Earl Hutz, Chief Operating Officer at ThoroughCare, Inc.

Improving Care Quality While Increasing Revenue Through Care Coordination with Earl Hutz, Chief Operating Officer at ThoroughCare, Inc. transcript powered by Sonix—easily convert your audio to text with Sonix.

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Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez is here, and today I have the privilege of hosting Earl Hutz. He is the Chief Operating Officer at ThoroughCare. He’s an accomplished operations, professional and services leader in the I.T. industry that specializes in enterprise software development, operations, consulting and deployment with significant experience and successfully leading professional services and technical operations teams. Thorough sound leadership is what drives him, and a strong communication and talent recruitment skills all combine him into an outstanding leader in health care. At ThoroughCare, they’re providing a tech enabled platform services option that supports health care professionals with the administration of care management and wellness programs. In his role as chief operating officer, he provides leadership and oversight for numerous diverse business functions, including product strategy and development, contracting, strategic partnerships, business development and investor relationships. The really neat thing is how they’re helping practices, large and small, care for their patients, and especially during this time. It’s important that we start looking at different options to do what we do better, more optimally. And so with that, I want to I want to give you a warm welcome. Earl, thank you so much for joining.

Earl Hutz:
Thank you, Saul, for having me today.

Saul Marquez:
Absolutely. So you guys are doing some fascinating things at ThoroughCare to simplify care management and also wellness programs. And so we’re going to dive into that pretty deep here today. But before we do, I’d love to just get a better feel for what inspires your work in health care.

Earl Hutz:
So I’ll I’ll go back to how I initially found myself in the healthcare space. I started my professional career as a as a software developer. And I’ve worked in the banking industry and happened to just familiarize myself with a technology stack that was being utilized by a healthcare services provider technology organization that we’re looking to to hire programmers. And it was an opportunity for me to take a step forward in my career. And I found myself in the healthcare space again, though no specific desire to be there, just the familiarity with the technology. And as I began my career in healthcare, I began to take immediate notice as to how I was making or able to assist in making a difference in the enrichment of people’s lives, in the sense that I’m helping build the solutions that healthcare professionals are using in order to manage patient care and drive them to work toward a better quality of life. So fast forward about 20 plus years and here I am today, and I really don’t see myself ever working outside of the healthcare domain again. It’s grown on me to that point where, you know, you’ll live it and you breathe it. And, you know, if you can touch the life of one person through doing what you do or through what I’m doing, it certainly can become an enlightening moment in your life and your career. So that’s really about it. There’s not any anything more deep in that. It’s just the opportunity to improve the lives of fellow Americans or fellow humans, for that matters. It’s just certainly an enlightening one.

Saul Marquez:
Yeah, Earl, now, that’s awesome. And you started in software development, in finance. And just so happens that, you know, that’s tech stack that you were familiar with, helped the transition and now you’re here even doing some pretty awesome work in health care. Let’s explore ThoroughCare care, your company. And so talk to me a little bit about what you guys are doing to add value to the health care ecosystem and specifically, who you helping and how are you doing it?

Earl Hutz:
Sure. So ThoroughCare, we were a provider of a tech enabled platform service and really were all about simplifying clinical staff workflow and driving healthier outcomes targeted toward the Medicare population, which Saul as you know, is growing to about 60 million Americans and about two thirds to 70 percent of which have multiple chronic conditions. So when ThoroughCare was formulated as an organization, it was initially about helping health care professionals assess their patients in a more streamlined and effective, efficient manner. We, my business partner, our CEO and founder, Dan Godla, we had worked together in prior space and some of the tools that we were using to help clinical professionals assess patients just we felt it could be he felt in particular, we’d done a little bit better. We started the prototype with Solutia that company and started the prototype. So we should towards helping providers provide help, risk assessments to patients, and in the early part of 2015, he started fielding phone calls from a number of groups or health care providers that he had been working with who were introducing him to a program that was recently introduced by the CNS called Chronic Care Management Program. So what is a chronic care management program? The Chronic Care Manager program is an opportunity for providers through support from clinical systems such as medical assistance or any staff under the physician’s clinical staff on positions or direction to provide non face to face engagement with their patients. And, you know, it’s just your normal type of care coordination, preventive and wellness type of activity. Get on the phone with your patient. Coached them through a comprehensive plan of care. You’d find goals and you identify the barriers to health improvements. So Dan took note of some of the opportunity provided through chronic care management. And before I move further on, that thing is also the doctors do get reimbursed for the services they provide. So 20 minutes of service increase on the national level to about forty three dollars. When you scale the numbers out to your practice levels, you look at the average practice and how many of their populations is Medicare eligible. And then you take the statistics behind, you know, the number of people that are Medicare enrollees who actually have multiple chronic conditions, which are qualifiers for enrollment in the program. You can see opportunities to drive quality improvements and also see, you know, revenue increases from it. So Dan started to pivot the platform a bit and allowing for some of the functionalities to meet the requirements that were stipulated per CMS association with the program. And then we were off and running and we started to gain a lot of traction in terms of signing up new practices to utilize our platform and helping them manage their chronically ill population outside of the office. So and again, we also provide the tools that help the doctors track the time that’s being spent and ultimately allows them to build for the services they’re providing. So really, that’s it. We’re not so unique in terms of a service that we’re providing for our technology. There are certainly a lot of tremendous organizations, software companies out there that right services that are similar to ours. But we wanted to, you know, find our space in this in this ecosystem of care coordination by providing tools that were easy to implement and that were really intuitive and streamlined and, you know, worked to help expand the user experience to a point where they could spend more time providing care to their patients and less time mired in trouble some technologies.

Saul Marquez:
So fascinating stuff here, Earl. We’re talking about practices, maximizing the care and also reimbursement for caring for their Medicare populations. You mentioned 60 million people, two thirds of which have chronic conditions. How do we take care of these folks better? And how do we get compensated for it? Tell me a little bit more about how this integrates into a typical practice. Right.. There’s the every practice has their unique setup. The EMR, each are landscape is highly fragmented. How do you guys fit into the picture?

Earl Hutz:
Yes, it’s certainly a great question. So we are not an electronic health record system. We are a complement to the EHR. EHR tremendous value. They do a lot of a lot of things and they serve a lot of different purposes. But we want to extend that process and and allow for the doctors to have a tool that provides them the capability to drive to specific purposes as they’re defined by, you know, an overarching care coordination operation or wellness operation, and also meet the requirements stipulated by CNS for enrollment of patients and for seeking, you know, claims reimbursements for the services. So there are very specific and targeted type of requirements in association with these programs. And, you know, admittedly, as doctors found themselves in the past trying to find ways to introduce these programs into their overall workflow, they found a number of challenges. They found that they weren’t able to maybe get to the level of detail is required within their EHR where they found the programs to be too complicated or, you know, the functionalities that were out there were just not streamlined to the point that they didn’t add too much additional overhead to their overall operations. So those are the things that we aim through our platform, you know, to eliminate. We want to help get rid of those issues and allow docs and their clinical teams to take advantage of these great programs. So we are interoperability is, you know, top of line, at least through through our lenses. We can integrate with pretty much any EHR platform we have direct partnerships with a number of groups, most notably three of the top EHR platforms, were partnered with directly Athena, Allscripts, EPIC., Dr. Crocco is another tremendous partner to us. We we work with an interoperability vendor who you may be familiar with, the learnedness redux.

Saul Marquez:
Oh, yeah. Reed OK.

Earl Hutz:
Tremendous. NICO Yes, we’re there. Yes, we are. We are friendly with Nico. We’ve had you know, it’s quite a you.

Saul Marquez:
We also had the CEO of DrChrono on as well. So small world, right? They’re really neat company.

Earl Hutz:
They are very unique company. You know, their their tablet only E.H. are. It’s really amazing. Yeah. You did. It certainly is. And from a partnership perspective, we can’t speak highly enough about the partnership we have with DrChrono. Quite frankly, you know, we have similar relationships with all of the charter vendors that we have. You have has partnered with and and they’ve been, you know, realistic and certainly transparent in the sense that they welcome groups like ours to help extend the ability to provide top notch health care services to an increasingly probable population icon. As you know, again, as people get older, we’re finding that the high majority of them are suffering from these chronic conditions, which can I don’t know, we can eliminate them in total, but we can certainly manage in a lot more effectively. Ninety five percent of the Medicare population has at least one chronic condition. And again, two thirds have two or more. And they’re certainly cost impact and health impacts. And there’s ways that we can, you know, keep these things in check and we need to have the Right.. Certainly we have the right frame of mind in terms of trying to move the needle from a reactive care model to a proactive care model. Certainly, we need the technologies in place to help support that transition. And we believe that we have a solution that offers just that guided patient assessments, a comprehensive care plan, the ability to track time and integrate with the EHR and exchange clinical summaries, exchange billing details and allow the process to be a very straightforward one and eliminate the overhead that is associated with the use of technology. All introduce another statistic. For example, we look at doctors. There was a study done by the advisory board or a number of groups that were put together through the advisory board. They posted an article on a study that was done. They looked into, I think, 60 different physician practices, and they found that 27 percent, 27 percent of the time spent by the doctors was actually providing care to patients. And almost 50 percent of their time was doing, you know, desk work. So what does that 49 percent of time? What do we define as desk work? Okay, well, some of it’s certainly working and charting and prescription refills and medication adherence and referrals and a lot of that’s being charted through the H.R. And you just have to believe that in that number, a lot of the time is spent by the doctors or their clinical staff essentially fumbling through the technologies that they’re utilizing. I think it’s seems or at least it seems to me that the doctors and clinicians are getting into their fields because they want practice care. They want to drive improvements in health outcomes. And we’re spending upwards of 50 percent of their day working within technology platforms and doing the things that kind of support the overall operation. They’re not doing the things that they really want to do. So we feel that if we can improve the user experience by even one or two percent, how many additional lives are touched by them in the course of a month or a year? And I don’t have. Again, I don’t have a specific number there, but it would be quantifiable. And there is that touch point with that patient, you know, gives that, you know, clinical, professional, the opportunity to make a recommendation to a patient or provide a service to that patient that improves their quality of life. Well, then we’re doing something right.

Saul Marquez:
Love it, Earl. And folks, here’s a take away. Listen to this. Their care integrates with any EMR. They’re able to help you maximize the care you provide to your Medicare population, maximize the payment associated with the time you invest. And the thing that strikes me as unique about you guys, Earl, and a chance to go to your site, Thoroughcare.net. You guys are curious Thoroughcare.net. The pricing. You know, I find that pricing is one of those areas that, you know, today you got to be competitive. And a lot of people are still kind of stuck in legacy models of pricing. But you guys seem to have a very unique pricing structure. And my unique I mean, highly affordable and customizable. Do you mind chatting about that?

Earl Hutz:
Not at all. So we will employ a number of different pricing models. So first of foremost, we’re not simply stuck or bound by one particular pricing policy. There are working in the software space. There are a number of different types of models. Most predominant one is, you know, your traditional member per month type of pricing where you’re just paying on an entire population. But we wanted to to, I suppose, take a little bit more of a risk in terms of how we are compensated, in the sense that we’re only going to pull component of the reimbursement for those that are utilizing our platform and supporting the fee for service programs will only take a piece of the reimbursement. If you are qualifying a patient for reimbursement. So again, explore the traditional chronic care management service where certified nursing assistant under the general supervision of a physician is providing 20 minutes of chronic care management service in a month. The national average reimbursement is about forty three dollars. We’ll take a piece of that qualification. So if you cannot work a patient to that threshold in a given month, we’re not getting paid. Aside from a small, small hosting fee that we charge just to pass through our costs, you know, we are required to pay to our hosting vendor. That’s the that’s the model we chose to employ because we re recognize that, you know, we need to be able to take more risk in this operation. And it’s not easier for the smaller practices that just pay us set fees if they have challenges in their ability. From an operational standpoint, in engaging with patients and they’re not able to move the needle forward and get patients managed in that time frames that qualify them for reimbursement, that we’re not we’re just not going to get paid for that service.

Saul Marquez:
So bottom line, 100 bucks per month and 250 bucks to set it up. Is that right? Yeah. So we are I mean, this is crazy, right? I mean, like in the grand scheme of things, it’s amazing. So anybody like, you know, running into issues like you have no excuse. There’s an opportunity here to really maximize what you’re doing. Or am I missing something?

Earl Hutz:
Well, there’s so there’s the hosting and the implementation. We just charge a one time fee that to, you know, load your your patient records into our platform set up and interact integration with the EHR to train your your staff on the use of our platform. So it’s a pretty cost effective setup process that we reintroduce it to set up the platform. And in fact, we can have an instance, show instance of your production environment set up in a matter of hours after contract execution, which is also we feel is a differentiator.

Saul Marquez:
That’s huge.

Earl Hutz:
For us. Posting is, you know, it’s about 100 dollars a month on average. Depends certainly on the size of practice. We’re storing a lot of data for managing a lot of patients after we hit certain thresholds. There may be a app or record cost of a couple cent of the per variant of the follows. After that, it will on scale. And then certainly, again, the predominant fee in our structure is, is the pull from the client. So Right., when you qualify the patient for the claim reimbursement, then we’ll we’ll take a small piece of that. If you are hitting minimum thresholds each month for guarantees against minimum numbers per month will drop your charges almost 50 percent or more on the per patient per per qualify claim reimbursement fees that we charge. So, again, it’s it’s small. I find myself in a position of puzzlement, I suppose. There’s not a better time for each time I look at the financial possibilities for a provider, especially those who are working in rural areas that are being paid by Medicare in terms of their contracted rates and are dealing with, you know, disproportionately higher volume of chronic patients. As we know or maybe your listeners don’t know, those who are living in rural areas are much more subject to the chronic ailments than those of us living in urban areas by, you know, a quantifiable number of percentage points. So when you’re when you’re a doctor in a rural area and you’re struggling for income, you need to get your people in a better position of health. These programs are really second to none. If you look at the average single doctor practice, we take it at about three thousand patients and they see about 20 percent, 20 plus percent are Medicare. And again, you get to you get to looking at about two thirds of them being or having two chronic ailments that qualify the patient for enrollment, NCCM. If you’re enrolling and actively managing half your population, you can see a revenue increase of anywhere between one hundred and one hundred and fifty thousand dollars a year. Now, of course, you can’t you can’t just add this to your existing clinical staff’s task list. You have to dedicate services toward the provision of these of these programs. And again, that’s under a doctor’s. So you can fire medical assistance to support them. The telephonic or telehealth based engagements with patients don’t require the doctors to be on the phone with the patient 20 minutes a month or charting the patient information for 20 minutes a month is a very small amount of time. And the doctor’s involvement is required for these programs. And again, a lot of a lot of the services provided directly to support of the medical system are certified nursing specialists. So marginally speaking, the revenue opportunity is tremendous. And and this is a way, again, not only to keep, you know, to to move people into a better state of health, but also to introduce more financial solvency to your practice and potentially allow you to keep it. We know a lot of practices of being swallowed up by bigger health systems and these types of programs. And I’m just talking about the chronic care management program at the moment. There are there is a portfolio of care management, wellness services, annual wellness visits, the Transitional Care Management Program for Management, for managing a patient from a readmission for 30 days after a discharge from the hospital in the remote patient monitoring program is that’s for us. That’s been we’ve been busy here, never in working to support the remote patient monitoring program, which allows a number of opportunities for providers to be reimbursed for providing remote monitoring devices to their patients and managing the information coming off of those devices and taking the necessary action based on the readings to be received by the practice. So, again, they there’s there’s a claim reimbursement just for providing the device. There’s a claim reimbursement for managing the content, coming off the device for 20 minutes a month. And these, again, tremendous revenue opportunities narrowed them altogether. You you as you. Yes. I’m sorry.

Saul Marquez:
No, no, that’s OK. That’s OK. So, I mean, there’s a huge opportunity, right? That’s clear. No doubt about it. There’s more than one area of focus that you guys are doing it. Let’s dive into what you feel has been a setback. Tell me what a big learning has been that’s made you guys better today.

Earl Hutz:
So such such a great question. I certainly the setback for us, probably as you can find yourself in any anyone who’s worked in the software operation, the guy I’ve been in for my entire career, you find yourself feeling like the solutions that you’ll build are are a one size fits all solution in the sense that you’ve identified a need and you documented requirements and you’ve put together a functional solution that you think will be applauded and accepted by everyone. And you release it to the to the wild, so to speak. And you come to find that there are challenges in the efficiency in the service that you’re providing. So I think like a lot of software organizations, again, you find yourself developing a solution. Sometimes it’s you know, you think that you’re providing that solution, which is going to fit a global customer need. And then you you find out you didn’t take enough steps to ensure that that was, in fact, the reality. So we certainly had, you know, in trying to further understand these platforms and how are our clients and our partners will utilize them? Well, we certainly found ourselves in the position, you know, were really not hitting the market. We should be. So for us, it became a harder pivot in the sense that we’re not clinicians, we don’t work in the field. I’m a technologist. I don’t have a clinical background. My business partner, Dan Godla. He’s cut from the same cloth as me. We certainly identify the opportunity to provide health care professionals with a solution that is efficient. We struggle to think it or see directly through their lenses because, again, we don’t provide care. So we’ve we’ve made it a point to our mission to, you know, provide solution being called solutions designed with clinicians in mind. And we don’t go out the door with any solution without having a clinical resource, look at it, provide us feedback and ensure that they can, you know, introduce an efficiency into their operations. So that that’s that was certainly a struggle for us, you know, in the early introduction of our part of our platform services in support of these programs. You think you know what you know. And then we come to the reality that maybe you don’t. And, you know, we’ve made it a point to ensure that, you know, we’re not the only experts here. It’s not about us. It’s about our clients. And if they can’t, you know, effectively touch the lives of their patients, then we’re doing them this service.

Saul Marquez:
That’s a great share, Earl and testament to you guys keeping your pulse on the market and kind of hearing what they want, not just building it and thinking they’re going to come. What would you say you’re most excited about today?

Earl Hutz:
Yeah, so a couple of things, if I could. So first, I’m going to go or reflect on a message that was similar question was asked to Mark Cuban recently. He feels calm in the world and he’s rather excited about it. And I am for very similar reasons. And he he basically started talking about how as Americans were, will persist in our ability to persevere and find ways to overcome situations that remind him, just such as the Covid pandemic Right.. And we overcome a lot of ways through entrepreneurship and the formulation of world changing businesses that, you know, maybe people wouldn’t have had or been forced into that capacity if there wasn’t a pandemic. Right. So a silver lining in all this is that when we look back on this pandemic someday, and this certainly applies to the health care ecosystem, we’re going to realize that there were, you know, anywhere from 25 to 50 world class companies that were spun off and created specifically as a result of this pandemic. So I kind of look into the crystal ball that that way. And I’m and I’m really excited about. What do you know, what will become of the world of health care just because of the innovation and creativity of people and their, you know, persistence and wanting to, you know, protect ourselves from getting into this type of situation again in the future and find opportunities to improve health outcomes. For us as an organization you know, we’ve had certainly have had barriers to entry in association with the programs that we support. Because I don’t you don’t as as a patient necessarily feel like you’re you’re getting something out of a proactive care model. Right. So if you’re a patient, you’re not, you know, rooted in this environment like you and I are, Saul, you if you’re a patient, you go to a doctor and you say, I’m sick and the doctor provides you medicine or they run blood tests or something and there’s a little bit more in the services provided is seemingly a bit more structured or concrete. And I don’t know that patients or notice of. Fully understanding the value of a proactive preventive care model. When you look at the world today and you realize that, you know, a lot of the people that are affected by Covid are those that are the chronic elderly. So people are becoming more aware of the fact that they are if they are targeted by this disease, meaning that they are part of the population that is that is defined as the chronic elderly. Then maybe they want to think about taking ways for taking the steps to improve their quality of life and give them a better chance of avoiding this pandemic or this disease. And if they are in a position where they do, you know, find themselves burdened by the disease, that a better health status could help them overcome it. So I think I’m excited for a shift, a further shift in the model from reactive care to proactive care, because I think people, the awareness within individuals as to the importance of quality of life improvements, it will start to take, you know, further shape as a result of the pandemic. And it’s you know, it’s where a lot of us have wanted to be for quite a long time. We don’t necessarily like to dig for silver linings in such a horrific situation such as this one. But the hope is that people will be more accountable for their care. The more an awareness will be much higher as a result.

Saul Marquez:
That’s a good one. Yeah, it’s certainly a lot to be excited about because of that. So love it. You know, the services and the technology that you guys are providing are highly valuable folks, thoroughcare.net is where you would go to find out more. Earl, let’s just leave the listeners with a closing thought. And then the best place where they could reach out to you or your team to find out more.

Earl Hutz:
Yeah. Again, I think my last message is I think my my most important one. I think people, you know, as the population will be more aware now of the value of of health improvements and the overall quality of life, better outcomes and how that translates to other types of situations such as the covid pandemic. And again, more than ever, the elderly Americans are ready and willing to engage with, you know, with their health care providers and increase their risk of infection. And that’s really on our health care providers to use this opportunity to drive the benefits of health care, coordination of wellness programs. You can reach me again. Our website is www.thoroughcare.net. And you can feel free to reach out to me directly. My e-mail address is earl@thoroughcare.net. Thanks, Saul.

Saul Marquez:
Hey Earl. Thank you. And appreciate all the work that you guys are doing to make things easier for for practice’s today. Covid is providing some huge challenges and being able to maximize what you guys are offering on chronic care management. And you know, even like you mentioned, the remote care aspects of it are going to be critical to survive. Let’s put it that way, but also thrive once this is all over. So kudos to you and your team, Earl. Thank you for sharing what you guys are doing.

Earl Hutz:
Well, thank you for that Saul. And thank you so much again for the opportunity to join you today. It’s a tremendous service that you are providing to our community as well. Thanks again.

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