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Kyle Kiser became CEO of Arrive Health in 2021 after serving as its President and Chief Strategy Officer for over four years. With Arrive Health, Kyle has developed a network of industry-leading health systems, health plans, PBMs, and IT vendors to improve patient access, affordability, and outcomes while reducing administrative burden. Prior to Arrive Health, Kyle was a senior leader at Welltok, Catapult Health, and Principal Wellness Company.

Health Evolution interviewed Kiser about his accomplishments as CEO, how Arrive Health is shaping the future of payment innovation and redesign, and what he thinks are health care’s greatest challenges in the coming future.

What is Arrive Health’s origin story?

Every day, more and more patients struggle to pay for their health care. That was the case over a decade ago when our Co Founder stepped in to help his mother, Lucy, make sense of her rising medication costs. The solution was clear: ensure Lucy’s physician understood her coverage and could identify lower-cost therapy alternatives.

Our Co-Founder’s idea to leverage transparency and accurate, patient-specific data to help his mother’s physician reach a better decision was the premise for Arrive Health‘s founding. It remains our focus today and, as our team continues to scale, we remind one another who we’re doing this for with the call to “Lucy up.”

What should prospective clients expect in the next 18 months? The next 2-3 years?

The cost of care is a major issue for Americans, and with 64% of adults telling us they would skip or delay care until they know the cost, it’s clear we’re in the midst of a health care affordability crisis. We believe that patients shouldn’t have to choose between the medications they need and the bare necessities, and we have to do more to help them access affordable care.

With this focus, we’re doubling down on our efforts to make it easier for providers and patients to understand the cost of medications, and for providers to support patients along their entire medication adherence journey. Our team is working on several enhancements to our core Real- Time Prescription Benefit (RTPB) solution to create a digitally enabled marketplace that supports consumer choice, affordability, and adherence. There are so many opportunities to impact access and affordability once providers have visibility into real-time costs and coverage details. A few examples of this are providers using the data to switch medications and avoid an unnecessary prior authorization, or alerting patients about an available discount/cash-pay program they can use to lower patient costs. As a bonus, all of this work benefiting patients also CEO supports providers – making it easier for them to deliver quality care and improve patient outcomes.

Which accomplishments are you as a CEO most proud of?

I’m incredibly proud of and cannot say enough about the team we’ve built at Arrive Health. We’re all personally connected to and uncompromising in our pursuit to solve the problem of patient affordability and access. As a result, we’ve built a network of partners and high-quality tools to help patients and providers better understand their options. We estimate our reach in excess of $20 billion in total health care spend impacted because of our connectivity – that’s something we can all celebrate and use as motivation to keep chipping away at the barriers to affordability.

What is the most difficult challenge you have overcome on the road to success?

Health care affordability is a massive challenge, and solving it requires an unwavering focus on the patient. Succeeding in this space has required a delicate balancing act among multiple stakeholders – payers, PBMs, EHR partners, and health systems – who have to work together in order to move the needle.

We’ve maintained a neutral view of each stakeholder and made it a priority to understand what they want to accomplish so that the solutions we create resolve barriers to their goals in a way
that always benefits the patient. This is definitely the harder path, but we believe it’s the right path. It’s been tough at times to balance the conflicting interests of stakeholders. But on our journey, we found that always centering on the patient enabled us to move these stakeholders forward.

What advice would you give to other CEOs and founders?

As a leader, you have to understand your clients’ incentives. If you don’t understand what’s motivating them, you’ll have difficulty solving problems that are most impactful to them and their customers.

What keeps you motivated to keep working on the problem of health care affordability?

One patient in the survey I mentioned above shared a thought I know we can all relate to when they said, “This is America, the land where health care is confusing, frustrating, and expensive.”

This is alarming in a world where most patients are responsible for first-dollar health care expenses. We are asking patients to take on more responsibility and risk. Information
asymmetry is no longer acceptable. The consequences of patients not being able to understand their out-of-pocket burden or worse afford it means they are less likely to seek and receive the care they need.

Health care innovation in this country is amazing. We are extending life span, curing diseases, and improving quality of life at an unprecedented level. We can’t let complexity and out-of-pocket costs stand in the way of people accessing those solutions.

How is Arrive Health shaping the future of healthcare in payment innovation and redesign?

Our network enables real-time, patient-specific, and location-specific decision-making at the point of order. This is an essential tool in the tool kit for new payment models and as value- based care is more broadly adopted. What’s needed is an individualized marketplace that allows providers, patients, and care teams to understand in a very specific way the cost and benefit trade-offs between different courses of treatment. Done right, this looks more like a “guidance system” that can emerge in place of some of the “hard stops” like those that now exist with prior authorization. Our goal is not to be a price transparency or prior authorization engine, but rather to rethink the way decision-making happens between patients, providers, and their health plan.