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Saul Marquez:
Hey everybody! Saul Marquez with the Outcomes Rocket, and welcome back to another episode on our show. Today, I have the privilege of hosting Nick Kirby on the podcast. He is the vice president of partnerships at Sprinter Health, where he leads sales, business development, account management, and also strategy. Prior to joining Sprinter Health, Nick was in the corporate development team at LabCorp, where he led equity investments, licensing deals, and also strategic partnerships. He did his MBA at Duke and also BS in chemical engineering. So definitely a bright leader in healthcare, and we’re excited to have him on. Nick, thanks for joining us today.
Nick Kirby:
Thanks so much, Saul. It’s good to be here.
Saul Marquez:
Absolutely. Look, we’re going to dig into the work that you guys are up to at Sprinter Health, but before we do, we’d love to learn a little bit more about you, and what is it exactly that inspired your work in healthcare.
Nick Kirby:
Yeah, it’s frustration.
Saul Marquez:
Fair, a fair answer there.
Nick Kirby:
All jokes aside, I think, like a lot of people originally got into the healthcare industry because, at the end of the day, it’s impactful in terms of helping patients. But for me personally, it’s the confluence of big, tough problems to solve with a lot of innovation from both science and technology, but also just generally new care models happening that have the potential to address a lot of these problems. So, throughout my career, I’ve always been super interested at the intersection of innovation and technology and using business as a vehicle to take that and help solve big problems in the world, and so healthcare is obviously really ripe with those. At the same time, there’s a lot of promise. And so a little bit of an eternal optimist where it comes to we can take on these challenges. We can use a lot of the innovations that are in front of us to address them. And so that inspires a lot of the work that, for me, personally, I think broader for Sprinter and our company, we’re really inspired about the idea of expanding access to care and bringing care where people need it to those who need it most and making it more accessible in general. And we hear a lot, just for me in the company every day, feedback from patients and that inspiration as well.
Saul Marquez:
That’s awesome. Yeah, big problems, and access is one of them. So, Nick, talk to us about Sprinter Health. What are you guys doing to improve the access problem?
Nick Kirby:
Yeah, it’s a great question, and it’s core. We are bringing care to folks who aren’t getting it today, and we’re doing so by going straight to their home or wherever they call home, and we’re providing a wide variety of different preventive services. So that sounds still vague, I’ll give you more explicitly.
Saul Marquez:
… again, yeah,
Nick Kirby:
Yeah, so we work directly with health plans and risk-bearing providers to identify the members who haven’t been in to see their primary care provider in a year or two or maybe even three years, who have chronic conditions and have specific gaps in care that they have not received. So these are guideline-driven preventive things that have frankly been around for a while that we know, when done at scale, have dramatic impacts and have a great impact on the patient’s outcomes. And so we’re taking those and identifying the folks who are at risk who have not been receiving these services, and then Sprinter, our team engages these folks through omnichannel outreach. We can send text messages, or email, or phone call. We’ve made it super easy for people to select a tie in a minute or less, book an appointment, and have confirmation. And so what we’re trying to do on the access side is by bringing care to directly to the patient and making it really, really easy, we’re able to do stuff like diabetic eye exams or check someone’s blood pressure. We’re actually doing a lot of social screenings today where we’re looking for housing, food, transportation, and security. We can draw labs while we’re in the home. We can do a wide variety of other clinical tools like fall risk assessments and things like that. And so effectively, what we’re doing is we’re meeting folks where they are, and we’re collecting all of this information, but then the key thing is, getting that to their primary care provider. So we’re a way to connect folks back into primary care and increase access and preventive care engagement. We’re not going in and necessarily treating the patient. We’re not managing our care ourselves. We’re just providing an affordable access point that helps risk stratify populations and get folks who need care most back engaged in the system. In a nutshell, that’s what we’re doing. I’m sure we’re going to a lot of other detail on how it works, but that’s just a little bit about us and how we’re uniquely positioned.
Saul Marquez:
Yeah, thank you, Nick. That’s really interesting, and really serving as an extension to healthcare providers, reaching those tough-to-reach patients.
Nick Kirby:
Yeah, exactly. And there’s a lot of at-home models out there today. And sometimes it really gets confusing because home, care at home is blowing up. There’s a wide variety of different care delivery models across the spectrum. And so sometimes it’s also helpful to describe a little bit about what we’re not doing to … our model. So, we are not a legacy home health post-acute, someone’s been discharged in the hospital 30-day, 90-day type episodes. We’re also not like a landmark where there are chronically ill complex patients that they’re caring for in their home for more longitudinal care. What we’re doing is we’re actually leveraging a slightly different licensure level and going to the home where we’re sending phlebotomy-certified medical assistant-type skill sets, but also a blend of a community health worker in a way. So that way we’re keeping our ability to scale, we can train folks on license and certify them, depending on the state in a matter of weeks versus years. And so we’re we’ve been building up a scalable workforce to meet folks in the home for kind of more of this lower acuity, but still high leverage interaction. So there are other companies out there, too, like Dispatch that are doing more urgent care, higher-acuity hospital-at-home models. Again, that’s not us. We’re really focused more upstream. So hopefully, that helps provide a little bit more.
Saul Marquez:
It does, yeah. Thank you. And actually, I was going to ask you, what’s different about what you guys do?
Nick Kirby:
Yeah, yeah, it’s a good question. There’s, I think one of the things is really the fact that we have a different licensure that we’re leveraging from a clinician standpoint. So all of our clinicians at Sprinter Health are called Sprinters. They go through all of our training programs, and they’re deployed into the home, and they’re W-2s, they’re fully employed. There’s a number of other companies out there that are doing more of a 1099 Uber-esque model where contractors can get on to a platform, they can go into the home, and that’s like a little; so we’ve taken the approach of going W-2, staffing, training everyone ourselves, deploying more targeted interventions and having a wide variety of different skills that are skills and services that are done. And again, more in that in that preventive realm.
Saul Marquez:
Yeah, that’s interesting. And then, is it usually white-labeled for health systems, or are you guys coming in as Sprinter Health to help people, and does it matter?
Nick Kirby:
It’s a great question. It’s actually co-branded most of the time.
Saul Marquez:
Okay.
Nick Kirby:
We still have Sprinter Health scrubs when we go to the door, and we still have messaging that incorporates our brand, but it’s often done in partnership with our health plan or referring provider partner, where we will say health plan X, Y, Z, as we’re doing some really important services for you that can be done at no cost in your home. So a lot of our engagement messaging has the branding of our partner, and they know that way, because we’re also relatively newer brand, so there’s still people who don’t have a lot of brand awareness. So we do leverage that relationship, and then we also make sure that they understand that we’re going to take all the results that we’re getting and get it back to their primary care provider. So again, it’s that kind of connectivity where the primary care provider is not going to have the resources to go to the home, but we can go to the home and collect the risk-based data that they need to best manage the patient and get them reconnected. And so there’s this kind of ecosystem where, yes, the health plan is often our customer, but we also have an entire provider engagement team that’s working with their network providers to let them know we’re going to see your patients. We’re sending them all of our encounter summaries. We’re blending in between both of those stakeholders.
Saul Marquez:
Got it. Yeah, thanks for that. And the last question I have on that track, is it a Medicare Advantage play, or is this broader than that?
Nick Kirby:
Great question. And it’s, what we’ve seen traditionally is most of the home programs are limited to the Medicare Advantage line of business. I think primarily just because the reimbursement incentives are the highest there. The nice thing about our model is, you can think of us as the roughly half the price of sending an advanced practitioner to the home. So, like an NP could cost you over $400. We’re coming in around per visit or roughly half that. And what that means is all of a sudden, we can go see other lines of business. So we actually have a lot of work in the managed Medicaid space. We work with exchange populations. We do also work with Medicare Advantage. But what we’re seeing is that the lower cost per visit all of a sudden unlocks these in-home models for new populations. And a lot of the work that we’re doing in the Medicaid space, these are often folks who don’t have great access to care. So we’re seeing people who haven’t been into a doctor in years, and we’re often finding a lot of issues and having, making sure that they did engage with resources that are available to them. So we often see, we’ll hear from patients, “Hey, yeah, my blood pressure is high, but I can’t afford my medication.” And they may not even realize that their health plan would not only completely cover it, but they’ll mail it to their front door. And so there’s care navigation component as well, where we can surface some of these issues to a case management team, and they can be addressed that way. And that, the whole purpose of going to the home is also to get a little bit more of an intimate setting, and so we have found that folks are a little bit more willing to talk about some of these issues in like a in a face-to-face setting.
Saul Marquez:
Man, that’s so cool. Thank you for answering my questions there. But it’s a very unique model and definitely all-encompassing. Folks, it’s a great example of how, if you figure out cost models that can scale, you can actually broaden access, which is the topic of today’s conversation, and get creative with the partnerships you can make happen, and ultimately, end of the day, equity and access is the name of the game here. Thank you, Nick. What would you say is one of the biggest setbacks you guys have seen in a key learning that came from that?
Nick Kirby:
Yeah, setbacks, I’ll rewind a couple of years back when we were really starting to grow scale in the early days. We had a number of different partners that had national scale, and we were only working with them in 1 or 2 markets, but they wanted us to be in 20, 30-plus states. And so we had this kind of interesting strategic decision to make, which is, the partners are projecting a lot of demand and growth; do we try to scale as quickly as possible to be a national provider and only do a couple services, or do we try and go deeper into the markets that we’re in and expand into doing a lot more complex kind of tasks? And so, because we knew going to 20-plus states would be really hard to try, an overnight scale of a workforce we’re doing. And so we had, there was a, this was seen as a setback because we had a risk of losing some of our early partners to folks who maybe had more coverage than us who were maybe hiring 1099 contractors across 40-plus states, and all of a sudden they have this bigger footprint. End of the day, we decided, look, healthcare is always been local, healthcare is local. We’re going to double down in our existing geographic footprint and deepen our relationships with partners there. We’re still going to continue to support our national scale partners, but we’re just going to let them know, hey, it’s going to take us years to get to national scale, and sometimes saying no to a partner at that early stage of a business is really hard to do. I think, ultimately, this was the right decision for us because we’ve been able to now have dozens of new services that we’re doing in the home. We’re still in five states, we’re adding several more right now as we speak, we’ll be adding more next year, but we’re doing it in a sustainable way. And what we found is doubling down and doing a really good job for our partners over the first couple of years, we’re now being asked, can you go to New Hampshire? Can you go to Michigan? We’re hiring ten-plus printers across Michigan as we speak right now. And so that has helped to take in, we’re taking a little bit of a longer-term view, but I think the key learning there is just not to be afraid to effectively say no to, when it’s oftentimes hard as an early-stage startup knowing that you have this kind of true North Star and go-to-market vision of building up a different type of workforce that can go into the home and do a lot of complex tasks, versus trying to just like rapidly expand revenues. So it was a difficult decision, but I think like where we sit now, it was absolutely the right call to make.
Saul Marquez:
That’s great. Yeah, kudos to you and the leadership team, Nick, for being able to stand by that. It’s hard, right, when you have revenue waiving in front of you and saying, hey, just scale what you have now and we’ll grow with you, versus our plan was this, and we believe it’s the sustainable route. You guys stuck with it, it’s paid off. So big kudos to you guys. So are people driving around in Sprinters?
Nick Kirby:
I like that question, and we get it all the time. So today clinicians operate out of their own vehicles, and we reimburse and all that good stuff.
Saul Marquez:
I had to ask.
Nick Kirby:
Yeah, maybe next year, sure. Unfortunately, Sprinter.com was taken, so where.
Saul Marquez:
Yeah, I imagine. How about Sprinter.Health? Was that open, maybe?
Nick Kirby:
That’s a good question. We may even have it for all I know.
Saul Marquez:
Yeah. That’s funny, man. All right, good stuff. As you think about healthcare and how fast it’s moving technology, finally, healthcare is moving faster than it has been in the past. What’s a trend or technology that’s going to change it as we know it?
Nick Kirby:
Yeah, I’m sure you’ve heard plenty about AI, so I won’t talk about that, not today.
Saul Marquez:
All good.
Nick Kirby:
You want another trend, though, that I think is here to stay is effectively allowing primary care providers to take on more risk than just the general adoption of more upside downside risk. As we talked about earlier, a lot of it has been, I think, limited in the Medicare segment. But I think we’re going to start to see that spill into other lines of business and to continue to realigning incentives to keep people healthy and do a lot more proactive care. I think that general trend is here to stay. I think the other thing that we’re going to see that has unfortunately eroded a little bit in the years is just general trust in the system. I think I said earlier, I’m an eternal optimist. I think we’re going to start bouncing back. I think a lot of the erosion of trust comes from complex, multifaceted causes. At the end of the day, I think when providers are not in a great spot, it’s harder for them to care for their patients, and if you have a limited interaction, there’s going to be a natural degradation of trust. And as providers adopt new tools and technologies that make their lives a lot easier, as the incentive payments change a little bit to allow them to spend more time with patients, I think we’re going to start to see a lot of trust rebuilding in the system. And so that’s, again, just a little bit more of an intangible thing, but I feel like we’re starting to hit an inflection point there, which is, in my opinion, exciting.
Saul Marquez:
Yeah, I agree with you, man, and I think a big part of that has to do with AI.
Nick Kirby:
It does. Yeah, right, right.
Saul Marquez:
And the ability to drive incentives to both providers and physicians that are immediate that care for some of these upfront proactive care measures is going to be critical in making some of the more value-based things happen like you guys are up to. So now, look, this is awesome, really fascinating work that you and the team at Sprinter Health are up to, Nick. I’m glad that you came and did this podcast with us today so we could share it. If people, if payers and providers wanting to learn more want to engage with you, where can they reach out, and yeah, what’s the best place for them to do that?
Nick Kirby:
Yeah, first of all, thanks so much for having me, Saul. This is fun to talk through. For contacting me, I’m on LinkedIn. My email is Nick@SprinterHealth.com, so I’m happy to chat anytime, talk through everything that we’re doing, what states are in, etc., and see if there’s anything we can do to help folks out while we’re already on
Saul Marquez:
Amazing. Nick, thanks for joining us. Folks, we’ll leave all of the resources that Nick shared with us today, including ways to get in touch with him and Sprinter Health, in the show notes, so make sure you check those out. And remember, take action on what you learn today. Don’t just stop at listening. Take action to improve your outcomes. Nick, thanks for joining us.
Nick Kirby:
Thanks so much, Saul.
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