Hillel's Tech Corner: Bending the cost curve of cancer

TailorMed was founded to change that broken dynamic, from the patient level to the hospital level, and it started by focusing on one of the leading drivers of healthcare costs.

By HILLEL FULD
TailorMed (photo credit: Courtesy)
TailorMed
(photo credit: Courtesy)
By now, it is safe to say that cancer has touched us all.  We can all name a friend, family member or co-worker who has been affected.
As we recently marked World Cancer Awareness Day on February 4, the CDC reported that between 2010 and 2020, the number of new cancer cases in the United States alone was projected to have risen about 24% in men to more than one million cases per year, and by about 21% in women to more than 900,000 cases per year.
Behind every statistic is a person and a family for whom the diagnosis is a “double hit” – threatening health consequences plus an automatic expectation of significant financial consequences. The New England Journal of Medicine reported that “Healthcare costs have risen faster than the consumer price index for most of the past 40 years.”
TailorMed was founded to change that broken dynamic, from the patient level to the hospital level, and it started by focusing on one of the leading drivers of healthcare costs and widespread areas of need – cancer.
As Susan Gubar wrote in her New York Times piece, addressing the phenomenon of financial toxicity, “With few viable solutions in sight, I am left pondering a paradox. What aims to save us can destroy us.”
“Financial toxicity” is a term I was unfamiliar with. It basically means that the financial burden becomes so unfeasible while a patient is struggling with disease and medical treatments, is can bankrupt the patient and destroy families. This in turn means patients will often reject treatment or medications due to the resulting financial damage from buying the treatment will cause them and their families. In turn, patients are unable to cover the costs of treatment, and the aggregate impact on hospitals can pose significant economic and financial challenges.
Enter data-driven, AI powered financial navigation.
TailorMed helps patients find the optimal financial solution for these patients based on their medical records and specific diagnosis. That ultimately means the patient gains. And the hospital gains, too, as this helps avoid bad debt caused by sending bills which the patient is unable to pay.
ACCORDING TO a recent survey of cancer patients, 20% of respondents said they spent more than $100,000 on out-of-pocket treatment and medical care expenses. Approximately one in 10 stated that they had declined a recommended cancer treatment because costs were too high.
In addition to rising costs for patients and their families, healthcare systems are also increasingly incurring bad debt. A study of healthcare systems found that for out-of-pocket obligations above $200, only 66.7% of the average balance was paid within a year, and 16.2% of the average balance was written off as bad debt.
TailorMed this week announced its completion of a $6 million round of financing. Leading the round was Triventures, a venture capital fund focused on data-driven transformational health startups, with participation from existing investor Sanara Ventures.
TailorMed offers a unique value proposition in healthcare – improving the financial performance of healthcare providers (e.g., hospitals, oncology centers and healthcare systems) while reducing economic hardships for patients. In other words, it removes the zero-sum game situation. Everyone wins.
The company has developed a SaaS solution that is compliant with HIPAA confidentiality provisions, and improves providers’ financial performance by assessing the entire patient therapeutic journey and identifying cost-saving opportunities. TailorMed uses data and advanced analytics to provide end-to-end automation for financial navigation, and streamlines all steps of the process, from benefit investigation and out-of-pocket cost estimation to enrollment into, and management of, approved care-financing programs.
The technology involved is quite complex due to its predictive abilities which help advise patients on specific procedures based on their record and existing statistical analysis.
TailorMed was founded two years ago and was accepted into the Sanara Ventures healthcare investment platform belonging to Teva Pharmaceutical Industries Ltd. and Philips. CEO Srulik Dvorsky and CTO Adam Siton, the company founders, are both graduates of the technology units of the IDF Intelligence Directorate. And Dvorsky has a decade of experience in the stroke-treatment company Brainsgate, where he was vice president of R&D and operations for several years.
TailorMed aims to end 2019 by deploying its technology in a few dozen hospitals, mainly ones that have a strong focus on cancer treatments. The company’s platform now supports oncology cases as it has extended its support to a broad disease base outside of cancer.