Connecting the Disconnected: Inside Personify Health’s Mission to Make Personalized Care the New Standard

What's up everybody? It's David. I'm your host of Highway to Health. Appreciate you being here. If you've tuned in in the past, you know this podcast is meant to celebrate the people and the organizations that are committed to improving access, experience, and outcomes for our patient community. That's why I'm excited to introduce Dave Thomas, executive at Personify Health. Welcome to Highway to Health. Thank you, Dave. Good to see you, man. Appreciate you being here. It's good to see you. So, you know, I kinda prepped you on this, but we start every podcast the same way. Appreciate you being willing to share a little bit about a healthy habit you've implemented in your life. Could be physical. It could be mental, but what do you do to stay at the top of your game? Yes. Thank you. And thank you for prepping me too. Yes. I do, I do something every day that really has affected me personally. I look for opportunities every day to say something kind about someone else. It has affected me in many personal ways, and I hope I'm having that same effect on others. But I do, start my day, every day by, you know, reaching out and trying to make sure I have a positive influence, throughout the day. So I start my day with that. Our platform at Personify Health allows us to give what they call shout outs. And so, I typically will start by shouting out to someone, in our company, who's done something great for the last week, or the day or whatever. Yeah. I think that's important. I mean, when we're focused on others, we're less worried about the challenges, the the things that we're going through personally. Gives you a minute. It's obviously great for them, and everybody likes to be recognized and rewarded. But internally, it does us some good too. Yes. Very much so. Let's talk about personify health. Yes. You know, this you know, we talk about access, experience, and outcomes, but we've seen a rise in this personalization in health care. Everybody's using that term, but it means something different to a lot of different people. How does personify how do you define personalized health? Great question. I think, the industry as a whole, has a big gap, and that is, just what you just just what you described. That personalization. We are trying to bring the member experience, personal to them from a navigation perspective and understanding of the plan perspective and so on and so forth. What I'm getting at is when a member, gets issued a a benefit plan at work or purchases a benefit plan on their own, there really is no assistance past that. They don't, have anyone to help them navigate. And so the more information we can give them that's meaningful, to them personally, in their own lives, it's very effective. So when companies wanna communicate, about diabetes, If you don't have diabetes, those communication pieces might be less interesting to you. But if you're interested in nutrition and sleep and mental health or something like that, and you start to receive those style messages, you're more apt to trust, that, relationship and the information coming at you because it is personal to you. So we're trying to bring a lot of that personalization based on, you know, the member's experience with their health journey. So you're looking at their past interactions with in a health care setting, understanding maybe what, you know, challenges they've dealt with in the past or what age they are, what they might be going through anticipating. How are you how are you gathering that information, I guess, so that you can deliver a personalized experience? Yeah. Part of it is, listening to the member, connecting with them in the ways that they want. So, we'll typically start with a health what they call a health risk assessment. And part of that assessment is understanding what the member likes, what they're interested in, and then using that information to bring them, meaningful data. The next thing that everybody's talking about, Dave, is is AI. Artificial intelligence, like personalized health, means something different to everybody. Is it real? What are we talking about? How does how does Personify Health see AI helping the the the patient or the member? Yeah. Definitely critical in, the overall costing of health, administration today too. AI used correctly in administration is a very powerful, tool. We use AI in a whole host of ways to help identify members that are most likely to engage so that we can quickly, affect those that that need it. And then on the claims administration side, where you used to have to, you know, pull large dollar claims and then get them to a clinical director, you can have AI search for claims that have maybe fraud, waste, or abuse in them, that you can then pull and give those to the to the professionals that would, directly address those. So AI is exciting, the way we're using it in health care. I think it's only gonna help, with costing over time, to identify and get really focused on, who we're engaging with and, you know, the types of claims we're we're looking at. Using AI to understand large amounts of data and to find trends, outliers, exceptions, is such a time saver. And with twenty million lives, I can't imagine how much data is coming from those twenty million. Not all twenty million are, like you said, are engaged every day and and, you know, are are part of that journey, but that'll even help you identify the ones that should be and that could be and even treat them in a personalized way much more quickly. Yeah. I think, you know, I shared a couple examples, but I think our data scientists would would agree with you that there's a whole host of ways to, dissect the information that we're using. And then, you know, using AI to look at, you know, overall outcomes after the fact and say, how can we, you know, take a similar, person and make it look just like that in in way of outcome versus, hoping every every single event works out the same. We can we can maybe affect it, on the front of it. That coupled with now, the biggest innovation, is the claims activity. So I'll, give you an example that that might make, make sense. If someone goes to the doctor and they have some blood work done and the doctor says, hey. I really think you need to lose weight and watch your nutrition because you're, you know, you're at a prediabetic state or some sort of a condition is going to result, based on your current lifestyle, you need to change those behaviors. That may be the last time that member ever gets an interaction relative to that. But if we're able to start to take those biometric testing and that information based off the claims activity and start to move content toward that member for better, eating habits, exercise plans, meal plans, those types of things, that's helpful to the member because they can advance what that physician just shared with them specific to to that person. So it's really cool. And engagement in the app, engagement with this type of information has it has to you know, it probably improves the adherence to a plan, to a to a prescription, to something to the direction or guidance that they're getting from a health care professional. Yes. Statistically, our engagement levels, with membership is, you know, in the mid to high fifties, which is great. But the reality of it is and is is it's not a hundred percent. It's not everybody we're touching. Right? And so, how do we do that? Well, that's a that's a really big achievement with, member engagement. And how we do that is communicating with them in ways that they're most likely to, want communication style. So some people like text, some people like email, some people like phone calls, Some people like visual or letters or materials like that. So we work in an omnichannel setting that, is more effective, for those members. So, I mean, that's where my head went immediately was, the different styles of information in engagement channels because you're working with a diverse population. I mean, the the clients that you guys have, the partners that you have, the different types of people that you have to educate, you have to engage, you have to inspire. How do you take that diverse population and meet the demand come because I know my parents learn differently than I do. My kids learn differently than I do. I can I can imagine that's a challenge? Yeah. The ways of communication is often a challenge. We serve today, about over twenty million, covered lives. One of the unique, aspects of our communication is that, you know, that omnichannel approach, but, also, we have the, you know, we have the ability to, for lack of better words, mimic, members that might, look just like that individual. So, we'll take members, and if we're having issue communicating with that member, we will find members that look exactly like them in a lot of ways. Geographically, same age, same, you know, male, female, and then we'll start to use effective measures with those folks and try to apply them, effectively with that that member we haven't been successful, outreaching. Another thing with health in general is just because someone, isn't, you know, willing or ready to engage today, doesn't mean they're always gonna be like that. If someone says, hey. Leave me alone or I don't, you know, I don't really wanna engage at this time. They might have an experience in their life, an emergency room visit or a scare through health that that they might change their mind, and we're ready, waiting for them to, you know, actively reengage. Or something even, you know, positive for where, you know, somebody gets pregnant and they're expecting. Well, things change pretty quickly, you know, in a life event like that, and they might need some information. They might need some guidance. And to be there when they're ready is important. What about language barriers? I mean, we you look around, and, I'm sure that that's gotta be a part of it too. Yeah. So super exciting, Personify Health, today. We're in a hundred and ninety countries. We communicate in, twenty three different languages that are most popular here in the United States. You're bringing up a a very important part of our success in health care is communicating to members in the language that they're most, comfortable in. Deductible, co pays, lab, x-ray, urgent care, that's not how a lot of people can do. Normal. Yeah. Normal. We don't say that at the dinner table. That's right. And there's no there's no real effective translation for those types of things. And so being able to communicate with members in their, the language that they're most comfortable with is super meaningful and another way that we get participation up. In health care today, in the United States at least, I think we oftentimes focus on Spanish speaking or English speaking materials, and we think we've got it all covered. But that's obviously, not the the final, set of individuals we're trying to communicate with. And this country is so diverse. Our clients are so diverse as you so well articulated, and, being able to communicate and bring their language to health care in the way that we do is is really, really powerful. Big piece to access to care and experience while getting that care is what level of health literacy that patient has. You know? Because I've been in health care thirteen years, I still don't necessarily understand my EOB. You know? I still don't understand my benefits and my coverage all the time. I have questions, and I've I've lived it and breathed it. I've explained it to many others over the last thirteen years. Still a challenge for us. And so understanding the level of health literacy of these patients and then being able to explain to them and discuss, educate them at the level that they need, is is a huge component to access and experience while getting that that care along the journey. Yeah. I want you to know you're not alone. Alright. At my own house, my wife will ask me a question, and then I you know, it's like the deer in the headlights. I I glaze over often too. But, yeah, it's, super important we meet the member where they're at, and making sure we're effectively communicating. Look. We have seventy five hundred very special client relationships, over twenty million, you know, affected lives in our ecosystem. And it's just so great that we have the privilege of learning, all of those different aspects and then bringing it to, to the benefit of of our of our service. Well, that's a huge benefit. I mean, you get to understand I mean, you get to take a fifty thousand foot view, twenty million members, and see trends, see needs, see challenges, see opportunities, and then help deliver a solution based on that data. It's gotta be it's gotta be a big differentiator. Yeah. With the limitations too in access to care, there's not a you know, the primary care physicians, a lot of times are aligned with the health systems that they, that they, practice at. And a lot of the independent, provider base isn't there anymore. So when members, you know, need care, in particular in an emergent or an urgent situation, they oftentimes, you know, don't know where to go first. That's not really easy. But to make, the communication pathway and then access to care through telemedicine or, you know, some of the avenues that the that the member would have access to, through us, is very meaningful for for that. On the experience topic, I mean, access is obviously important. We've got to make sure that these patients are getting what they need when they need it. The experience side to me, you know, at least in my personal experience, and even with my kids and my family, like, the experience with the practitioner, the doctor, the clinician is usually really good. Rarely are you dissatisfied with that experience. The dissatisfaction or the frustration usually comes at the beginning or at the end where I don't know where to go. I don't know who to go see. I don't know what I am covered to, you know, to access. And then at the end, what does this mean? How much what wait a minute. How much is this exactly? I I see Personify Health as a solution to those two big frustration points. What are you seeing in terms of the biggest frustration points that the patient population are experiencing? And then how how are you guys taking taking note of that? Awesome. This is, like, super, this gets at the core of what is so passionate to me. Everything you just described is exactly what happens today. And I think Personify Health prides ourself on making sure that we're there for the member before the claim or before the, they enter into the health care system to try to do two things. One, inform them just like you said of what they have if they ever had access care, but keeping them well. Like, keeping them out of the system. Right? Giving them alternative pathways to being well, feeling better, tracking their sleep, tracking their weight, making it easy to get information all in one spot. And then if they have a question, you know, click quickly linking them to our service teams or quickly linking them to a health coach or a care provider. Those are the types of things we can do in front of it. Now if they enter the system, helping them navigate to low cost, higher quality care, within the confines of their plan or or what they have available to them, is just so important. And then afterwards, both helping the member and the employer making sure claims that are submitted on their behalf are, intentionally, what they they need to pay. Right? And helping the member understand, the benefit. And then from the employer perspective, making sure claims that were submitted on their behalf, have integrity behind them. There's no upcoding or upcharging any fraud, waste, and abuse or claims that were submitted that should be, resourced elsewhere. That's something we we do very, very well, at percent of health as well. It's like having an advocate, you know, on your side, and it's so needed. I mean, we're all so busy that, obviously, your health and your family's health are priorities, but we're also distracted. And and our bandwidth is so tight that, you know, it's almost like I'll go anywhere. I'll worry about the rest later. But that decision sometimes can lead to some really costly consequences, for the patient and the member later on, and having this information readily available makes a big difference. Yeah. I love the way you just said that. The, David, the if you saw, we we typically, will present to employers, our solutions. And one of the slides that comes to my mind is all of the things that the member actually has to think about when they also have care. You know, their network, their EOB, their ID card, who's eligible on the I mean, there's just so many things that a member has to go through, you know, when they think about accessing care, And it just tends to go out, you know, the ways that we call them member advocates at Personify Health because we truly are advocates for those members. Even with our clinical teams, the way you, stated it was so great because we help them prepare questions for the doctor. When they get in front of the doctor, I think it's referred to as white coat syndrome where they just, you know, they I'll do whatever you need to do. Panic in front of them and forget all the things that they were supposed to to talk to them about. We'll help them prepare those, questions, follow-up with the provider, give the provider information too, active information about their, their patient that they're, that will help them treat the patient and so on and so forth. So it's it's it's connecting all of the pieces together, in a really meaningful way, but making it, you know, sort of this, you know, Google or Amazon or Netflix experience where it's just really comfortable for for all parties to access the the data and and care information? The experience expectations now. I mean, outside of health care, we get the same a similar experience pretty much everywhere. The bar is low. Right? Right? Well, in health care, it is. Yeah. Yeah. But when I go to Chick fil A Yeah. My expectations are high Yeah. Because I get the same experience every time. It's quick. It's quality. It's affordable. Yeah. Right? Amazon, Netflix, all these other things that you just described meet that same expectation for me. And health care has to get there. We have to get there to where we can meet the same experience expectations that we're getting in other places. Yeah. That is, that is key. Personify Health is trying to, make that possible with health care. Connect the disconnected. Bringing together so many key elements, with a user experience that is second to none. And if you think about today when when someone has a claim or tries, you know, or, you know, an employer that has a well-being motion to try to keep their members well, Once the member enters the health system, they they gotta go learn a whole new set of people, and they have to leave that environment to go here. What if that was together? And that's what personify does. But that that is really the disconnect in, in health care, the before, the during, and the after that you spoke up, that we're fixing. And the exciting thing is it's here. We're the health care is changing so fast, but the focus on member navigation is what we're doing that is the biggest differentiator. If you can connect the member, with an engaged platform to help them understand where to go for low cost, high quality, the the outcome's gonna be good. Right? The sexy fun stuff to talk about is the savings, but but the quality of life for that member is gonna be much, much better. The feedback that we get from our member membership on the platform, is just really special. Tells tells the story, in itself. What so, I mean, it's here. We're seeing it. It's being implemented. What are we seeing in terms of impact across the twenty million lives that you guys are a part of? Impact in way of I mean, are we seeing an an improved, you know, health care journey? Are we seeing lower cost by, the employer? Are we seeing healthier populations? What's the biggest positive impact we're seeing with this increased navigation advocacy? Yeah. So, without sounding too pie in the sky, it's all of the above. I mean, the the members' engagement when they get to the right place or they get information that's specific to them, they're going to have a better quality of life and a better outcome. They're going to be more engaged, with what they're trying to do. And the cost implement implications of it are dramatic as well. The impact we're having on cost is great, and we're very responsible with measuring that. We're having external sources validate what we're doing at Personify, but I think that's important to to to watch those outcomes as they improve, finding areas that are better. I'll tell you one that's that's making a big difference is clinical, activity with our membership. So, you know, when we're looking at members, the more our clinical teams are engaged with the member, we're finding that it has a dramatic impact on where they go. And then then that also translates into a reduction of wasteful spend in health care, which gets at cost. Right? Which we're all trying to do. But an example that I think everybody, talks about in in the industry right now is GLP one or weight loss or, you know, the things that that are affecting spend. But, you know, if you look at alternative ways to help people lose weight and GLP ones have their place. They they're very effective, for the right membership and and that kind of thing. But the reality is there's such a, eager need for, you know, these types of things in the marketplace. But if you have ways that members can effectively lose weight without GLP ones, then show it to them. Help them get there, through health journeys that are meaningful to them. And then you're gonna have a better impact on the member and their quality of life, but the the cost will follow right right there. Give them options. Yeah. You know? Let them choose their journey. And a lot of a lot of patients, a lot of members will decide the lower cost option, or the preventative option as opposed to, you know, the bigger, you know, health care event later. You you mentioned something that, I wanna touch on. You know? Almost in every other area, you get what you pay for is common. You go buy a car. You want a nicer car, you're gonna spend more for a nicer car. You want nicer shoes, you're gonna spend more, and you're gonna get nicer shoes. I'm gonna put you on the spot because this is not something we've talked about. But why doesn't higher cost health care equal better health care? Maybe sometimes it does. I think if you looked at I, well, what you're touching on the most in my mind is that everyone goes right to cost, right, for health care, or then they start to limit things. If the cost is to Iowa, we gotta take this away or higher co pays or higher deductibles, things like that. But, there's been many studies that directly show the highest cost doesn't equate to the best quality. But in some instances, that's misrepresented too because there are some very good, facilities that cost more, because they do it. I think if you break down, in my opinion, and experience over the thirty years I've been in health care, looking at providers and what they do well. Some of the cost comes because they don't do it that often or that's not what they're, you know, known for or what they wanna be doing. But if you send a member to a particular facility, while it may be higher in cost, but it's gonna be done right because that's what they do, you're gonna have less readmissions, less complications, longer, health effects for that care versus a low cost option or or even, you know, forgetting cost. If someone doesn't do it a lot, that member ends up readmitting or having complications. Now you've just escalated cost tremendously, you know that. But the quality of life for that member is not great. So if you can marry the two, I think it's the best of both worlds. Oftentimes, we go right to cost, but, but but when you mirror the member with where they're going to be most successful with that health care event, I think that is the magic. Connecting them with the proper care, the right place, right time, and then you'll get you'll get a good outcome both ways. Are you seeing you know, with some of these new innovations in therapy and other things, are you seeing more and more opportunities to avoid the big surgery or avoid the big operation or procedure with maybe a new innovative solution or a different type of therapy that could deliver a similar or higher quality of life, at a lower cost. Are you seeing that? Yeah. Definitely. I think there is some I'm not a clinician, but I know that, you know, some of the medications today, while the cost has shifted to the pharmaceutical or the drug side of things, certainly, you're seeing a less, you know, less admission rate into the hospital for those same I mean, there's some even, you know, disease states today that are that are curable, and you'd have never thought that, you know, ten, fifteen years ago. But the you know, some of the drugs are very expensive, and then over time, they'll come down, you know, through through those, you know, different, clinical aspects. But I think definitely, yeah, there is, an appetite for how do we fix members through clinical outcomes, at any any way that they're, achieving it through drug or through clinical care. But at the end of the day, there is definitely a shift from, you know, keeping the members out of the hospital, but, you know, that that's at an expense, maybe elsewhere. Yeah. It, you know, I'm thinking of where you have a shoulder injury a couple years ago, and it was immediately sold immediate shoulder surgery. Now with PT and some of these other things, surgery, it didn't it didn't always have to be surgery. You know? And defaulting to that procedure is sometimes costly when you could, you know, through some navigation and some advocacy and some education, maybe find a solution that saves you a lot of money, delivers a very similar or even better outcome. And you're not also not out of work, and you're not you you can still throw the baseball with your kid, and it's the quality of of life that's improved. That's what excites me, about health care too here recently is just I mean, we're living in the golden age of innovation. Yeah. And there's some of these therapies and treatments that just weren't around. Well, think about what you're talking about too. This is, again, what really gets me excited about not just not just our platform. Obviously, I'm an advocate for it, but keeping people out of the system. Like, if if there you know, David, every day I get up, I I, check my weight, and I record it. I check my mood. I I record, you know, my sleep. All of those things, I do those shout outs that I talk about. I say something nice about someone. Those are the ways I start my day. It doesn't take long, but then there's active fitness plans that I follow. I have access to health coaches that keep me out of the system. I've never felt better about myself, never been in better shape, physically or otherwise, but but I am investing in it, but it's not the the platform has allowed me those resources to be able to do it. I think we're we're challenged as a whole, when someone wants to lose weight or exercise or get a hold of their care from a holistic perspective. It can be difficult with no assistance or navigation, in those, in those measures. And And that's why I like asking that question at the beginning of every podcast because we do. We have a responsibility. You know, there's a great health system, and we're lucky lucky to have access to it in a lot of ways. But you gotta take care of yourself, you know, physically and mentally and and spiritually, and find a a habit or a few habits that keep you healthy for the people that you love, the people that depend on you. And if you don't implement those things, you're it it is costly later on. And and that's why I like asking because I've learned a lot from people like you who have cool new habits that I haven't considered, and I take bits and pieces of those and try to implement them because, you know, I wanna be around for as long as I can for the ones that I love, and everybody does. And so I appreciate you sharing those things. Last question. You know, we've talked about access experience outcomes. We've talked about, the way employers are saving money, patients and members are saving money, the type of engagement that we're delivering. But if, you know, if somebody's watching, listening, and they can only remember one thing or take away one thing, what what's that key takeaway for them? I would say that, the I'm a positive person. I think the horizon's so great. Everybody is hustling to try to figure out how to get the member, more engaged. I think that is the, you know, the kind of gold, if you will, in this whole thing. I'm excited about it. I don't think before when you looked at and I mentioned, you know, Amazon, Google, and Netflix as, you know, experiences that are comfortable, a lot of, you know, folks on the platform and things like that. But it it's just you wouldn't even think it's possible in health care, and we're changing that. So that's what I'd like, if I had one thing that it's it's here. It's possible. I just think we we've got to embrace the member. Listening to them, bringing them resource, listen to the employers that that we serve in the health care space, and really bringing them products that make sense, for their populations unique to them. Personalizing, the experience from an employer perspective and a member perspective, And the greater you get at that, the outcomes will just follow. To start with money or cost isn't, in my mind, always the best, but to start with, the drivers of, the system and the utilization of it and breaking down, you know, what's possible for those members is is exciting to me, and it's here. Well, a guy that has been on this podcast before is he said it's hard to herd cats unless you move their food. And if we're educating and engaging in a personalized manner with the information that's most valuable to the member, that's the food. And if you do that, they'll engage with it. They'll learn from it. They'll improve their quality of life, their quality of health, and it'll take a lot of stress off the system, take a lot of stress off off the employer. Well, it's becoming possible. The right message at the right time to the right person. That's kind of the secret sauce, and y'all are already a lot of the ways there. I'm sure AI is gonna help get get even closer. This health care journey can be a lot more pleasant for the greater population. Pretty large population, twenty million people as a part of the Personify Health community. So thank you for being here. Thank you for sharing some of those things. Having me. And I agree with you. It's exciting. Let's be optimistic. Let's be positive because some of these things that are happening in health care right now are gonna make this journey a lot better. Thank you all.