“An interesting phenomenon that is emerging amongst many successful start-ups targeting high-risk populations is the focus on what I’m calling a “node” condition. These “node” conditions (e.g. a terminal illness, end stage renal disease, chronic pain, behavioral health, and frailty) are the most advanced in a patient’s medical history and serve as the cost driver condition for a patient. Because of this centrality, the specialty care team responsible for the “node” condition can best manage the total cost of care for the patient.
This is the concept behind the “specialty medical home,” a model being piloted across the country. Many spectators have doubts as to whether specialist physicians can truly manage the total cost of care of patients, and entrepreneurs are rushing in. Early stage companies are designing full stack, tech-enabled services to manage these “node” conditions, and then inking contracts with payers/providers that allow start-ups to “go at risk” and participate on the upside of potential savings realized.
An interesting early stage company attacking the high cost node condition of end stage kidney disease is Cricket Health (First Round, Boxgroup). Co-founded by former LinkedIn exec Arvind Rajan and Aberdare Partner Vince Kim, the company’s HOPE platform identifies patients at risk for advanced kidney disease and delivers a navigation service that educates and attempts to lower the cost of care for these patients.”