CENTENNIAL, Colo. – After several years spent working in senior positions at medical device companies like Abbot Technologies, Wright Medical, and Boston Scientific, colleagues Rod Nuss and Patrick McCarthy had a clear understanding of the healthcare system’s financial complexities. In 2014, the two decided to apply their expertise to building a company that could reduce healthcare spending.
“When we approached Humana with our initial idea, they told us, ‘This is great, but we have a bigger problem,” said McCarthy. “We need a way to monitor our patients when they’re outside of the hospital so we can reduce readmissions.”
The remark resonated with the pair. In 2008, Nuss had undergone abdominal surgery. A few years later, McCarthy had broken his hip while skiing. Both had experienced complications during recovery. Both understood the importance of staying connected with caregivers.
“We decided we were going to connect patients to those who care,” continued McCarthy. “It was the same business model. We would still be focused on reducing the cost of hip and knee surgeries. It was just a different application.”
Six months after Nuss, McCarthy, and a third partner, Scott Hardin, founded their company, ValidCare, the Centers for Medicare and Medicaid (CMS) announced new guidelines for hip and knee surgeries. Hospitals would now be penalized for excess readmissions. Nuss and McCarthy felt validated. The transition to value-based care had begun, and their company was perfectly positioned to take part.
Powering the Transition
According to McCarthy, his company’s mission is to make value-based care a reality for patients everywhere while allowing providers to reap the financial benefits of the new care model. ValidCare accomplishes this with its platform, which connects patients and caregivers throughout a surgical episode. The platform also aggregates care data from multiple providers in its database.
“Most providers lack a way to reach out to patients in real-time,” explained McCarthy. “They’ll set up a patient portal, and they’ll have an app that will allow patients to check into their appointments. But they won’t be able to gather information throughout an episode, from before the surgery to well into recovery.”
Providers generally introduce patients to ValidCare in the days leading up to surgery, instructing them to download the company’s app as part of their preparations. Once patients download the app on their computer, tablet, or smartphone, ValidCare begins sending them pre- and post-operative care instructions, including content specific to their procedures and targeted surveys.
“Hospitals could arguably do this on their own,” admitted McCarthy. “But with CMS comparing everyone in certain markets, providers need a repository of information, a way to gauge not only how they’re doing, but also how they’re doing in relation to their competitors.”
By aggregating care data from multiple providers on its platform, ValidCare is attempting to become that repository of information. According to McCarthy, doing so will produce a “fishbowl effect,” enabling providers to compare their performance to that of their peers.
“By collecting and comparing patient-reported outcomes, we’re generating information that will allow providers to determine how much CMS is going to reimburse them,” explained McCarthy. “We see it as a way of giving providers a chance to compete for reimbursement.”
A New Transparency
By letting providers keep an eye on their competition at the local, regional, and national levels, ValidCare is bringing transparency to the healthcare system. But McCarthy sees the platform making the healthcare experience more transparent as well.
“Our platform has been shown to significantly increase patient engagement,” he said. “We’ve seen a 70% utilization rate once patients start using ValidCare.”
By consistently assessing patients through standardized surveys, providing them with important care instructions, and closely monitoring their progress, ValidCare removes the confusion patients can feel prior to and after a major surgery. From McCarthy’s perspective, empowering patients in this manner can give providers a big advantage over their competition.
“Value-based care is coming, and that means you’re not getting paid for volume anymore, you’re getting paid for outcomes,” McCarthy explained. “What we’re measuring and reporting on are those things which are common, but we allow the healthcare experience to still be individual, and that’s a big deal.”