one doesn't need. And so that
(10:47):
just reams of paper and frankly armies of humans that
were trying to keep track of all of these rules
and all of the yes' is you know what requires
what doesn't because there wasn't a technology solution. It was
it was really that impetus that led to the realization
that wow, this is this is a problem that if
we can solve this back what I would say, this
(11:09):
back office BS problem, doctors could be doctors, and nurses
would be nurses, and patients could get the care they deserve.
And so that's we've been on this mission.
Speaker 1 (11:17):
I mean, is there if you think about it, is
there amount of time that you think of the average
doctor spends on PA or maybe his staff or her
staff spends on spends on PA.
Speaker 2 (11:27):
It's hugely variable because.
Speaker 1 (11:29):
Depending on what you're treating, right.
Speaker 3 (11:32):
Depending if you're a primary care doct or a specialist
or whatever. But you know, industry data would say doctors
spend on average eleven hours a week dealing with this,
which is pretty insane. I'm not I'm not sure that
I well, yeah, you're not practicing at the top of
your license for those eleven hours, not at all. And
(11:52):
I mean, I'm I would say my practice, I didn't
spend eleven hours, but whatever it is, I mean, and
if it's an hour or two, that's an hour or
two that you should have been either taking care of
your patients or at home with your kids.
Speaker 1 (12:08):
No makes sense. So we have the technology, or I
think we have the technology to solve this problem. Can
you talk about building that technology stack and what you
actually have to build to tackle this problem?
Speaker 2 (12:19):
Yeah? You know.
Speaker 3 (12:20):
So the way I think about the problem is if
you're really going to solve it, a provider wants a
solution that's going to help with all my specialties I say,
all my ologies, Okay, cardiology, orthopedicxology, radiology, et cetera. And
you want it to be a solution for all your payers.
And so you don't want to have one technology that
(12:42):
works for United but doesn't work for the Blues as
an example. So you want it to you want it
to handle all your payers. And then this process of
prioritization involves you know, ten different steps, and so you
want it to help with all of those steps. And
so that you know there are a bunch of things
that you can do where you could, you know, just
help one specialty, or just help with certain payers, or
(13:02):
just help piece of the puzzle. The way we think
about building, the way we've built our solution is to
help with all ologies, all payers, and from beginning to end.
And so to be able to do that, there's a
lot of really kind of mundane blocking and tackling, connecting
into payers, interfacing with portals, connecting into the medical record.
(13:24):
That's sort of the blocking and tackling work. And then
there's the sexy artificial intelligence stuff where you've got to
comb through massive amounts of unstructured data, both clinical data
and non clinical data, and understand what pieces of information
the payer actually wants so that they can make an educated,
(13:47):
knowledgeable decision. And so we use AI to comb through
the medical record, comb through all of that information as
well as historical yeses and the information that led to yes,
and then we submit that right information through all those
pipes that we've either partnered with folks.
Speaker 2 (14:05):
Or built ourselves.
Speaker 1 (14:07):
Maybe just a quick question therese I think I understand
the unstructured data from the provider side. I'm thinking about
notes and all that sort of stuff that could be
in any sort of form. And all these disparate data sources,
is it also instructored on the provider or the payer
side as well?
Speaker 2 (14:24):
Absolutely?
Speaker 1 (14:25):
And so and what's an example of that.
Speaker 3 (14:28):
So they're really sort of two pieces of mostly unstructured data.
There's the there's the medical clinical information as well as
the metadata around the patient. And then there are these
policy the policies, and so you know, a pair will
usually you know, show to a provider, make available to
a provider for this CPT code for this patient member.
(14:51):
Here's a twenty page document that.
Speaker 2 (14:55):
It could be a few pages.
Speaker 3 (14:56):
There are some that are up to one hundred pages
long that are these that a provider would need to say,
you know, does my patient meet this criteria? And that's
the work that the human on the payer side is doing.
They're they're reading this medical policy and they're looking at
the unstructured clinical information that's coming across the facts or
(15:18):
however it comes, and then they're saying, does the clinical
information submitted match this unstructured medical policy that we have
on our side?
Speaker 1 (15:25):
Okay, gotcha. So you guys are a relatively new company
twenty twenty three. I think as you're founding, how have
you what have been some of the milestones in your
relatively new journey, you know, what have you had to
build and what are some of the early successes you've
had with with clients on either side.
Speaker 3 (15:41):
Yeah, so we you know, we our focus has been
on solving the problem for providers and so we've you know,
we've been building for a couple of years. We also
bought some assets, bought some technology that allowed us to
jumpstart some of this work as well. And so you know,
we now have north of two hundred hospital is using
the system to help them. For most of them start
(16:04):
in certain specialties and then and then expand.
Speaker 1 (16:06):
There's a way and and expand you start in cardiology
or imaging, whatever the big buckets are, and then.
Speaker 3 (16:11):
Exactly and so that you know, we just feel really
really proud of the work that we're doing with these
with these provider customers to help them, you know, submit
millions of these things every year, and that's millions of
patients that we're turning the prior ofth out dramatically faster
then would be done if it was a human And
we're you know, like I said before, we're in the
(16:32):
business of yes, and so we're getting the right information
over so that are our provider customers. You know, they
usually don't know what their success rate is before we
show up because it's very difficult to track. But you
know what we see as we start to work with
them over the first several months is they start to
get approval rates in the very high nineties up to
ninety nine percent. Oh wow, which which means that there's
(16:53):
no more of that back and forth that we're talking
about at the beginning. And it also means that patients
are getting you know, they're getting the s and they're
getting the care that their doctor thinks they they should.
Speaker 1 (17:03):
No, that's great. I mean, I'm sure it's everything under
the sun, But what what sort of solution are they
most of your current customers, what were they using before
they started using Hamada? Were they using another provider? Are
you displacing somebody or was it still this very manual
process for most of them?
Speaker 2 (17:18):
For the most part, it's a manual. Yeah, it's it's
a they're all using the old post it notes, you know, spreadsheets,
et cetera. There.
Speaker 3 (17:26):
You know, there are some groups that do outsourcing for
prior authorization as well as a bunch of other sort
of reb cycle back off of stuff for healthcare providers,
and so some of them, you know, use those outsourcers,
but for the most part, either you know, it's done
by a human that they've outsourced it to, or it's
a human that they you know, pay and have as employee.
Speaker 1 (17:49):
So is the competitive landscape fragmented or or is it
still just this legacy legacy workflow? Yeah, maybe I'm not
asking the question right, but I I guess what I'm
trying to wrap my head around is are there a
lot of people who are kind of competing or coming
into the market with the technology solution or who are
competing against each other or are they really just competing
(18:11):
against the legacy workflow and that's where most of the
turnover is going to be.
Speaker 3 (18:15):
Yeah, I mean, I just want to see the problem
solved for patients and providers and frankly for payers as well,
because you need to solve it for payers so the
patients get faster.
Speaker 2 (18:25):
Decisions as well.
Speaker 3 (18:26):
So if you look at the competitive landscape for the
most part on the provide on the provider side, you're
you're looking at outsourcers, and many of those outsourcers are
now bringing technology across everything, across everything as well.
Speaker 1 (18:40):
You mentioned rep cycle, a whole bunch of other things,
I'm sure.
Speaker 3 (18:43):
And then you know, and then there are certainly a
couple of others, you know, wonderful companies that are also
tackling this on the provider side as well. There's a
lot more folks that are trying to tackle it on
the payer side.
Speaker 1 (18:52):
Oh interesting both you.
Speaker 2 (18:55):
Know, existing companies and startups.
Speaker 3 (18:58):
Because it's all, like I said, once the information gets
sent over the payer, they have to do the exact
same work on their side. And it turns out it's
even more expensive on the on the payer side. And
you know, payers can take up to thirty days to
turn around a decision. And and so if you can,
you know, if payers are very interested in implementing technology
(19:20):
so that a they can remove their friction and you know, well,
certainly there are some some historical bad actors in trying
to make it friction lad And you know, in my experience,
that's not the mentality that that payers have. And they
really want they really want to get they want to
get to the right answer as fast and cheaply as possible,
(19:42):
now understand, and that's doing it with technology.
Speaker 1 (19:45):
So one of the things you mentioned was that it's
more expensive on the payer side. Why is that we're
humans and so or is it just the complexity of
those big organizations.
Speaker 2 (19:57):
It's probably it's probably a combination of both, Jonathan.
Speaker 3 (19:59):
But you know, so on the provider's side, we know
that it's anywhere from ten to twenty dollars for a provider.
Speaker 2 (20:04):
To do the work of submitting it off. Okay, pretty expensive.
Speaker 3 (20:08):
On the payer side, that number ranges from twenty dollars
to one hundred and twenty dollars. And so again that's
because of you've got a whole army of nurses, doctors
and other.
Speaker 1 (20:19):
Humans that are deal medical directors that.
Speaker 3 (20:22):
Sort of exactly that are doing that work. And so
if you think about solving it for the patient, for
the member, you got to get the right information out
the door, and you want you want the payer to
give a faster decision so that care can be delivered.
And so that's you know, that's the ecosystem today.
Speaker 1 (20:39):
So maybe that's a good segue into your business model.
So you sign up a provider or a hospital system
or or I don't know, a surgery center. How do
you guys actually make money for the service you provide.
Speaker 3 (20:51):
Yeah, we're a you know, we're an artificial intelligence SaaS
based solution, and so we you know, we sell them
software that connects into their medical record. Most our customers
are Epic and Oracle, but certainly others as well, and
you know, then they're for a bulk of their prior authorizations.
Our computer can do the work from beginning to end,
(21:13):
ship it out the door. Human doesn't even have to look.
Speaker 1 (21:15):
At it, okay. We also know that it doesn't happen
every time.
Speaker 3 (21:18):
It doesn't happen every time, and so you know, then
in that scenario, then the humans that you know at
our hospital customers would use our software okay, to pull
the right information to understand the medical policies and then
you know, be the final, you know, the final approver
of the information that we've pulled together.
Speaker 1 (21:39):
And then ship and then ship it over. Got it?
And to how long when you sign up a new customer?
Is that a year week contract I imagine or maybe
longer a couple of years. Yeah, we're you know, imagine
it's kind of sticky. You don't want to be pulling
this sort of thing in and out of the system.
Every year.
Speaker 3 (21:52):
Yeah, it's you know, they're they're multi year contracts, and
you know, like like I said earlier, usually you know,
starting a couple of specialties.
Speaker 2 (22:02):
And then and then you expand throughout the entire hospital system.
Speaker 1 (22:06):
No, it sounds good. So maybe a very basic question.
But I'm thinking about what you're saying about technology on
one side and then technology on the other side. How
do you guys think about maybe the bias from each
of the two parties and the conflicts that they have.
Because I'm thinking about AI from the provider wants to
make sure the procedures approved. I will assume that the
(22:28):
AI on the payer also does, but at the same
time might also have a little bit of a bias
towards cost. And how do those two things come together?
And is there this conflict of like the AI agents
being in conflict of each other.
Speaker 2 (22:45):
Yeah, I mean I would.
Speaker 1 (22:47):
Or maybe we're not there yet.
Speaker 3 (22:48):
I don't know the way I describe it as we
are in an arms race. Okay, we're in an AI
arms race prior authorization, one agent on the provider side
and agent on the payer side. And having said that,
you know, I we feel very strongly an AI should
never say no. On the payer side, Okay, that is
(23:12):
just inappropriate. So you know, the way we think about
AI being utilized effectively on the payer side is how
do you understand that unstructured data so that you can
take this process that today takes thirty sixty minutes for
a human and turn that into something that they can
evaluate that clinical information within and.
Speaker 1 (23:32):
Get to that yes.
Speaker 3 (23:32):
To get to the yes, because everybody understands on both sides,
the vast majority of prior oss end up at yes,
and so let's just get to that answer quickly. And
if the answer is it's unclear or you know, maybe
it should be no, then let's streamline that process as well.
Speaker 2 (23:52):
But that part needs to be done by a human.
Speaker 1 (23:54):
Got it, No, that makes perfect sense. I don't think
I want I don't want machines deciding yeah my care
at the end of the day. I mean, maybe we'll
get there, uh, I hope, but we'll see what happens.
That's for a future podcast. There you go. You know,
if I think about your business model, so your software
as a service, you know, what are the levers to
to reaching profitability? Is it just volume? Getting more customers
(24:17):
on the on the platform for the most part, and
at that point, you know, the numbers work themselves out.
How do you think about the longer term? I guess
horizon from a financial perspective, Yeah, I mean.
Speaker 3 (24:29):
I very much believe in businesses that have you know,
long term uh longevity.
Speaker 1 (24:36):
Sure.
Speaker 2 (24:36):
To do that, you need to be you need to
be a profitable business.
Speaker 3 (24:38):
And so, you know, we worked very hard with our
with our partners too, you know, to build something that
delivers our ali straight out of the gate for them
and is delivered in a way that we can you know,
be a profitable business. And so I'm you know, I'm
proud to say that last year we were we were.
Speaker 1 (24:56):
Break even excellent yep uh.
Speaker 3 (24:58):
And you know, I think that that's us up very
well for you know, for being being a thriving business
so that we can really solve this patient, for solve
this problem for patient.
Speaker 1 (25:09):
Well. So that's a good question. I mean, if you're
profitable or near profitability, now, you know, as your business grows,
you're gonna have to continue to invest in the business.
What do you have to invest in over the next
couple of years to be successful on that trajectory?
Speaker 3 (25:24):
Yeah, We're we are, you know, we're we're a one
trick pony. We're only solving prior authorization here. There are
a lot of other pieces, like prior off fits into
a lot of the other pieces of the rev cycle
for providers and similarly other aspects claims, et cetera on
the payer side. So, having said that, there are lots
of different pieces of pri authorization, there's in patient, there's outpatient,
(25:47):
there's the physician side, there's drugs, there's medical. So we
are very much investing in in product expansion in twenty
twenty five. And so you know, there's both product expansion,
but then there's also you know, investing in new you know,
(26:08):
new AI tools and ways of doing this even better, faster,
cheaper than we already are today. And so our product
is AI. We use AI to you know, to build
our software as well. And so you know, we've seen
even just in this last year, dramatic efficiency gains in
our engineering team just from you know, just from some
of that investment that we've we've done on that side.
Speaker 1 (26:29):
I probably should have asked this earlier in the discussion.
But within that world of PA you mentioned medical pharmacy,
are you primarily being used in one or the other.
Speaker 3 (26:39):
Yeah, we've historically focused exclusively on what we would call
medical benefit, so medical problems, that's imaging, surgeries, things of
things of the like. We I'm really excited to say
that all of our customers have said, listen, we really
really need your help on pharmace, interesting specifically in specialty pharmacy.
(27:03):
And so if you look at all of the well
if you look at something like seventy percent of the
drugs coming down the pipeline are all specialty.
Speaker 1 (27:11):
Pharmacy, we're over fifty percent of spending is specialty, that's exactly.
And so most of that goes through the medical benefit.
Speaker 3 (27:16):
Though it's I think we're at about fifty to fifty today,
but increasingly.
Speaker 1 (27:23):
It's going to go through the pharmacy sid it's got.
Speaker 3 (27:25):
Well, increasingly it's going to go through the medical even
more through the medical kind. And so consequently our provider
customers saying please please please help us with the specialty drugs.
And so it's you know, excited that we're starting to
do that now as well.
Speaker 1 (27:38):
You're probably going to have to go up against some
big incumbents in that space. I mean, I'm thinking of
cover my meds and that sort of thing you how
do you think about how you're going to compete against
some of these bigger players.
Speaker 3 (27:49):
Part of the reason that we didn't do pharmacy benefit
is there are some wonderful companies that have solved this,
or I would call it basic drugs basically pharmacy drugs.
There really isn't a great There aren't great solutions out there,
especially in the special side, because the problem so normal
pharmacy prior offs.
Speaker 2 (28:07):
It's usually just send the script.
Speaker 3 (28:09):
You don't need to send a bunch of other information
or get it or clinical information. But with specialty drugs
it's more like a surgery, and so you do need
to submit clinical information all.
Speaker 2 (28:19):
This other stuff.
Speaker 3 (28:19):
It looks and feels virtually identical to getting approval for
a surgery. And so consequently, you know, we feel really
like we're in a great position because of the capabilities
that we have doing for surgery and imaging. To take
that exact same capability and now deliver that for specialty
drugs is actually a very good I.
Speaker 1 (28:38):
Just had this epiphany while you were saying this. I'm like, oh, yes,
especially oncology, drug could be hundreds of thousands of dollars,
but I could probably get my knee done for forty thousand.
I don't know whatever the number is, So you know,
a fraction of hat.
Speaker 2 (28:50):
That's exactly right.
Speaker 3 (28:51):
And so consequently, earlier I was talking about these medical
policies that range from twenty pages to one hundred pages.
If you look at the specialty pharmacy drugs, they tend
to be on the longer.
Speaker 1 (29:04):
Side of that.
Speaker 3 (29:05):
It's because there's they're they're very, very expensive, and the
problem for a provider is you deliver that drug, you've
administered it, patient already has the drug. If if the
payer then says, wait a minute, we're not paying for that,
that's a really big hit.
Speaker 1 (29:21):
Somebody's got to pay for it.
Speaker 3 (29:22):
That's a really big bill that that patient and provider
on look for it. So solving this problem the specialty
side is really important.
Speaker 1 (29:28):
One maybe taking another tack at the problem the overarching problem.
Are there any is there anything coming out of Washington
or on the regulatory front that is pushing for more
transparency or less friction.
Speaker 3 (29:43):
Yes, And I mean this has been because this this
has been such a lightning lightning ride issue on the
in the physician community for many years.
Speaker 2 (29:54):
Sure, but then.
Speaker 1 (29:56):
You know, we've got a couple of them in Congress, it's.
Speaker 3 (29:58):
Got a couple of them. And you know, the AMA
has done a lot of work to really highlight you
know what the you know, patient delays and just the burdens,
you know, the burden on providers and so it you know,
even you know, even before Brian's murdered last year, there
was a lot of attention on the hill in DC,
(30:18):
but then also in state legislatures and so yes, there's
a lot of energy at federally as well as in states,
and you know right now, specifically North Carolina and a
whole bunch of others, there's a lot of work being
done to try to you know, ranges from you know,
some states trying to say, hey, you can't do prior
(30:38):
off at all, which.
Speaker 1 (30:40):
Most you know, most might be one extreme.
Speaker 3 (30:42):
Yeah, most people in the industry think that's a you know,
an impossible like that can't happen.
Speaker 1 (30:45):
Because it is it is we need a couple of
bad actor, Yeah, exactly.
Speaker 3 (30:50):
And you know, it turns out that not all physicians
are delivering care that are that are meeting guidelines, and
so there does need to be some kind of check
and balance. So on one hand, you know, the idea
of prior off going away, but really what you know,
there's a new CMS not new, there's a CMS mandate
out that goes live for payers first and then for providers.
That a brings some level of transparency, but also requires
(31:14):
certain turnaround times that players have to meet. And so
for urgent ones within two days and for non urgent
ones within seven days, which is dramatically faster. Yeah, thirty
days that historically been the case.
Speaker 1 (31:25):
And almost forces them into a technology solution. That's exactly right,
because that's good for you guys. You just get it.
Speaker 3 (31:32):
Better to be lucky than go And I would say
that the regulatory landscape is only heating up more, you know,
it's it's definitely not a problem that's going to go away.
Speaker 1 (31:42):
So maybe asking you to put back on your physician
hat or your entrepreneur hat, maybe a combination of both.
But you know, if we take a broader view outside
of PA, you know, i'd love to hear your views
on what's been kind of driving the cost crisis and
maybe what you if you were in charge, what would
be one or two solutions you might have or thoughts
you might have to really improve the cost crisis that
(32:05):
we have in this country. How long do we have
pod just do it in a couple of minutes.
Speaker 3 (32:10):
A couple Well, the really short answer is it's very
it's very very complex, of course, and there's no like,
there's no simple magic silver bullet.
Speaker 1 (32:18):
I'm putting you on the spot hereably.
Speaker 2 (32:19):
Yeah, no, I love it. The drive is really on.
Speaker 3 (32:24):
You know, the increase in costs is really on all fronts.
Labor costs are going up, that's you know, it started
before COVID, but really accelerated with COVID, So labor costs
on the provider side are going up, all the durable
good costs are going up. And then we also have
all of these really expensive drugs and as we were
(32:45):
talking about earlier, you know, almost all the new it's.
Speaker 1 (32:49):
Really wonderful that the is fantastic.
Speaker 3 (32:52):
The innovation is fantastic. And patients that previously you know,
couldn't get problem A B or C treated now have
treatments for it, and all those are expensive. And so
you know, if you looked last year, commercial fee for
service insurance rates went up eight to nine percent, and
for you know, for a family.
Speaker 1 (33:10):
That's that's meaningful.
Speaker 3 (33:13):
That's a meaningful amount of money. And so you know,
I don't know exactly what the average family for is
spending on a commercial insurance rate, but it's in the
twenty thirty forty thousand dollars a year, and that's just
that's just not sustainable. And so increasing labor costs, increasing drugs,
increasing devices, all of these things, and then there's just
an enormous amount of waste. And so you know, up
(33:35):
to some studies would say a third of care delivered
doesn't you know, necessarily follow a guideline, could be in
a gray zone. Some of that you know, as a doc,
I'd say some of that gray zone is appropriate and
some of that gray zone isn't appropriate. And so couple
that with all of the paperwork that hospitals need to
deal with. If you look at providers thirty years ago,
(34:00):
they had ten administrative staff per physician. If you look
at it today, it's forty to fifty administrative staff per physician.
And that's just dealing with all this back office bs
so that the doctor and nurse and care providers can
deliver care. And so most people in healthcare would say
those forty to fifty people per physician are not making
(34:21):
the service. You know, it's not a Ritz Carlton experience, right,
There's just a lot of stuff that's happening behind the scenes,
and that's cost interesting guys.
Speaker 1 (34:30):
I think a lot of people come out on the
administrative side as the one area to really focus on
that we could make a real material change.
Speaker 2 (34:37):
There's no doubt in my mind.
Speaker 3 (34:39):
You know, even when I started, you know, building companies
to try to solve back office problems for healthcare, we
are at a at a vanguard moment where we now
have technology available to us that that was just not
available even two years ago, that we can solve some
of these problems. And so that coupled with frankly, a
(35:00):
cost crisis on both a provider and payer side. You know,
healthcare is slow to innovate in many ways, especially around
this administrative stuff.
Speaker 1 (35:08):
And so you know, it's all the regulations and exactly
it's difficult clients, it's it's it's hard to move the ship.
Speaker 2 (35:14):
You know.
Speaker 3 (35:14):
Yes, And now I can say, you know, very favorably
that c suite leaders on both the provider and payer
side recognize that this is this is unsustainable and we
have all of these back office costs we need a technology.
We need technology solutions to do this, and and prior
off is one of those. There's also, you know, a
(35:36):
whole bunch of other back office things that are very
well sell, very well suited for technology. And I would
say the immediate thing that I could see and should
that we should expect to see over the next couple
of years here is that providers and payers are going
to adopt artificial intelligence to handle this back office stuff.
(35:57):
And they're going to work on the fringes around what
you using AI for care, but for the most part,
it's going to be in this back off of stuff.
Speaker 2 (36:04):
And you know, I just I.
Speaker 3 (36:06):
Just hope that that is a huge step in the
right direction to actually reduce costs, not just add costs and.
Speaker 1 (36:13):
System I have a ton of questions, but I'll try
and keep it to one or two. Are there one
or two technologies or improvements in AI that you're looking
forward to, because I think when I listen to the
in videos or whoever it might be, they talk about
these waves and I don't know that I could even
define what the waves are because I'm not a technologist.
But is there are there any that you're really looking
(36:34):
forward to that you know, we'll have this, we'll drive
an inflection in either your business or the healthcare sector
in general.
Speaker 3 (36:41):
What we're going to see in the next twelve to
twenty four months in new care that's so new capabilities
around generative AI and in traditional AI, it's going to
be mind boggling. And we're going to we're going to
see it implemented in non healthcare frankly before we're going
to see it implement in healthcare. But you know, around voice,
around video, around unstructured data, around agents that are i
(37:07):
mean even today but increasingly so over the next year
or two, able to do autonomous work that humans did
in the past. It's just remarkable. And then if you
look at what we're seeing advanced in the robotics field
and what what some of these robots, these AI driven robots.
Speaker 1 (37:27):
Can do again with all the sensors and everything, I.
Speaker 3 (37:30):
Mean, it's just remarkable. And there's so much movement of
people and movement of stuff within healthcare. How those you know,
how those technologies can be used to frankly make hospitals,
which are generally inefficient places, be more efficient and sort
of less requiring people to do some of those things.
It's gonna be it's gonna be pretty pretty amazing.
Speaker 1 (37:51):
So maybe I'll dovetail that into a little longer time
span than twelve to twenty four months. But where do
you want humanity to be in? I don't know, five years,
ten years.
Speaker 3 (38:00):
There are hundreds of millions of prior authorizations every year,
hundreds of millions, and that means hundreds of millions of
times patients are having to wait to get care or
it's not being done well, and so they're getting stuck
with a bill on the back end.
Speaker 2 (38:16):
And so what I you know, what I.
Speaker 3 (38:18):
Would love to see is that we're tackling the majority
of those prior offs for providers all across the country.
Speaker 1 (38:26):
Well said, you mentioned it before. You've been involved with
a number of companies. I mean that's all. We've mostly
been talking about Humata, But you also are working with
a number of other different entities. Maybe you want to
touch base, touch on a couple of those that you
find the most exciting and where you're doing some other
work outside of PA.
Speaker 2 (38:42):
Yeah.
Speaker 3 (38:42):
I love all my children equally, So there we've got
five wonderful kids. I love all my children equally. Am
involved in a variety of other things, really proudly, my
wife and I have launched a new venture fund focused
on female founders called Simana, called the Donna Fund, named
after my mother, and you know, we're on a mission.
(39:03):
Two percent of all venture dollars go to female founders,
both in healthcare and outside of health care.
Speaker 2 (39:10):
And if you look at if you look at you know.
Speaker 3 (39:14):
The attendance rate, the graduation rates in both undergrad grad
school and med school predominantly women.
Speaker 1 (39:22):
And so there's this huge guests to disconnect there.
Speaker 3 (39:25):
Huge gap of you know, women that are getting funded
in in you know, in their entrepreneurial ventures. And and
I've you know, I've been very fortunate that have been
able to raise money from really wonderful people and really
wonderful firms and just excited to put some of our
capital to work to help these these force of nature
(39:45):
women do really amazing things. The other point there is
eighty percent of all health care decisions are made by
the woman.
Speaker 1 (39:53):
And now it's interesting, we've had a couple of female
founders on the show, but mostly in the women's health arena,
and they always point to that that statistic as well.
Speaker 2 (40:03):
Yeah, it's just fact.
Speaker 3 (40:06):
So it's you know, it's not only the right thing
to do, but it's also the right thing to do
from a business standpoint, that women should be leading more
of these companies, and so we want, you know, we
want to help make that happen. So not just women's health,
but you know women that are tackling healthcare and technology. Yeah,
building healthcare into.
Speaker 1 (40:21):
Now understood anything under the sun, anything under the sun.
So if you're a female or a woman founder, reach.
Speaker 2 (40:26):
Out to the Yeah, we'd love to hear from you.
Speaker 1 (40:29):
So one of the ways I like to wrap up
these conversations is to focus on a life lesson that
that drives the guests to Jeremy, is there something that
you're comfortable sharing for me to your personal life or
your business experience that really drives you on a day
to day.
Speaker 3 (40:43):
There are lots There are lots of things that my
team would you know, my team and share. I've got
lots of silly little sayings that I like to use.
Success comes from failure and life is a team sport.
Entrepreneurship is a team sport. That's not the one I
want to share, but a good motto, you know, and
(41:04):
and a bunch of similar ones, but you know, the
one that comes to mind.
Speaker 2 (41:07):
I remember earlier in my career, I.
Speaker 3 (41:09):
Had the opportunity to meet Doug Leoni, who you know,
the famous venture capitalist with the Ransiquia Capital for a
long time, and you know, I was asking him, what
are what are some of the things that you look
for in your you know, in people that you back,
and his answer was failure.
Speaker 1 (41:28):
Interesting.
Speaker 3 (41:28):
And so, you know, one of the things that I
think about in both you know, personal life, but also
definitely in building companies is you've got to make failure
acceptable and and maybe even celebrated, because it's those failures
that allow you to build something great on the other side.
And so embrace failure and don't shy away from it,
(41:50):
and great things will happen.
Speaker 1 (41:51):
That's excellent. Thank you for sharing that story, and thank
you for giving us a great lesson on prior and
humut of Health and the Donna Fund. I'm looking forward
to your continued success. So with that that's Jeremy Freeze,
founder and CEO of Human of Health. Thank you so
much for joining us on our latest episode, and please
make sure to click the follow button on your favorite
podcast app or website so you never miss a discussion
(42:13):
with the leaders in healthcare Innovation. I'm Jonathan Palmer, and
you've been listening to the Bandguards of Healthcare podcast by
Bloomberg Intelligence. Until next time, take care,
Host
Jonathan Palmer
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