Tom Sullivan | March 24, 2021
Since Transcarent announced last week that Glen Tullman has joined as CEO, expanding upon his Executive Chairman role, the startup has been described in myriad ways. Telehealth vendor. Navigator, whatever exactly that might mean. And none other than the ever-vague IT cliché: digital platform.
Tullman, however, refutes those descriptions explaining, instead, that Transcarent is a consumer experience not altogether unlike Apple’s approach to the iPhone. More on Apple shortly.
Tullman also explained why executives should have been more receptive to the wake-up call from Haven and what Transcarent intends to achieve that did not happen at Livongo, which merged with Teladoc Health and where he remains on the board of directors.
Transcarent is about experience not the tech
“We’re not a navigator. We’re not a telehealth company,” Tullman said. “I think of us like Apple.”
Citing a statistic that people under 30 only use the specific phone function of mobile devices 18 percent of the time, meaning 82 percent of the time it’s being used the device is not technically even a phone, Tullman said that translates to Apple not exactly being a phone manufacturer.
“Apple designed an experience and that’s what we’re doing here,” Tullman added. “We are going to create an absolutely different kind of experience that puts the consumer in charge of their health and care and do so by adhering to the principles that have worked with every other consumer industry.”
He said Transcarent will deliver unbiased information, trusted guidance, and easy access to valued care, the third not to be confused with inexpensive care.
“That’s what’s revolutionary,” Tullman said. “We don’t fit in existing boxes because no one has created a great health care experience.”
Which is not to say no one has tried.
Glen Tullman, Transcarent
Haven: A missed wake-up call?
Amazon, JPMorgan Chase and Berkshire Hathaway joined forces to build Haven largely because PBMs, health plans, and health systems are no longer aligned with their business. The CEOs of the three behemoths, Jeff Bezos, Jamie Dimon and Warren Buffett, saw an opportunity to reduce costs and even though Haven has since shuttered, Tullman cautioned that entrenched health care executives did not take that threat seriously enough — instead striking a posture of “they thought could come into health care and teach us?”
“Can you imagine a large health plan ever saying our goal this year is to reduce revenue by 30 percent? Why would those organizations ever want to cut costs?” Tullman asked. “But imagine the wake–up call if three of the smartest and largest companies in the world said your business model doesn’t work anymore.”
What’s more, Tullman added that when enterprises with the size and scale of Amazon and Walmart signal they are moving into health care, to think they’re not coming or pretend it won’t happen could be a death knell for incumbents.
Despite the changes COVID-19 has accelerated, paired with the threat posed by new entrants, he’s expecting that many health care executives will revert to pre-pandemic business processes and practices after COVID-19.
“There will be a push to move back,” he said. “There are a whole lot of people who absolutely are going to try to go back to the old system.”
‘Breaking a myth’
Americans are consumers making decisions every day until they come up against the health care system and are told they cannot make decisions for themselves because they don’t understand the complexities of medicine.
Tullman said Transcarent will be “breaking that myth,” because it believes people can make decisions with the right guidance, unbiased information and appropriate access to care.
“If you need to fly to Cleveland Clinic or need assistance to travel to a specific center of excellence location there’s no cost to you, no co-pays, no bills because that is already built into the Transcarent cost and is part of the experience we provide members,” Tullman said.
He explained that the idea people would overuse care services as a reason that co-pays are necessary is unfounded. And he noted as an example the unlikelihood that people with diabetes would actually prick a finger all day, and have to go the ER after running out of equipment as something basically no one would do.
Life after Livongo
“Livongo was terrific and we were able to transform what happens for people with chronic conditions starting with Patient 1: my son,” Tullman said.
Tullman built Livongo after witnessing how hard life can be for people with chronic conditions facing frequent and oft-unnecessary ER visits, an ostensibly never-ending stream of medical bills and potentially burdened with managing 5 coaches and 4 apps. Because approximately 70 percent of people with diabetes also have hypertension, Livongo expanded from diabetes to other chronic conditions and essentially did what payers, PBMs and other innovators have strived to do for the last 20 years, which is make health care less costly and complex for those patients.
“At Livongo people asked me ‘Now that you have done it for chronic conditions, can you do it for surgeries? For medications? Can people receive treatment at home rather than going to a hospital?’” he said. “When we merged with Teladoc and I became a free agent, those calls didn’t decrease, they increased.”
Tullman noted such calls were primarily coming from two groups, large self-insured employers and people telling him about their hard-to-believe experiences. Hence, his role at Transcarent.
Why fixing health care is personal
While stating that he did not listen to the Grateful Dead growing up, Tullman ranked one of his favorite quotes of all time as this from guitarist Jerry Garcia: “Somebody has to do something and it’s just incredibly pathetic that it has to be us.”
He was applying those words of wisdom, of course, to the fundamentally flawed health care system, particularly as it relates to the passing of his mother. When she was diagnosed with terminal illness, Tullman went to three doctors and asked if they thought she could beat the disease. They all said no but she might live an extra three months.
“Her response was: ‘So I can spend a year with my grandchildren or be in the hospital the entire time? That’s not even a choice,’” Tullman said. Fortunately, his mother was herself until almost the end. “Treatment would have come with no quality-of-life improvement at all. But that’s what they told her she should do.”