Offering all children access to free healthcare through in-school virtual medical clinics
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Providing All Children Access to Healthcare with Josh Golomb, CEO, Hazel Health was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.
Welcome to the Outcomes Rocket podcast, where we inspire collaborative thinking, improved outcomes, and business success with today’s most successful and inspiring healthcare leaders and influencers. And now your host, Saul Marquez.
Saul Marquez:
Welcome back to the podcast. Today, I have the pleasure of hosting Josh Golomb. He’s the CEO of Hazel Health, a healthcare company that’s reshaping the pediatric landscape by offering all children access to free healthcare through in school, virtual medical clinics. Hazel partners with schools to improve student health and decrease absenteeism by providing students with instant access to a network of doctors for a speedy diagnosis and care plan. Josh is an experienced Senior Executive and has Co-founded New Healthcare Enterprises and presided over several large organizations, fostering tremendous growth. As former CEO of Direct Primary Care Startup Paladina Health, which raised one hundred and sixty five million and was acquired by New Enterprise Associates in 2018, he has proven success in developing forward-thinking healthcare organizations while delivering exceptional clinical and financial results, which you all know, that’s the key cornerstone of what we do here in Outcomes Rocket — outcomes and results. He’s passionate for education and for engaging teams and partners in a vibrant, patient-centered culture that celebrates innovation. Josh received both his undergrad and MBA from the Stanford University, and it’s with a pleasure that I gave Josh a warm welcome. Thanks for being on the podcast, brother.
Josh Golomb:
Thank you for having me Saul. That was quite an intro. Thank you.
Saul Marquez:
Hey. Well, it’s quite the career, my friend. So I’m excited to dive into the details and what’s on your mind. And so to start things, what is it that got you interested in healthcare?
Josh Golomb:
You know, it’s interesting. So when I was in college and I went to college, I was sure I wanted to be a doctor. So I was the first in my family to go to college. And I got there and I was taking the science classes and I love them. And then I had this experience. So through Stanford Medical School, there was a program I got to run bringing high school kids around the Bay Area. Kids are typically in underserved areas that were really high potential and we’d bring them to campus for five weeks during the summer. And the goal was to get them exposed to science and hopefully get them to want to pursue the medical career. And so it was one of those amazing experiences. I’d say that the kids we work with impacted me in many ways more than I impacted them. And it got me excited. It made me realize that you’re not really passionate about healthcare. I was more passionate around the sort of systems side. And this idea of this setting is “how can I get these amazing kids to get into the medical field and bring their talents?” That was more exciting to me than the idea of me being a physician myself. And so that drove a lot of my career choices along the way of how do I impact healthcare or the medical career from sort of a system and policy perspective.
Saul Marquez:
Love it, man. You know, it’s so interesting how that happens. And and so here you are. I mean, still continuing with that drive, that mission to help our nation’s youth through providing now healthcare to them. Access is a big problem. And so what’s on your mind, man? What do you think the number one thing that needs to be on health leaders agenda today and how are you and your team at Hazel Health approaching it?
Josh Golomb:
Yeah, you know, I think that I think probably one of things I wish there was more focus on is particularly, I’ll say, the underserved communities. I’ll talk about I’ll use just some Medicaid recipients in particular is a lot of folks. It’s about right now in the US that 40% of all kids and living up pediatrics, a lot of all kids get their insurance through Medicaid or what’s called SCHIP. And so that’s so great that we have these kids that have about 95% of kids now have some kind of healthcare access. And it also sometimes pains me that there’s not more of a focus on that population. And I read a stat recently that that last year there’s 7 billion dollars that poured in from venture capital firms, from healthcare systems and healthcare companies in a big bucket of digital health. And so… and if you actually pull apart the data, so little that is focused on underserved populations and a lot of that dollars are focused on people who I think this assumption that folks are more well-off, middle and upper class folks and it’s interest because there’s both huge need. And then we spend most of our days are spent working with kids from all parts of the country who really need access to healthcare. And the data shows that 95% of those families and the parents have smartphones and are clamoring for more healthcare, more ways to access. But see, what were I said, “I don’t see as much investment of these amazing new technologies and people that could probably most benefit from that.” And so that’s the stuff that I get excited about. And I should say sprucing up what we are seeing, a big movement of other great organizations out there that are starting to focus there. But that’s where I is… this is this idea of could healthcare innovations be focused on all Americans, not just those that the upper tiers.
Saul Marquez:
Yeah, I think that’s a great call out. And I think it’s fascinating the approach that you guys are taking. So you’re taking a platform, which is a school and this is where kids are. And you’re quickly accessing these kids. And giving them access through telemedicine. So I’d love to hear from you, Josh, some of the early results, how things are going and maybe even an example of how you’re creating results by doing it differently.
Josh Golomb:
Yeah. Yeah. And if so, if you don’t mind a quick digression, stories like this, a personal story that guides a lot of my work. And so I’ve got three sons, my oldest one, Gabe, who’s actually now 14. But when my wife and I went through this experience with Gabe our first. So when he was 18 months old, we found out that he was deaf. And so it turns out that my wife and I both have this recessive gene for deafness connection. Twenty six. And we didn’t have any idea to have any cancer in our family. But all of a sudden we found out at our first child that first time through this parenting thing that one of our other son couldn’t hear. And so hugely challenging, you know, as you can imagine, for especially for a first time parent. And this whole experience we had for the next six months of trying to figure out, they better understand that we’re pretty uninformed, tried to navigate our health insurance, how to navigate some county and public services. And Gabe is fantastic. But we ended up getting him cochlear implants and it was a line to make it sound simple is a really long journey for him to get to where he is now, which is he’s doing amazing. He’s about to go into public school, high school, getting straight A’s. And the kid is my absolute hero.
Saul Marquez:
That’s great man.
Josh Golomb:
Yeah. But I share the story because when my wife and I were going through this, we were both well-educated. We had good insurance. We spoke the language. And it was really, really hard to navigate the healthcare system, even with great providers out there. And we think we are so thankful that there was great physicians, audiologist, speech therapist, just navigating that system was so incredibly hard. And there were few times along the way when we were at places like trying to figure out what county services that you could get and we’d be in the room with other parents. And I remember just feeling like, “my gosh, this is so hard for us to get what we need.” And we’re like coming from a place of privilege. It’s we know what to do to access it. And if we didn’t speak the language, we didn’t have great insurance. The trajectory would be much different. And a lot of the work that drives me and I think this is part of the Hazel culture is like how do we make sure that everyone has access to great care and has a way to get connected into that to these great providers that are out there and to make sure that the system is an enabler and that are the people being healthy. So it’s quick, quick digression…
Saul Marquez:
Love that you shared that, Josh, because it’s real. I mean, you know, it’s real. And I know that a lot of people listening can identify with that. We’re all in the same boat. And so I appreciate you sharing it.
Josh Golomb:
Yeah. Thank you. And so what’s interesting is as we enroll kids into Hazel, you know, one of things that we do is we ask for families, get a bunch of background information, get the medical history, but we also get some data on how their current experience of healthcare is. And what’s interesting to be asked family who their primary care doctors are, and I should say I’m a huge believer in the importance of primary care and everyone. I think we’d like every person, virtually every kid to have a local primary care docs. You know, the primary care physicians are our heroes and you know, the folks who do spend a lot of time supporting care. And sadly, when we enroll these families that typically Medicaid, only about 50% of them tell us today that they have a primary care doctor, even though they may have access through their insurance, they may have even been assigned someone through their insurance. And so a lot of the work that we imagine doing day one is how do we help bring that 50% broadly into the healthcare system? How do we give them a great healthcare experience and give their kids some access to care, solve some problems right there and then for them, but then also hopefully connect them to a local doctor over time that can also help, make sure that they’re getting the kind of local care that they needed. So that’s a lot of what we’re built around doing is how do you make sure that the things that all kids need, but particularly kids are underserved, can get access to in school every day.
Saul Marquez:
Yeah. And I think that’s a great call out. And frankly, when you take a look at the social determinants of health, transportation being one of them, access is mainly to do with how do I get them there without missing a day of work to miss my rent payment. Right. So it’s hard to navigate and it’s hard to work. So tell me, you guys are having some early success, but what are some of the setbacks you’ve had that you learn from that have made you better?
Josh Golomb:
I think that you know, for us, like so much of the learning has been a couple of buckets. But the first one is how do we really partner with schools and be great partners for them and the good schools? Mostly when they think of schools, you think of it, you know, these teachers are working hard for kids. But there’s also this all these other great folks in schools that are already doing things your way before Hazel ever got involved. And so you’ve got school nurses that, you know, they’re often these like these super heroes on the front line working with both kids and their families. There there’s hopefully some schools have social workers where they’re dialed in. And it’s interesting because you know that term social determinants of health, I’m a big believer that sometimes the people talk about in the abstract and when you’re working in a school setting, all that stuff is like front and center and it’s all the stuff that the school staff is navigating, but they’re navigating through. I mean, did everything through kids. You may have food and security and may kids who qualify for the free breakfast program, free lunch program and whether or not they’re able to access that. We’re dealing with the students that maybe foster you, they’re homeless. And so in the school setting, I think for us, one of the biggest learnings is how do we start from a point of this all this great work already happening? How do we support them? How do we use both our providers and the technology to help them make more progress and connect the dots and get them more access to resources they have today? So that’s, let’s say, on the partnership side and then with families, I think a lot of the work to be doing is also just to realize that and to make sure that we are operating from a place of where they are and having been in healthcare for a long time. One thing about this is that we have a tendency to want after every single visit to solve some big problem for a patient or a family. And it’s interesting cause some of the families we work with, especially those that haven’t really had great access to healthcare, will find that like some of the first couple of things I want to do with the family we’re seeing their kids is just like just make their life easier. So like the example you gave of like what? It’s hard enough for me as a parent to get out of work, pick up my kids when they’re sick and I have relative schedule flexibility. But if you’re paid hourly. Your boss is upset if you leave work. You know, it’s really hard for a lot of parents to get get their kids from school, let alone be able to get an appointment that same day. And those families we work with, we’re like just like the first two times we interact with them. But just like we’re gonna solve that problem to make sure your kid is seen. Hopefully they’re helping out. We actually find that kids are as when they show up in the office. About 90% of the time we’re actually able to keep them in school that they’re clinically appropriate so they can stay. They’re getting more education. I mean, it’s great for them academically to have that academic time and it’s so much easier for the family. And so we find as we solve that, it’s really important, but really simple issue that for those same families, when maybe later on there’s more complicated issue we need to work through them. But they trust us. They see us as an advocate and that we’re trying to help them and not just where they need to be help and not just what we want to solve.
Saul Marquez:
That’s a good call out. So, Josh, at this point, you guys are operating just in California or have you expanded beyond that?
Josh Golomb:
Yes. So we’re in today, we’re in California, in Nevada and in Arizona about fifteen thousand kids on service right now.
Saul Marquez:
Got to come to Chicago, man. Anything I could do to help? Let me know.
Josh Golomb:
We would love to be in Chicago.
Saul Marquez:
Well, let’s definitely chat after this. Anything that we can help you with is definitely a big deal because you’re doing some great things. What would you say one of your proudest leadership experiences has been to date with the company?
Josh Golomb:
You know, it’s funny because when I think of the things that get me proud, like I was a combination of an analytical brain and a very kind of like individual case brain. And so like the data, we get data back from schools where they’re looking at how it is impacted. And so at this macro level, view will have, you know, seeing about a 40% reduction in health related absenteeism from our partners. And so when I get that data and all that. There’s a ton of data out there that shows that absenteeism in attendance is correlated with academic performance, graduation rates, even metrics like incarceration rates that children’s attendance is. And it’s sort of common sense. But what’s interesting is even when you look at its rates and things like kindergarten, those play out in fourth grade, fifth grade reading and writing scores, even when attendance gets better later in life, is being in school early on is a big driver. So I get fired up about that because I think about the system level impacts of kids having more access to school. But then honestly, this stuff, when I’m driving home and I see my kids at night, they tell them stories about work. It’s always in the individual stories. And so like just this week, this great story from our providers where a girl and one of our schools and a third grader always been doing really well in school. The last few months, things have been taking a turn, having some behavior issues. And the school asked us to kind of get engaged. And also some things are showing up as physical health symptoms. And so providers spent we had a good chance of spending 15, 20 minutes with her and really do both the physical assessment, but also ask a bunch of sort of health screen, well-child visit sort of questions and uncovered a bunch of stuff that was going on outside of a school setting that was playing out in, you know, in your physical health. And how she was doing in school and the ability to talk to them was interesting as we were doing this in partnership with the school nurse and the social worker, because you’re also trying to triangulate and we uncover about the details. We uncovered some stuff that was pretty important going on in this girl’s life. And then we’re able to partner with the nurse and social worker to get her and her family the services that she needed. And yeah. And then the feedback that we got from the parents, from the school site, which is awesome because it was something that they have been a few potent steps. They were able to get the child’s already doing the job. Reports that you feel is far better that she was able to share some of this is getting some of the help that she needs. And that to me is just like, you know, this girl could be my daughter or anyone’s daughter. That’s the stuff that honestly gets me the most fired up about the work that I do is the little stories that we know that make up the big data chains.
Saul Marquez:
Yeah. That’s huge. Josh, and you know, the thing that crossed my mind, too, is like suicide. You know.
Josh Golomb:
Yeah.
Saul Marquez:
The thing that these kids go through and the pressures when you get into these social environments as a young youngster, it’s definitely impactful work that you guys are up to.
Josh Golomb:
Yeah, I’d say that’s it. This piece are in mental behavioral health for kids. I mean, it’s hugely important right now. And luckily this year we’re seeing a lot of people focus more energy than before with that. I would say the name earlier last month and, you know, a decent sized districts, they had already had eight suicides as a high school district, eight suicides this school year. And it just is crazy. And, you know, a lot of focus we need to have as a country. And how do we make sure that we’re undertaking the root causes, but particularly connecting kids who need it to the services that they need.
Saul Marquez:
Yeah man. And that’s for sure. I was listening to a podcast the other day, “How I Built This” have you ever heard that podcast?
Josh Golomb:
I have.
Saul Marquez:
One of the guys he was interviewing, some rapper. I forget the rapper’s name. I’m just like, this is going to show how bad I am. Like music stuff. But the guy had a song. Oh, the guy’s name was Logic. And he had this song. And the name of the song is actually the suicide number. Like the suicide line number.
Josh Golomb:
Oh, interesting.
Saul Marquez:
Yeah. I was like I was really inspired by it. So the thought is, hey, man, maybe you guys should reach out to Logic and do a little thing with them because that might be kind of cool. anyway. Side note, reel it back in. Totally. Great things to be proud of. What’s an exciting project you’re most fired up about today?
Josh Golomb:
Yeah, actually, it’s totally connected to the point you just brought up, which is we’re just how do we start to integrate what we do in the sort of physical space? Mental, behavioral health? And so we’ve been working with a number of districts to have something that’s already been trying to figure out this thing, some of the things they’re trying to tackle for the first time, but so much especially for kids. I think that’s true for all of us. So much of mental behavior health and physical health is connected. There’s a lot of data that shows and two things work together. And so I’m excited. How do we actually build that more in our model? Both both screening tools, but then also the ability to connect to other specialists these kids may need access to. Because they’re still in it. There’s both the identification of kids that may need access to services, but there’s also then the referral process and there’s still a lot of stigma for all families around how to access these services. And so the hope is that we’ll be able to show that you can deliver, you can bring more of those services using technology like technology like we do for Hazel to kids in schools. And so I’m excited that will very soon have some programs up and running to assess whether we can make a big impact in this area.
Saul Marquez:
That’s exciting, man. Good for you. I think it’s it’s a great area to tackle and it’s becoming more and more of a focus for insurance companies, for providers, and also companies providing services like this. So kudos to you and your team. I always think of Rene Descartes. He says, “I think, therefore I am.” It’s integrated, my friend.
Josh Golomb:
But Descartes and Logic are in the same like three minute period.
Saul Marquez:
Oh man, one of those mornings. But it’s good. It’s good. So this is the part of the podcast, Josh, where we do a lightning round and then we follow up by a book that you recommend to the listeners. You ready?
Josh Golomb:
Yeah. Let’s go.
Saul Marquez:
All right. What’s the best way to improve healthcare outcomes?
Josh Golomb:
Improve healthcare access.
Saul Marquez:
What’s the biggest mistake or pitfall to avoid?
Josh Golomb:
I’d say to focus on the technology or the innovation as opposed to the patient themselves.
Saul Marquez:
How do you stay relevant as an organization despite constant change?
Josh Golomb:
I think honestly listening. Particularly to your patients, but also to your partners and making sure that they’re very easy down building companies to get so focused on what you’re building and not so much what people are telling you what they need.
Saul Marquez:
Wise words. What’s one area of focus that drives everything in at Hazel Health?
Josh Golomb:
At Hazel Health. It’s all about the kids and me and their families and making sure that we’re always grounded and that every single day.
Saul Marquez:
Love that. And I’ve got two new ones here. One of them is, what is your number one health habit?
Josh Golomb:
Ooh health habits. That’s a good question. I think the biggest thing I’m trying to build in for myself this is to actually make sure that I actually take quiet time. Actually, I spent a lot of time on my own time on planes for work. And I always used to only get work done on planes. And very wise person told me, is that’s your one place that no one can reach you to make sure that you always take at least 30 minutes of quiet reflecting time. And so from that well-being perspective, that 30 minutes, I get the unfortunate trap up in that I had time on a plane to take 30 minutes. And that’s been incredibly important quiet time for me. And I try to build that on my commute to and from work.
Saul Marquez:
That’s great. And what do you do with the quiet time Josh? You just meditate? Do you journal? A mix of both? What do you do?
Josh Golomb:
Yeah. You know, for me, I’ve found that I personally like reading something short and then reflecting or listening to podcasts or listening and just listening to music and something that triggers self reflection and then making the time. I would say that I don’t do this perfectly. If I actually journal something down or write something, that’s the best way for me to turn it into action. But I’m only like 25% of the time likely the heck turned into writing. But it’s good to just have quiet.
Saul Marquez:
Now, that’s awesome, man. It’s a good practice. And what would you say is your number one success habit?
Josh Golomb:
Oooh gosh. Big question. Number one success habit. I think the best thing that I do that is when I like the thing that always grounds me is someone to listen to patients, actually. I think we have a lot of provider. All that… the doctors, and PA’s and MP’s that work for Hazel, they get together every morning and they’re talking about specific clinical cases and what they’re doing. And it is really easy in my role to get so caught up at building things and meeting and talking on podcast and talking about the world as if I’m the one doing it. And the best thing that I do, I was on yesterday and like the store, I gatekeeper, not just when I just shut up and listen and hear what’s really happening in the field and the questions. And, you know, sometimes it’s great story. Sometimes it’s finding out this like that we thought was brilliant innovation that providers hate and isn’t actually working or it’s not actually solving a problem. And so you I’d say shutting up and listening is the best thing I can do. And I should do it more often.
Saul Marquez:
I love that. That’s great. And what book would you recommend to the listeners Josh?
Josh Golomb:
You know, it’s funny cause I made a ton of books that I love. I’d say the one book that I brought back to every company that I’ve helped build. There’s this company called a book called Five Dysfunctions of a Team by Patrick Lencioni. And it’s just a super idea if you’ve ever read it before.
Saul Marquez:
I haven’t.
Josh Golomb:
It’s super simple. It’s the kind of book you can read in like two hours. It’s sort of like a cheesy fable, but it’s all around it, basically sort of team building. This and this parable, they do a rant like what does it take to build a team? And so every company that I’ve led be periodically review it every year or so. And then there’s sort of five principles of what drives effective teamwork. And we’ll usually read it, assess ourselves. But it’s it’s always simple, good grounding for what it means to build a strong team.
Saul Marquez:
Love that great recommendation is definitely on my list now, Josh, I appreciate that. And listeners put it on your list, too. It sounds like a great one. If you are a leader of an organization which most likely listening to this you are, so outcomesrocket.health in the search bar type in Josh Golomb and the company’s name is Hazel Health, doing some outstanding things for the nation’s children. Josh, this has been an awesome discussion and I’m definitely going forward to following you guys. What would be your closing thought? And then the best place of the listeners could learn more about you and your company?
Josh Golomb:
Yeah, I like my disclosing thought is like I think I’m so excited to see so many talented people getting into both healthcare and in education. And it’s been it’s fun for me to see how many people been just investing and getting into this that maybe didn’t happen 10, 20 years ago. So I just love the people. My biggest push would be people who have passion and excitement to pursue that. And, you know, whether that’s something like Hazel or something else that follow that passion, you know, we’re growing Hazel. So I’d love to meet more people that are excited to work with us and our partner with us on the outside. So my email address is josh@hazel.co. So that’s co, not that com, but we would love to meet other people excited about doing great work in healthcare and for kids in particular.
Saul Marquez:
Outstanding, Josh. And folks, take Josh up on that invite, reach out to him anytime and you could find his contact info, obviously. He just gave it to you. But also in our show notes. So make sure you check out the episode on the website. Josh, a true pleasure, my friend. Thanks so much for sharing your wisdom on this front.
Josh Golomb:
Thanks Saul. Also, it’s great to meet you. Thank you for having me.
Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration, and so much more.
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