American Well’s UnitedHealth Coup: Perspective from CEO Roy Schoenberg

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the patient in front of them. You can guess how often that is going to happen. But with Online Care, because the physician is seeing the patient through the computer, it’s like having a TelePrompTer saying what needs to be done right in front of them.

X: So American Well is providing the channel for this clinical analytics content. But the content itself—that’s not something you are building or generating at American Well, right? That’s what you’re now getting through this partnership with OptumHealth?

RS: Yes, the content, the clinical insights themselves are coming from eSync. ESync is creating the observation that “This patient hasn’t been compliant with their beta blocker drug therapy,” for example. Then through Online Care Insight, that information can be injected in front of the next physician that this patient actually sees. That physician then has the ability to discuss it with the patient.

X: Okay, let’s switch gears to today’s announcement.

RS: The announcement that came out this morning is more of a commercial announcement, in the sense that Optum, like Blue Cross Blue Shield of Minnesota or Hawaii, has partnered in a commercial contract with American Well to deliver the online care services to a very large distribution of patients. They are a national plan. You know about the relationship that OptumHealth has with UnitedHealth. Their intention, as they’ve written in their press release, is to roll out Online Care at that scope. So the release is really an evolution in the adoption of Online Care.

X: What interested me about the news is that it seems to represent an opportunity for American Well to expand much faster across the country, rather than adding one state plan at a time. Is that the correct interpretation?

RS: That is absolutely correct. But bear in mind that we have more than one national health plan. There is Optum/United, there is Aetna, there is Wellpoint, and there is a big overlap between them in terms of geographical coverage. So you are going to see Online Care adopted by other health plans, even if they serve the same states. We are very encouraged by the fact that a national health plan is very aggressively, and with a lot of conviction, rolling out Online Care.But that does not mean we are done with the U.S. This is not going to be our last announcement. [Editor’s note: American Well has not announced deals with Aetna, Wellpoint, or other multi-state providers; Schoenberg is referring to the the fact that these are national insurers in the same league as UnitedHealth.]

X: How do you expect to see Online Care actually rolled out across the plans that OptumHealth serves? The wording in your press release was that the rollout would happen “state by state”—what does that mean?

RS: I can’t speak for Optum. But the general notion of rolling out state by state is tied to the fact that becuase Online Care is a care delivery platform, it has to abide by the rules that govern healthcare delivery in each state. For example, the system will only match you with physicians who are licensed to practice in your stage. You can’t see a physician licensed in another state—that is illegal. The rollout is going to involve switching on the connections between patients and physicians in each stage where Optum has an operation. With regard to which states, or how many in parallel, or in what months of the year, those announcements will come from OptumHealth.

X: Was there anything about my story Wednesday about your announcement that you wanted to correct or add to?

RS: What you’re writing is completely accurate, at least from our standpoint. I would just add that we unveiled the notion of Online Care exactly a year ago, at AHIP [the annual meeting of America’s Health Insurance Plans, a trade group] last year. At that point we announced that not only is the software available, but Hawaii is going to be the first plan. Within about six months, we had launched to the entire state. Within three months after that we announced that Minnesota was going to be the second state. And finally, at the one year mark, we are announcing that one of the largest plans in the country has plans to launch it nationally. That is extremely encouraging. There are further announcements coming down the line very soon. I think this is testament to the fact that in a world where healthcare requires a fresh look at how you use technology, this is the writing on the wall, the proof in the pudding.

X: Well, that leads to one last question. From my perspective watching the company, an awfully long time went by between your Hawaii announcement and your Minnesota announcement. The OptumHealth deal has come on the heels of the Minnesota news more quickly, but overall, it would seem that the adoption of American Well’s technology has been extremely gradual up to now. Have you been frustrated with the pace?

RS: I would actually say quite the contrary. What we are doing is literally changing how healthcare is delivered. There are very interesting statistics about what it takes to get a new electronic medical record system to be more prevalently used, and the numbers are ridiculous. A real movement in physician workflow takes about 15 years to complete. Within one year, we have gone from the point of announcing a concept to a national rollout of a new mode of healthcare delivery. That is, to me, a staggering, unbelievable pace of deployment. And it’s not just that consumers and physicians like it, but the financial driving forces of the market, the plans themselves, are literally lining up to do this.

Now, we want this to be everywhere just as much as you do, but Rome was not built in a day. Gartner came out with a statistic a week or two ago saying that by 2013, 25 percent of care that can be handled online will be handled online. That is an incredible prediction, given the fact that until a year ago, this was just a dream. But whether it’s 25 percent or 30 percent or even 15 percent, it’s an incredible shift. Just think about how long it took for Amazon to shift people to buying books online—it’s been more than 10 years. And healthcare is much more conservative; the barriers to shifting how the healthcare industry behaves are way bigger. Yet we’re seeing all this fundamental change right in front of our eyes.

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