Healthcare
Here is the 29-slide presentation a former Cigna executive used to raise $40 million to improve how lower-income older adults receive healthcare
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- Belong Health works with insurance companies to provide care to dually eligible patients.
- On Wednesday, it raised $40 million in Series A funding from NEA and Maverick Ventures.
- CEO Patrick Foley also worked at Medicare startup HealthSpring, which was acquired by Cigna in 2012.
Belong Health, a startup serving a portion of Medicare Advantage patients, wants to take an incredibly slow and steady approach to growing.
The startup offers virtual and in-person care for Americans eligible for both Medicare and Medicaid. It uses partnerships with local insurance and healthcare companies. Dually eligible Americans are qualifying adults 65 or older who have lower incomes and qualify for state-specific Medicaid coverage.
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Belong will partner with its first company, the health insurer MVP Health Care in New York, in January and plans to expand to other states over the course of several years, cofounder and CEO Patrick Foley told Insider. Foley previously worked HealthSpring, a Medicare startup that was acquired by Cigna in 2012. Foley stayed at HealthSpring within Cigna until 2014.
On Wednesday, Belong Health raised $40 million in Series A funding. NEA led the round, and its general partner Mohamad Makhzoumi will join its board. Maverick Ventures also joined the round after its partner accelerator, Healthcare Foundry, incubated the company.
Healthcare Foundry founder and Belong Health cofounder Alon Krashinsky told Insider that his accelerator had been considering starting a company that offered Medicare Advantage plans in 2014 before he met Foley later that year.
Building that foundation from scratch was a “big bite,” Krashinsky said, adding that companies that pulled off similar businesses had already raised hundreds of millions of dollars, which made it harder for smaller companies to compete.
“We ended up revisiting it instead as a partnership with health plans and met Patrick, but the thesis had been brewing for a few years,” Krashinsky said. The company ultimately launched in June, according to a company press release. It is based in San Francisco and Philadelphia.
Belong Health provided Insider with the presentation it used to raise $40 million in Series A funding. The presentation was edited before Insider’s review to remove sensitive financial information, customer information, prospective-customer progress, and other proprietary information. The areas in which the presentation has been edited are marked as “redacted” below. Insider opted to include the redacted deck for the sake of transparency and to keep intact the original flow and layout of Belong Health’s presentation.
Here is the 29-slide presentation Belong Health used to raise $40 million in Series A funding from NEA and Maverick Ventures.
Belong Health is a startup that offers virtual and in-person care to patients who are dually eligible for Medicare and Medicaid healthcare plans.
Americans who are eligible for both plans are typically more complex patients, Foley said, and local health-insurance plans or healthcare facilities end up spending a lot of money to treat their conditions. Some patients also have needs outside the traditional healthcare system, like inadequate access to food or housing, that can affect their long-term health.
Belong Health partners with those insurance companies and healthcare centers to offer care both virtually and in person to those patients. It employs care coordinators who have areas of expertise, such as social workers and addiction counselors, and can help patients address a primary concern, in addition to other healthcare needs.
In its presentation, Belong Health outlines an example patient named Robert. In Robert’s case, his care coordinator is a community health worker who can meet with him in person on an ongoing basis to help decrease the frequency of his emergency-room visits and address some underlying issues, like unstable employment, that contribute to his need for care.
The clinical approach was designed by Dr. Jennie Byrne, Belong Health’s chief patient officer. Byrne told Insider that Belong’s approach was rooted in her behavioral-health background and took all aspects of a person’s situation into consideration when designing treatment or otherwise coordinating care in complex situations.
In addition to Foley and Byrne, Belong has a large cofounding and executive team with deep healthcare and startup expertise. Krashinsky and Brian Lovett are also cofounders through their involvement with Healthcare Foundry, the accelerator in which Belong was started.
Foley and Krashinsky both said that because dually eligible patients spent so much money on healthcare through coverage and tended to have complex social and health conditions, even al improvements could accomplish goals in cutting spending and improving their quality of life.
Medicare Advantage, on its own, represents a multibillion-dollar opportunity, according to figures from the Congressional Budget Office. It’s an area where multiple companies could ultimately be successful, Krashinsky said.
And with an aging population, Medicare Advantage spending is poised to increase daily, as Belong Health outlines as part of its total prospective market.
But the fastest-growing segment is people who qualify for both Medicare and Medicaid, according to data from the Centers for Medicare and Medicaid Services. These Americans are typically older and living on limited or otherwise fixed incomes who qualify for Medicaid. Those patients tend to have complex social and healthcare needs, Byrne said.
Source: Centers for Medicare and Medicaid Services data-analysis brief
That may be why many startups do not focus on that particular group of patients, Byrne said, which has made the overall experience for those patients worse as other parts of the healthcare industry improve their software and other areas for patients’ convenience.
By partnering with local insurance companies that offer dual-eligible plans, Belong is able to start reaching out to patients and making sure they get what they need for healthcare, in addition to needs like mental-health care.
Belong Health builds software that insurance companies can use to communicate with patients virtually, via text message, or in person through Belong’s network of professionals. Over time, Belong hopes to build facilities that may be lacking in specific communities to best serve patients in those areas, Foley said.
Belong Health’s software provides doctors with data they wouldn’t otherwise easily access, Foley said, and can help determine the best way to treat a patient with a complex set of conditions. Over time, Belong wants to be able to offer a “one-stop-shop” network for insurance companies and health systems that work with dually eligible patients.
Its software also helps bring all of a patient’s conditions and care providers into a single area to better coordinate their care. If a patient is homeless, for example, their social worker would be listed along with their primary-care provider who is helping them manage diabetes.
Belong employs nurses to help treat patients at home. It also wants to help with hospice and palliative care.
One way Belong appeals to smaller, local facilities is by analyzing and sharing data from multiple sources, Krashinsky said. Many of those companies don’t have the capacity to analyze their patients’ data, he said, or if they do, they have access to a smaller subset that provides an incomplete picture of a patient’s overall health.
Belong works with healthcare-company partners so that it’s not starting completely from scratch, Krashinsky said.
Many prospective Belong partners don’t have adequate funding for modern software upgrades, Krashinsky said. Belong was built to accommodate a variety of technology systems that a local clinic or insurance provider may already rely on, he added.
It can also use other data sources a partner may already be using. That can help merge all areas in which a patient may be receiving healthcare or other community support, Foley said.
Starting January 1, Belong Health will be available in partnership with MVP Health Care. It will launch in the Hudson River Valley and communities around Albany, New York, Foley said. In the first year, he said he anticipated that Belong would serve up to 3,000 members.
Krashinsky said that it was common for Healthcare Foundry companies to launch with what he called an “anchor partner.” In effect, the startup can essentially build tools specifically with the partner in mind before officially launching.
Foley said Belong Health’s expansion was realistic and that he hoped to serve patients throughout New York state over the next several years. He said he may add partners in other states over time but that the relationships with those partners took a substantial amount of time and effort to build.
Medicaid plans are managed by states’ departments of health, which presents Belong Health with several prospective partners to pursue. This strategy also makes managing the differences between state and federal plans more challenging, Foley said.
Expanding to more states beyond New York will be a years-long process, Foley and Krashinsky said. Part of the $40 million investment will likely go toward building tools for other regions.
Through its partnership model, Belong Health shares risk with the companies providing the insurance plans. If the insurance plan isn’t saving money, Belong Health doesn’t make money, Foley said.
Foley said Belong would invest in developing software, hiring professionals, and eventually building out clinics before the startup made money. Over time, the savings will get split between Belong and its partner.
“Belong is a decade-long bet on this market exploding in growth,” Makhzoumi, the NEA general partner and Belong board member, told Insider after saying that investing in a company with the early results Belong had was a “no-brainer.”
Belong Health will use the funds to hire more care providers in New York, as well as engineers and other employees to build the software patients and doctors have requested, Foley said.