No THCB Gang today because my kid is in the hospital (minor planned surgery) So instead I am reposting this great interview from last week.
I just got to interview Glen Tullman, CEO Transcarent (and formerly CEO of Livongo & Allscripts) & Aneesh Chopra, CEO Carejourney (and formerly CTO of the US). The trigger for the interview is a new partnership between the two companies, but the conversation was really about what’s happening with health care in the US, including how the customer experience needs to change, what level of data and information is available about providers and how that is changing, how AI is going to change data analytics, and what is actually happening with Medicare Advantage. This is a fascinating discussion with two real leaders in health and health tech — Matthew Holt
Lesson learned: Don’t bet against Glen Tullman. Transcarent’s CEO brings his legendary “paper schedule packet” to our interview to prove the point that he carries Livongo’s first growth chart around with him everyday as a reminder of the number of overnights it takes to build a “overnight success” of a business. As Glen puts it, “When you’re building these companies, everybody remembers where you ended…they don’t remember where you started.”
So, how in the world did we get to this public prove-you-wrong? Catch the conversation that led us there as we talk about Transcarent’s growth two-years in and address the elephant in the room about why there have been so few customer announcements from the employer-focused health and care company. We get a few name-drops here, and also assurance that publicity around some new Fortune 50 and Fortune 100 clients is imminent. Lots of other interesting “build-mode” talk about what else is starting to come together at Transcarent including the “first independent provider network in the country” and more details on the recent Prescryptive partnership which is aiming to rewrite the script on how employers source pharmacy benefits.
Livongo Alumni Updates from ViVE 2022 continue! Former CEO Zane Burke drops in to talk about his new gig as CEO of Quantum Health, the “original” healthcare navigator biz, and how he’s bullish on the notion that navigators aren’t going anywhere any time soon.
Now, for those who’ve followed Livongo’s founder Glen Tullman as he’s launched his new business Transcarent – and a whole lot of “navigators aren’t working” rhetoric to position it – one might find it very interesting to hear Zane’s take, particularly how what he learned at Livongo has led him to adopt a viewpoint so opposite Glen’s.
Is the market large enough for both approaches to employer benefits optimization – and all the other permutations with and without primary care in between – to win? And for those of you who remember when Zane and Glen ran opposing EMR companies…is this Cerner versus Allscripts all over again?? And speaking of, I get a GREAT candid take on what IS happening in the EMR market today and whether or not Zane thinks challenger tech co’s will finally be able to win over health systems and unseat the EMR incumbents.
Turns out, that if you’re lucky enough to catch Glen Tullman in an impromptu chat just off the main stage at ViVE 2022, he’s warmed up enough (we could maybe even call it ‘fired up’ enough) to kick it into overdrive, roar past the usual talking points, and tell us what he REALLY thinks about what’s happening in the healthcare market today.
Things are changing. And, if you listen to this chat from start-to-finish, one of the key, overarching themes is payment model reform. From the news about Civica RX’s commitment to $30-dollars-or-less insulin (an initiative Glen helped lead and fund via his family foundation) to the 10X growth of virtual care coming out of the pandemic and the rise of “Big Customer” (aka Walmart and Amazon) in healthcare, the bottom line is that we’re no longer talking about fixing the way care is paid for – it’s actually starting to happen.
What is Transcarent’s role in all this? For those who might still be confused, tune in. This IS confusing, but I think the candor of our situation here may have given rise to one of the best descriptions of the business yet. Glen goes point-by-point on the way Transcarent is attempting to shift the paradigm for cost-and-quality across five (5!!!) different aspects of care at one time, using different strategies, novel technologies, cross-industry partnerships, and never-before-seen relationships with health systems to deliver what “20 years working with payers and 5 years working navigators didn’t deliver” for self-insured employers and their employees.
Transcarent raises a whopping $200 million Series C funding round that values the year-ish old business at over $1.6 billion – valuing the up-start higher than quasi-competitor, Accolade, which is sitting on the NASDAQ with a $1.3 billion dollar market cap. Executive Chairman & CEO Glen Tullman shares some very revealing details about the round, why he’s deliberately added leading hospital systems onto his cap table, and what he’s got to say to the doubters who might question whether not Transcarent is a billion-dollar business just yet. (Spoiler alert: Glen says Transcarent didn’t even take the highest valuation they were offered…)
The investors are interesting for all those who want to read into the strategic messaging there: late-stage Livongo investor Kinnevik led the round alongside Human Capital and Ally Bridge Group, existing investors came back in, and, probably most surprising, are hospital systems Northwell Health, Intermountain Healthcare, and Rush University Medical Center. Apparently, other hospitals wanted in too but missed the chance thanks to a tight timeline. Glen explains his rush and why the capital is essential to further build out Transcarent’s offering in light of the market opportunity he’s seeing among employers.
This is a payment model innovation play, folks, that is basically arming those large, self-insured employers with the bargaining power and healthcare ingenuity of Glen Tullman, and what he says is the best executive leadership team he’s ever assembled. The pieces are certainly starting to come together, and it looks a lot like a new age payer to me. Transcarent’s basically got the prescription drug pricing power of a PBM in its relationship with Walmart… a national network of top-end health systems who are either partners or have skin in the game thanks to this funding round… the centers of excellence business it bought with BridgeHealth… AND some ‘coming soon’ care-at-home, cancer care, and behavioral health offerings Glen teases us about here. All that is offered to employers at full risk to Transcarent, which takes no copays or coinsurance from members, doesn’t charge any per-employee-per-month fees to their employers, and is keeping providers happy with payment up-front. If it’s not a payer because it’s better than our current definition of a payer, that might be the only reason why!
Still, Glen tells us that partnerships with some of the market’s “most innovative” payers are coming soon, along with new customer announcements. And, what will he spend this $200 million on to further build-out Transcarent’s offering? I’m not afraid to ask if there’s a chronic condition management co he’s got his eye on acquiring!
How much longer do we have to wait for Glen Tullman to be on the NASDAQ with Transcarent? In this episode of Health in 2 Point 00, Jess and I discuss several new deals in the healthcare space. Suki raises $55 million, bringing their total up to 95 million; Robin raises $50 million , bringing their total up to $65 million; Cerebral raises $300 million, bringing their total up to $420 million; Nomi raises $110 million ; and Apti Health raises $50 million, bringing their total up to $65 million.
Days after announcing their deal with Walmart, Transcarent’s Executive Chairman & CEO Glen Tullman and meet again (in-person!) to pick up our conversation right where it left off. For the details about the deal, see our last interview; for what the deal signifies for the disruption of the healthcare payer and the ultimate rise of the healthcare consumer, tune in now and take note.
The plot of Transcarent’s story is starting to take shape. Their conflict is with the “big middle” of healthcare where drugs are marked up, care needs pre-authorizations, and docs labeled “this is NOT a bill” are ridiculous artifacts of a payer-first healthcare experience.
“The system behind our healthcare today is working exactly as its designed: for payers. We want to re-design that,” says Glen. “It’s not, ‘how do we get through that better?’ That would be navigating. It’s ‘how do we go completely around that and re-design the experience?’”
Glen talks us through the leverage retailers like Walmart and Amazon really have to help take on non-innovative payers what role Transcarent is playing in all of this, and how startups like GoodRx, Ro, and Capsule who are successfully challenging PBMs are demonstrating that payment model innovation is possible.
And, while we wait for the next big deal to come from ‘healthcare’s best dealmaker, we’ve got some foreshadowing: a quick mention of Oscar Health that registered on my radar as interesting, along with some very specific details about how Transcarent will expand its offering next, looking at MSK, cancer care, behavioral health (particularly for teens), and bringing in more “human voices” for their members to turn to for advice.
Walmart is looking to scale its healthcare business in a brand-new way: setting its sights on self-insured employers. Today the retail giant announced a go-to-market partnership with Transcarent that will make its “everyday low price” prescription drugs and healthcare services available to self-insured employers for the very first time. Transcarent’s Executive Chairman & CEO Glen Tullman drops in to give us the inside story on the deal with Walmart, what it means for the industry, and how it could once-and-for-all ignite the ‘disruption of the payer’ that we’ve been waiting for since JP Morgan, Berkshire Hathaway, and Amazon came together to found Haven.
Transcarent and Glen are hell-bent on re-making the healthcare payment model by eliminating as many middlemen as possible, reshaping the health and care experience along the way. So, what does this partnership with Walmart mean for that mission and for Transcarent? Is this “THE Deal” we’ll look back on as the one that catapulted Transcarent into a new phase of growth? Remember when Glen’s last company, Livongo, shot into the stratosphere after its deal with CVS Health? I ask Glen if he’s running the same play in a much bigger game and finally concede: Transcarent is NOT a healthcare navigator!
For those keeping score at home, Glen Tullman is scaling up Transcarent faster than he did Livongo. The startup just closed a $58M Series B, bringing its total funding just shy of $100M. In less than 8 months. What’s the hurry? Have we ordered the balloons for the IPO yet? Glen says he’s out to fix the core problem first, and, in this interview, we get into the details about what that problem statement is all about and you might be surprised.
This is more of a payment model story than anyone may have all initially realized. And, while we may keep trying to put Transcarent into the “healthcare navigator” box or call it a “second opinion service” or a “centers of excellence play,” the truth is that those are all means to achieve a much larger end, which is about redefining the healthcare experience and its payment model for self-insured employers. Remember when Livongo created its own category of care (applied health signals) because they didn’t fit in with what a ‘chronic condition management’ company meant to the market? Well, I think Glen just used this interview to soft-launch a new category of healthcare company here again with Transcarent…
“People always try to put us in a category,” says Glen. “Are you a navigator? No, we’re not a navigator. We do navigation. Are you a health management company? No, we’re not. Are you a supplier? No, we’re not. Are you a PBM? No, we’re not. But we do all of those things to create an experience and that’s why, when you think about it, we’re a health experience company and that’s a new category that no one has.”
I get Glen to talk specifics about what this really means — directly managing healthcare spend for employers in a ‘category-creating’ completely at-risk way – and the examples really do help bring it to life. So does hearing about how he sees Transcarent as completely different than Accolade or Grand Rounds, which are often listed as competitors.
What other trouble do we get into in this 30-minute mega chat? OF COURSE I get his take on this year’s record-breaking investment into health tech, whether or not he thinks we’re in a bubble, and how Amazon, Walmart, and other non-traditional players are going to impact healthcare moving forward. Lots of insights in this one!
Believe it or not, Jessica DaMassa and I have been banging out digital health tech & funding news for 200 episodes of this oh-so-cute little show. To celebrate, after several takeover episodes when Jess replaced me with a number of special guests, this time four of the digital health & health care digerati replaced Jess to ask me some oh so serious questions. It’s a special edition with guest appearances from Glen Tullman, Eugene Borukhovic, Lisa Suennen & Ian Morrison, as well as plenty of BS from us two regulars! — Matthew Holt
