Q2 got here in a hurry, and it feels like just last week we were slogging through the rain at JPM in SFO. The year is off to a fast start, and we had a ton of fun sitting down with Coley Parry this quarter to chat about how he’s building a risk-bearing business focused on Medicare and Medicaid patients at Friend Health. It’s a neat look behind the curtains at some of the complexities of caring for this tricky population. We also spend some time in this installment looking at the inefficiencies in our broken primary care model, as well as diving deeper into constructing that elusive candidate experience that everyone is always talking about. We hope you enjoy, and as always, welcome your feedback on this issue, and what you’d like to hear about in the future. Happy reading, and see you at the HLTH conference in a few weeks!

— Tim Gordon, Founder & Managing Partner

An Interview with Coley Parry,
CEO of Friend Health

Coley is the Founder and CEO of Friend Health, a risk-bearing organization that deploys multi-disciplinary care teams and proprietary technology to bring in-home primary care to patient populations that need it the most. Friend Health works with some of the sickest and highest risk populations, collaborating with their partners to drive reimbursement, better outcomes, cost savings, and the efficient deployment of those resources to patients most in need.

TIM: Like many healthcare entrepreneurs, you founded Friend Health because of a personal experience with the healthcare system that wasn’t good. Tell us about that, and how it led to you starting the company.

COLEY: In the late 80’s, my father had a valve replaced in his heart. He got one of the first human valves, which was fantastic at the time. In the mid-2000’s he started going to the hospital a lot – he had a pacemaker put in, a defibrillator put in, and ultimately was placed on the heart transplant list. He had become an ER super-utilizer. He was in and out of the ER 2-3 times a month by the end of it, and when he’d be discharged from the hospital, that safety net that was supposed to be there via the Visiting Nurses Association and home healthcare just didn’t exist in the way that it should. The local home healthcare companies were a black box on information for my family, my dad’s cardiologist, and his PCP because they have had no incentive to update their technology or business model. They operate on ‘check-a-box’ healthcare: do 5 visits, get paid $2,500 from CMS, and then be on their way. There was no longitudinal care or coordination. My dad was chronically ill, not sick within neat 30 or 60 or 90 day boxes, and neither are any chronically ill patients. They’re sick over a long time period, so we should be seeing them on a longitudinal scale. So our real idea is: how do we deliver a better, more friendly patient experience over the long term, rather than these little boxes that don’t work. Because at the end of that 30 days, my dad is still sick.

Primary Care: Rebuilding the Gateway to
Our Healthcare System

The healthcare ecosystem has been experiencing a seismic shift. From companies like Boulder Care who are facilitating innovative treatment strategies for those affected by the opioid crisis, to startups like Robin Care who are changing the face of cancer patient advocacy, it seems that every healthcare institution is being transformed by “disruptive innovation.” The challenge is in bringing change to parts of the care continuum that are trapped in a cycle of misaligned incentives. Our nation’s primary care model is antiquated and broken. Doctors are incentivized to see the maximum number of patients possible, which translates into less quality per patient interaction. A volume-based system leads to fewer questions, more standardization, and less depth of care, which in turn leads to worse outcomes for patients, and helps fuel a bloated and costly system. As the gateway to our healthcare system, we are missing a tremendous opportunity for impact with primary care.

A few years back, I experienced firsthand how our broken primary care model can lead to a dramatic negative outcome, and how as the patient – however “informed” we may be – we often base the quality of our experience on the wrong things. In 2013, my sleep health began to decline dramatically. I was getting a couple of hours each night, if that – not quite full-blown insomnia, but pretty damn close. It went on for close to two years. To this day, I don’t know the root cause. There was plenty going on in my life at the time, so stress is a likely factor, though it’s possible there were others. To me, the best way to describe it was feeling like my body was out of balance.

I did all of the things they tell you to do when you can’t sleep: I stopped watching TV in bed, kept the phone away from my face before sleep, didn’t eat too close to bed time, cut back on the booze. I took the basic over-the-counter stuff – CVS Sleep Aid, Nyquil, Melatonin – sometimes it worked, most of the time it didn’t. Soon my lack of sleep began to impact my work. I was groggy, out of it, not firing on all cylinders. I didn’t want to over-caffeinate or else I’d be up all night, so I started to feel utterly helpless. I was trapped.

Designing The Candidate Experience:

An Exercise in Brand Stewardship

Walk into any Apple Store on the planet, and you’ll receive an immersive customer experience. The sleek layout, meticulous design, and seamless end-to-end experience all serve to generate positive associations in the minds of customers. The end result is that even if you don’t buy anything on a trip to the Apple Store, you end up leaving with a distinct, lasting impression of the Apple brand.

That’s exactly how companies should be designing their candidate experience – with the candidate in mind. Yes, the main goal of a hiring process is to identify and attract the best candidates, but that doesn’t mean we should overlook other opportunities therein, namely brand advocacy. You’re often providing a first glimpse of your company (especially for startups) to every single person who walks through your doors. Think of your candidate experience as an experiential marketing opportunity, not just for future employees, but for all of those industry professionals who you don’t end up hiring. Every company should ask themselves: what lasting impression are we leaving on each individual we interact with?

I was given a stark reminder of the role consumer experience plays in decision making recently, when inside of the same week I had two remarkably different customer experiences. One with AT&T, and the other with Handy. AT&T knocked it out of the park and the other service provider nearly drove me to create a Yelp account just to save others from the misery. The candidate experience is no different, and for me it highlighted our propensity to be more vocal about negative experiences.