Expert Opinion: Grant Verstandig, Founder of Rally Health and Chief Digital Officer, UnitedHealth Group

Every industry has a few key players – individuals who have established their roles as true innovators. In the world of digital health, one such innovator is Grant Verstandig.

Grant’s story to date is unique. A Fortune article (October 2016), “How a 27-Year-Old College Dropout Is Simplifying Health Care,” gives an overview. Fortune reports that when Grant was a freshman lacrosse player at Brown University, a knee injury and multiple surgeries forced him to quit the sport. While navigating the health care system and recovering, Grant had an epiphany of sorts and realized that his life’s mission was to simplify the way people navigate the health care system and manage their health and well-being. He dropped out of college soon after that and in 2010 started what would become Rally Health. Today, Rally has joined forces with UnitedHealth Group and employs more than 1,000 people. In 2018, Business Insider included Grant on its list of 30 leaders under 40 in health tech who are using technology to shape the future of medicine.

Rally Health Believes in Simplicity

Rally’s mission, posted on the company’s website, reflects Grant’s seminal belief that health care needs to be simplified:

“To be effective, health care needs to be simpler. Our goal is to break down complex topics and ideas into actions, empowering consumers to take control of their health before facing crisis or injury. And should they become injured, quickly finding the right doctor and getting upfront costs should be easy.

“As a digital health experience, we are focused on members’ overall health. Personalized daily goals, recommendations, and rewards are key for prevention, while cost transparency and access to information are crucial when it comes to getting care.”

The goal, the website copy states, is “To put health in the hands of the individual. That energy permeates everything we do.”

We are pleased to include this edited conversation between Grant Verstandig and Kevin Pereau, in which Grant reflects on where health care has been in the past, and where simplifying it will take it in the years to come.

Grant Verstandig on Forces that are Driving Change in Health Care Today . . .

I think you’re right about the stages of health care evolution that you describe: Health 1.0, Health 2.0 and Health 3.0. (Digital Health 1.0 was the time when the popular notion was dispelled that consumers wouldn’t engage in their health management; Digital Health 2.0 was the time of the Quantified Self movement and the rise of predictive analytics; Digital Health 3.0, happening now, is the time when we are extending the health care value chain to include nutrition, exercise, and mental health.)

That is sort of the macro landscape. Something I would add is that socioeconomic and sociodemographic changes have been a major driver of change, and a driver of engagement for Rally, too.

Specifically, every day there are about 10,000 people who age into the Medicare system, and when they do, they tend to utilize more care and spend more money, not less.  At the other end of the spectrum, we see that Millennials are not consuming health care services in the way many expected they would. They tend not to have a traditional physician relationship, and so they basically don’t utilize care . . . until they really do. And when they do, it’s an enormous jump that tends to spike around things like complex neonatal care. As you know, each day in the neonatal intensive care unit can cost $10,000 or more.

Further, across the board – from Millennials to seniors – we are seeing a tremendous increase in the rate of obesity and its associated chronic illnesses such as diabetes and heart disease. That population used to be about 30% of the people in the United States. The number is expected to be as high as 50% of the population in any given state in 2030.

The interesting opportunity for Rally Health is that there are now large segments of the population that are increasingly engaging in the health system and could benefit from using Rally, our consumer digital health platform, to help them manage all the complex elements involved in their health and health care, from understanding their benefits, to meeting their health and wellness goals, to finding care providers and pricing care.

On the Evolution of Digital Health . . .

Today’s digital health solutions have come a long way to deliver real value in people’s lives. In the beginning, that wasn’t necessarily the case. When thinking about digital health, people would say, “Okay, I just go online and do all these digital things . . . but does that make the health care experience easier to navigate, less expensive, or more effective? Does it make it so that the care I get for my mother is easier, or for my son, or for myself? Does it simplify things or lower costs?”

Today in digital health, we can answer “yes” to all of these questions. As an example of what digital health today can do, at Rally, we can tell our members who are prediabetic and interested in losing weight, “If you lose more than 5% of your BMI [Body Mass Index – ed.], we will lower your health insurance premiums.” And, “If you use our coaches, you will save even more.” We make it easy for them to do these things. They can simply click a button and have a live, digital coaching session. More than 90% of all the coaching sessions we do now are digital; just a few years ago, 90% were telephonic. And we are finding that that is exactly what people want.

On the Value of Simplicity . . .

Simplicity is where we think the magic really happens in digital health. When we were first developing our Rally platform, former Apple CEO John Sculley, who was on our board, would tell me all the time that it is what you leave out of products — not what you put in them — that gives the consumer an “AHA” experience.

We have to remember that however simple we make health care seem to a consumer, it’s extremely complex behind the scenes. And that’s the point of digital health – to take complex issues and processes and make them simple for the consumer who wants to be empowered to discover information and resources that are specifically relevant to them.

At Rally, we aim to meet consumers where they are in the health care system and simplify whatever they are doing or experiencing at that time, no matter what they are doing. If they are searching for a physician, we can meet them there and help them find one. If they are trying to figure out what the best preventive cancer screening would be for them, based on their data, we can help there, too. And each of these processes feeds others.

On Reducing Costs and Improving Outcomes . . .

If you are about to interact with the health care system, Rally can help you make the most informed and best choices for you based upon factors such as your specific medical condition, the physicians or facilities located near you, their quality ratings, and pricing.

For example, imagine the experience of a first-time mother whose child has an ear infection. She could use Rally to quickly discover her options for care. She might see that a visit to the ER could cost up to $10,000, and that a visit to the urgent care center would cost less than going to the ER, but could still be pretty expensive. She would also see the option of scheduling a virtual visit and could have the antibiotics to fight her child’s infection delivered right to her home in less than 24 hours. She would see that this choice is significantly less expensive. The point is that by using Rally, she would learn about her choices, including lower-priced options that could meet her needs just as well as higher-priced options.

A big part of what we are doing now is taking data and using it to make personalized recommendations for our members. Similar to how Amazon Prime makes recommendations based on what consumers have bought in the past, Rally can say, “You are seeing a primary care physician, but did you know there is a higher quality premium care physician in your plan who is closer to you than the person you are seeing now and could offer a 10-18% lower total cost of care?”

If you look at the overall value of the digital health support offered by Rally for consumers, the cost outcomes become really compelling.  For example, UnitedHealth Group reported that when a consumer selects a premium designated physician, they reduce their costs of health care by more than $300 per care episode. In 2017, United saw over $100 million in medical costs saved for customers through our Rally Care solution.

On What’s Coming Up at Rally Health . . .

We’re launching a digital-first Medicare Advantage product, replacing the usual paper-first approach to communication. Our goal is to lower the cost of care by several percentage points for Medicare Advantage members by bringing to market a personalized, digital-first, mobile-first product that helps them make better informed health care decisions.

We have already found that for our Medicare members, there is a 1000% increase in engagement when they are offered a cost-saving incentive, compared to about a 200% increase in the rate of engagement for people who are between the ages of 41 and 55.

Medicare consumers in particular want to understand what they are spending, and how they can save money. Many of them are retired, health care is expensive, and they are concerned about the cost of care. We expect that our members will not only be surprised, but delighted to see how Rally can help them get better and more convenient care for less money.

We’re a mission-driven company, and this is an example of Rally trying to tackle one of the biggest challenges in health care: managing and serving the needs of the rapidly growing Medicare population. The idea is to apply the same technology and experience we use to serve our current member base to also serve those who are a part of something as large and complex as Medicare.

On Supporting Healthy Behavior . . .

At the very foundation of Rally is our commitment to support healthy behavior. Our Web and mobile solutions help people get healthier by supporting them in making simple changes in their everyday routines, setting goals, and tracking their progress, while earning rewards along the way. We offer programs for losing weight, reducing stress, quitting smoking, and much more, that are all tailored to the individual and give them the support they need.

One good example, which I mentioned earlier, is our digital weight loss product Real Appeal, which focuses on addressing obesity and its associated chronic diseases. Its digital coaching sessions can have a major impact on helping people set goals and understand the importance of eating better, exercising more, and staying on track to safely and steadily lose weight.

Simplicity comes into the picture here, too. Right now, if you Google “portion size” or “perfect plate,” you are going to get hundreds of pieces of information, some of which offer conflicting advice.  Our digital weight loss product concentrates on the literacy piece around nutrition and helps people understand how to plan a plate, for example, and what kinds of foods are recommended for them.

Contributing to Real Appeal’s adoption is the fact that we have said we are not going to charge the consumer a penny for it. If you are a Rally member who is eligible for the program, based on your BMI, you can use Real Appeal. By taking the cost of our program away from the consumer and tying the program to better outcomes for insurance companies and employers, we have created a positive proposition for all parties.

In just a few years, our Real Appeal program has helped hundreds of thousands of people lose a combined total of nearly two million pounds.

On What Digital Health Will Look Like in Five Years  . . .

I will say the most important thing by a factor of 10 is personalization, which very simply means that how I use my health data is very different than how you use yours. My diet, exercise, metabolism, etc – it’s all different from yours. Each of us will be able to take different approaches to our health and health care depending on our own unique health profile, and we will rely on digital technologies to help us.

Personalization is what has made and will continue to make tech wildly more successful and stickier than any other industry. Look at Netflix: It understands what you liked to watch in the past and from that, suggests what you might like to watch in the future, and it’s available on demand whenever and wherever you want it. Digital health is taking health care in this direction.

It’s important to the future of digital health that we continue doubling down on delivering personalization. Not only because of what you and what I want and need from our personal health care can be so different, but also because there are things that are different about our local environments. Health care is exceedingly local, and how we take that personalization and link it both to each person’s health and their local environment will be key in the future of digital health.

Summing Up the Coming Age of Health Care . . .

Today, our Rally consumer digital health platform already has more than 20 million registered users. When you look at the potential impact that digital health can have from a public health perspective, the potential that numbers like this represent is truly mind-boggling.

For example, we could leverage the reach of a digital health platform like Rally to undertake a public health campaign to encourage everyone to get a flu shot. In fact, we could address any number of core issues similar to the way that we took on smoking over the last decade. Smoking went from being cool to barely acceptable, and then to “you go outside.” The next example might either be something not-to-do, like smoking, or it might be something to-do, like getting a flu shot.

At the end of the day, health care is a series of very small decisions that people make in the course of any day, and how we help people enhance their decision-making power, and engage them and empower them through digital health to make the right decisions about their health, that’s the future of health care. It’s as simple as that.

Grant Verstandig is founder of Rally Health and Chief Digital Officer of the United Health Group. A young health care visionary to watch, Grant founded Rally Health in 2009. Today, Rally has joined forces with United Healthcare and now employs more than 3,000 people.

Thank you, Grant, for contributing to ‘The Digital Health Revolution’ and to the world of healthcare. – Kevin Pereau, The Digital Health Guy

You can find this interview in its entirety in ‘The Digital Health Revolution’. If you haven’t done so yet, you can sign up here for updates and to get your copy today.