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Welcome to the Solving Healthcare Podcast.  In this inteview we discuss Apostrophe Health with the CEO, Cheryl Kellond.  Cheryl is an incredibly gifted and passionate leader who is on a personal mission to fix healthcare in America.  Her company is unique in that they are building a health plan that can be used by any sized employer and use many of the same purchasing strategies that larger, global companies used to procure health services on behalf of their employees.

We discuss contracting strategies including reference based pricing, direct contracting, and why cash pay can be used strategically to leverage trust and rapport with providers.  Also a unique component of her service is an advance payment feature wherby the providers are reimbursed for 100% of the allowable payment amount including the patient’s share of the expense (deductible, coinsurance, copayment).  Listen to the podcast to understand the logic and why.

Advancing the entire amount to the provider allows patients to focus on recovery and healing without the worry of coming up with their deductible.  Apostrophe consolidates the entire member amount and reconciles charges to produce a credit card like statement allowing patients to enter payment arrangements, interest free.

Podcast show notes:

Apostrophe Health Intro:

Interview with Cheryl Kellond, CEO of Apostrophe Health

  • Origins of Wearable to starting the Company to the idea of building a healthcare company that can fix America.
    1. Spark for Apostrophe – Rosen Hotels – “Cut waste out of the system and you can fund other benefits and programs to take care of your people.”
    2. Basic Tenets of Apostrophe – Simplicity, Transparency, Love
    3. How Large employers purchase benefits on behalf of employees. Tenets of best practices of large employers bundled into Apostophe Health.
  • Provider Relationships & Repayment Options
    1. Discussion of Reference Based Pricing & other reimbursement strategies.
    2. Reimbursement Strategy for providers, get the provider out of the collection business.
    3. Easiest payor in the business & payment over the phone
    4. How they handle new relationships.
    5. How they get to 20-30% savings off a typical carrier model.
  • Employer & Employee Relationship
    1. Direct Purchasing
    2. Concierge Service
    3. Smart Shopper Options
    4. How employees will be directed to the best cost & quality of care
    5. Pre-Auth & Employee Education to direct folks where they need to go.
    6. Virtual Primary Care & Telemedicine – Free or Reduced Care for members.
    7. Quote about Megan’s service experience.
    8. How to measure love within the organization.
  • Health Literacy vs. Getting people where they need to go.
    1. Getting people where they need to go
    2. Build trust
    3. Literacy increases as trust is built
    4. Where Apostrophe gets Quality data
    5. Care Interception points for redirection care
    6. 2nd Opinions using quality providers and how to get best care regardless of where person may live.
  • Best Practice partners to help reveal best quality
    1. Vendor Review & Efficacy for members
    2. Must assure smooth member technology experience
  • How does apostrophe demonstrate value to employers & employees
    1. During first quarter, then follow up meetings.
    2. Stewards of one of the largest expense line items.
    3. Types of employers attracted early on
  • Message to smaller employers about the power you have to shape healthcare in your community.