Inspired with Alexa von Tobel
00:17:50 · Jeremy Gurewitz
[00:17:50] S0: Yeah, there's like a very, very long answer to this. I don't want to take up this entire conversation with that. So I'll try and boil it down. So I've spent a lot of time now studying The US health care system as part of the work here at Solace and trying to understand it. Without going into the full history of US health care, if I had to boil it down, what... What's occurred is there is oftentimes a bunch of well meaning regulations and rules that end up resulting in very, very limited ways in which providers feel they're allowed to do things. There are also structures and and and not meant to be political, but just like in terms of how the rules have been set up where there are basically local monopolies everywhere. And you can look throughout The US health care system. There's consolidation. There's been limited things. And I think, you know, what we see in historically is when you have monopolies there and you combine the monopolies with the very tight rules and regulations, it ends up being that there's no real incentives or ability for people to create a better outcome. And so you end up having all these cumbersome steps. You have all of these processes, and there's no real incentive to make things better. And so that's the challenge, I think, that's occurred. We could go into any particular detail about why a particular rule is the case when you look at even just, for example, getting health care records. There's a very, very long list. And truly, the rules go into the thousands of pages about how health records are generated, the way in which they're allowed to be generated. So so we've actually connected to... They're called, like, health information exchanges. We're we're connected to one of them that allows us to get health records. In normal databases, if you have someone's name or whatever, there's like an ID or there's a way to connect someone to their record. In The US health care system, you're actually not allowed to have that for various reasons. And so if you have someone's information, you have to search for them geographically. So which is the most... Software, would never say, okay, we're gonna look for this soft database search geographically. So I think that makes no sense. But that's just one example, one niche example of searching for health records.
00:20:16 · Jeremy Gurewitz, Charlotte Ross
And the health care system is full of rules that have good intentions but have kind of combined over time, combined with the limited nature of competition and supply that's resulted in these really, really challenging places. [00:20:31] S2: And one of the things that we've loved about you from the beginning is you've come into this, you don't have a healthcare background. Obviously, you have your personal story, your brother's a doctor, you're a savant when it comes to topics. But it's not like you kind of grew up in the healthcare system. You're coming at this from a real consumer angle. And I think with that, have an ambition of building a marketplace that's like an Uber or an Airbnb, but in health care. Can you talk a little bit about just the advocate side of things? Obviously, before Solace, advocacy was like this niche thing. And now you're really creating a path for these people. Tell us about who they are and like how this population is growing and where do you think it kind of will become, you know, what it will become in like ten years from now?
00:21:22 · Jeremy Gurewitz
[00:21:22] S0: Yeah, for sure. So before Solace, you know, there were folks that were calling themselves healthcare advocates, the most passionate, wonderful people. Got to meet a lot of them. And when we first started Solace, had conversations with many of them to convince them to give us a shot and work with us. People generally with health care backgrounds who have dedicated themselves towards solving this exact issue and are experts in this. As we've grown Solace, what we found is there's an incredible supply unlock where there are tons of nurses who really want to be health care advocates. And they are, in fact, in their day to day. I think so many people, if you've ever been in a hospital or a place, incredible nurses do incredible work. And so we found that there's a lot of nurses who want to be health care advocates. And so we bring them on the platform. We have kind of a training program that kinda catches them up with kind of some of the things that they'll be working on. And, yeah, we we connect them with patients. And so I think it's just a fantastic opportunity for nurses who want flexible hours, who wanna work for a super mission oriented company, and to be able to work remotely is something that I think is just incredibly exciting for them.
00:22:36 · Alexa von Tobel, Jeremy Gurewitz
[00:22:36] S1: Jeremy, if you think about how Solace is changing outcomes, how do you think about that? What are the metrics that you care about? And and, again, I think it's already an incredible lift to know that if, god forbid, you get any medical diagnosis that feels worrisome where you're making a big decision, go to... Go to Solace and get an advocate who just works on your behalf to help you answer any question. But if you want to change the category, what do you measure? How do you think about that? [00:23:06] S0: Yeah. So it's a very fair and great question. We've been asked it in a bunch of different ways. So we started this from a consumer perspective. And so the first place we have to go is, like, our consumers actually, our patients finding value in the product. And we have... And we've been accused of this. Like, how is this real? We have something like an NPS of, like, 90, which I think is, like, insane. [00:23:27] S1: Wow. Wow.
00:23:28 · Jeremy Gurewitz
[00:23:28] S0: Yeah. Like patients really, really find... And we ask just kind of the standard question, like, would you recommend this to others? Did you have a good experience? We ask them to rate solace. We ask them to rate advocates. And just the responses are off the charts positive. So I think that's the first place you have to start. It's necessary. I wouldn't say totally. I'll go into some of the other things here. But you have to start there. Because I think oftentimes there are folks that try and approach solving health care without taking what the patient wants into consideration. So a great way to reduce health care costs is just not provide care to patients. And there are countless examples of this in the past where, and this is where some of the challenges arise where, if you have very intensive prior authorization protocols, if you have very intensive processes to even get access to physicians, you can lower health care costs by just not providing patients care. I don't think that's really what people want. So you have to start. The foundation is, are patients having a good experience? Which I think we clearly have. The next step from my perspective is like, is there a way to measure improved outcomes, lower costs? And so we have some preliminary data right now. So we're still not fully... You know, we haven't fully published all of it yet, where we look at longitudinal claims. So in other words, like, you just look at health care claims data. There's a standardized process where folks submit codes representing the health care work that people do. And you can look at the cost for patients before working with Solace and then afterwards. And what we find is that when patients work with Solace, there's lower costs, which is really, really exciting. We don't have kind of like full numbers to announce yet, but it's something that when we publish it, I think is going to represent a pretty significant game changer for the industry. And we didn't even really talk about the history behind coverage. In 2024, Medicare changed their regulations to cover health care advocacy there. And part of the thesis, and I've been lucky enough to engage with CMS and speak to the former head of Medicare who actually instituted these codes. And they had preliminary data from... And there's studies that show this actually. And I actually didn't even mention this.
00:25:36 · Jeremy Gurewitz
When we're first starting Solace, I was looking up studies. And the study would go basically we did some version of health care advocacy. We had a nurse engage with patients when they were transferred or discharged from the hospital and followed up and made sure they knew what to do and helped them with any questions and worked on their behalf. And the study would go it made sure that patients weren't readmitted to the hospital. It massively improved outcomes and costs. And then we ran out of funding and then the program never continued again. And so when you speak to some of these folks at CMS, they have seen these studies. And so that was part of the idea behind them creating these codes is can we create a way to actually because they've known that this problem has permeated throughout health care. And so the work that we've been doing, I think, has been confirming that. And so then the last piece is improving health care outcomes. And so there, there's a whole bunch of data. It can be challenging because it's like, do you want to use mortality as an endpoint? You could. That that can help for, I think, severe illnesses. But then there's also kind of other questions around quality of life, for example, and even just early, are you connecting folks to the health care system? So we're seeing increased engagement, which I think is something that's really, really powerful and is one of the key things that people look at. Are patients more engaged with the health care system? Are they engaging with primary care? There's been countless studies that show that when patients are engaged with primary care, that's preventative. It prevents the worst and escalatory diseases and costs that tend to occur. And then right now, ask them this question. Think, again, we're still working. We've hired just recently a whole bunch of PhD researchers to go and attack the outcomes problem very directly. But we just ask patients, do you believe that you got a better outcome with solace than you would have otherwise? And the answer is just undisputably yes. And so I think we have very, very clear data information to show that solace it's kind of like this magical trifecta that doesn't really happen where it's good for patients, it's good for costs, and it's good for The US health care system. And I think it's something that's just super exciting.