Why We Invested in HealthJoy

By Peter Christman & Ezra Galston

While Senator McConnell and his Republican counterparts have delayed the Senate’s August recess to continue working on healthcare reform, we, like many Americans, have been reflecting on the fundamental failings of our current healthcare system.

Namely, the vast majority of Americans understand their healthcare plans and benefits at best superficially. While it’s common to be familiar with your deductible or co-pay, too many people are unaware of virtually everything else under their plan umbrella. That is in contrast to personal finances, where the savings rate in the US has accelerated substantially since the recession, or energy consumption, where consumers are getting smarter and more efficient. The reality is that very few people interact with their own healthcare until they need to and, when we ultimately call upon providers to take care of us, the incentives are dramatically misaligned.

We believe these failures are largely systemic, but exacerbated by a lack of advocacy, a lack of empathy and a lack of personalization. Whereas the digital age has democratized information and increased transparency for hundreds of industries, healthcare is nearly as opaque as ever. HealthJoy—a central hub for all consumer healthcare decisions—is changing this.

HealthJoy ingests the details of your health plan and presents them to you transparently and intelligently, enabling you to make the right decision about your care when you need to. That might be choosing the best in-network specialist, finding a medication alternative at a lower price, making sense of a medical bill or talking to a live doctor in the middle of the night about a stomach pain. HealthJoy’s mobile platform enables you to do so with ease. And, as the platform’s virtual assistant becomes more familiar with your needs, a more proactive, personalized discussion about your health starts to occur. But, why the HealthJoy platform—a third party advocate for your health—deeply matters is that neither large health organizations nor insurance carriers are capable of or incentivized to provide it.

Take the 156M Americans who access healthcare through employer-sponsored plans. Most care events are paid for not by the patient receiving care but by a third party. Since the care is being delivered on someone else’s dime, we as patients have little or no incentive to concern ourselves with the cost. On the flip side, employers are forced to establish and manage the healthcare networks of their employees. But, it is employees who are incentivized to do so more effectively, given that it’s their own health that is at stake.

The most obvious counter to these structural misalignments, which continue to produce lower quality care, higher costs and imbalanced provider-patient-payer relationships, is to place the consumer in charge of paying for and coordinating their own healthcare. The rise of high-deductible health plans (HDHPs), which increase the amount consumers are responsible for paying before their insurance kicks in, represent one manifestation of this response. Nearly 25% of workers are now enrolled in an HDHP, up from 4% in 2006, and expected adoption by 2020 is roughly 50%. At the same time, digital health companies are empowering consumers to coordinate their health from their smartphone—be it getting a contact prescription, checking a mole, or improving fertility wellness. Just last week, Apple won approval of their patent application for a new device that computes health data.

But, despite cost-shifting efforts and better tools for consumer-directed care, engagement rates with on-demand, consumer-centric health platforms have been uninspiring. That’s not unexpected given the average benefits enrollment package remains 200+ pages long and the first generation of consumer health apps are largely neither personalized nor integrated tightly with their users’ health plans. Yet, our initial premise—that the average consumer does not interact with their healthcare until they are forced to—looms large. Perhaps consumers aren’t the best arbiters of their own healthcare.

Over the past 18+ months, Justin, Doug and the HealthJoy team have proven otherwise. Their direct-to-consumer platform amassed 50,000+ users and showed industry-leading utilization rates and results that now underpin their entry into the self-insured employer market. We are proud to announce our role in leading HealthJoy’s Series A round and look forward to supporting the team as they continue to build the leading consumer-centric health services and decision platform.

Disclaimer: Chicago Ventures is an investor in Opternative.

Lindsay Knight


Posted On

August 14, 2017


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