The Millennial Entrepreneurs Saving Insurers Millions Through High Tech, High Touch Care

Apr 4, 2019

Shameet Luhar and Philip Rub, co-founders of Vheda Health have created an end-to-end solution for health plans, saving them $17K+ per member per year. StartUp Health sat down with Luhar to hear about his entrepreneurial path to become the preeminent leader in member compliance among Medicaid/Medicare health plans.

early as high school, Shameet Luhar knew he was headed towards a career in healthcare. But the pieces didn’t fully gel until one weekend when he was 29. Shameet and his co-worker (and co-founder) Philip Rub took the seed of an idea Shameet had been developing in grade school and in two caffeine-fueled days drafted a business plan for a pitch contest. That plan — which got them to the contest’s quarterfinals — was the beginning of Vheda Health. The idea was for Shameet and Phil to take their experience as health insurance consultants after their previous company, Resolution Health, got purchased by WellPoint (now Anthem), to create a better kind of compliance company. And that’s what they did. Now, when they walk in the door to talk to a new health plan, it’s with the knowledge that they can save that plan more than $17K per member per year, on average.

Email Shameet and Philip at vhedahealth@startuphealth.com.

They do it through a combination of high-touch hardware, software and services such as member identification, monitoring and live health coaching/outreach that drives behavior change, saving health plans money. But the secret sauce? Data. Vheda Health can look at massive population health data sets and identify the right populations that yield at least a 3:1 ROI for Vheda Health’s specific intervention programs, such as heart failure, diabetes, hypertension, COPD, behavioral health and more.

Shameet, a Maryland-native who returned to his home state to set up shop, is just getting started. Good enough to lock in the second largest health insurer in the US and a former employer.

StartUp Health sat down with Shameet and talked about his entrepreneurial motivations, the uniqueness of his product, and his “aha!” moment.

Q&A

What was your journey to becoming a health entrepreneur?

I got my first taste of the health IT field when I joined Deloitte right out of college, which led to consulting for health insurance companies. It was there that I really started understanding the inner workings of how a health insurance company operates. I learned how health plans work in terms of interacting with members, about the various programs offered to members that have chronic conditions, how plans increase revenues and lower their costs. That paved the path for my work in 2010 at Resolution Health, a data-analytics company, purchased by Anthem. There we developed a clinical rules engine built to analyze claims and send members messages to elicit behavior changes on identified care gaps. The problem was that the whole system at Resolution Health (and Anthem) was paper-based, so the data was too old to be useful, ultimately costing the insurer money. Around this time, in 2013, we saw the beginnings of a generational shift in healthcare, triggered by three key events: smartphone adoption was increasing, access to remote monitoring was coming of age and the ACA passed. We realized that to drive change, and save insurers money, health plans are going to need access to real-time data. And with that, the seeds of Vheda Health were planted.

What gave you the confidence to step away from a secure job into the tumult of health entrepreneurship?

When you’re working on projects for a Fortune 50 company, the work can become repetitive, and so your mind has a natural tendency to wander. Phil and I were working on the same enterprise projects. I came to him with this idea and he and I started talking and we said that there might be some legs to this. Phil’s wife is a type 1 diabetic, so he’d seen a lot of the struggles that she has had with access to care. We happened to land on an opportunity for a business plan competition. Phil and I looked at each other and said, you know what? We might as well throw our hats in the ring and see what happens. Over a weekend, we wrote our first business plan for the company and we made it to the quarterfinal round.

You’ve got a pretty young team. What are the opportunities and challenges of being a team in its 30s?

When we are meeting with leaders of a health insurance company and describing our philosophy and value proposition, Phil and I are the youngest people in the room. Sometimes there is a stigma against younger entrepreneurs, but it comes down to how you communicate the value. There’s always going to be skeptics because health insurance is a very risk-averse industry. So you have to hit them with the hard financial impact that you can provide to them in a short amount of time. If you’re able to communicate the value in a very effective and simple way, everybody sits up in their chair, their ears perk up and you’re ready to go. And that’s why every time we go into a meeting, we always hit them up with our results first. Results are what get their attention.

What stats do you lead with?

Vheda Health is a member compliance company saving health insurers an average $17,175 per member per year.

And how do you do that?

As a member compliance platform, we are bringing disparate data sources into a singular solution. This means we combine hardware, software and services that decrease emergency room overuse, inpatient admissions and inpatient days. Vheda Health focuses on under-resourced (Medicaid) and elderly (Medicare) populations, providing the hardware and software they need to improve their health, but then we also layer on human touch. This human touch is key because it drives behavior change and results. We assign every member enrolled in one of our chronic condition programs access to a health coach that they meet with through live video and text message through Vheda Health’s mobile app. Additionally, they receive “human touch” support from our tech team who can help them resolve any technical issues with their hardware or the app itself. They also receive support from our triage support. So each member is being tracked by various remote monitoring devices, and if one or more of their values is out of range, they receive a phone call from one of our triage call center support reps to help them normalize that value before it turns into a high cost event. The combination of those three things enables us to reach our members over 100 times per month. That’s an industry-leading number!

Message Shameet and Philip on StartUp Health HQ or email vhedahealth@startuphealth.com.

What hardware do you deploy?

We combine the best hardware currently available. Every member that’s enrolled in one of our programs receives a care package in the mail that includes an iPhone with unlimited talk, text and data. It’s preloaded with the Vheda Health mobile app, the health plan’s mobile app, along with hotkeys with quick access to all the health plan services, such as the member’s care manager, their nurse access line, their member services line, transportation and our tech support number. And then we include various biometric remote monitoring tools, based on the person’s condition. A member enrolled in Vheda Health’s heart failure program, for example, will receive a blood pressure cuff, weight scale and a pulse oximeter in their care package.

That seems like a pretty unique value prop in this space.

I don’t know of a single company offering a full end-to-end solution. A key differentiator for us is our value on simplicity for the members at the health plan. We’re focused on removing as many obstacles to compliance as we can. That’s why we pair all the devices ahead of time and make sure each device has a year battery life.

What was one moment when you realized that this wasn’t just a good business idea, but you were actually helping people?

For me, it was when we started to analyze the results of our first client, a Medicaid Health Plan in South Carolina. When we analyzed those results, Phil and I looked at each other, like, holy shit, this is really working. Because not only were we saving the health plan money, but the average number of hospitalizations went down, average hemoglobin A1Cs went down, average member weight went down, and members were actively complying with the program. When we did our exit assessment, a number of members said they would probably be dead if it wasn’t for our program.

You talk about saving health plans $17,175 per member per year. Where do those savings come from?

We bucket it into three categories. The first is in decreasing emergency room overuse. The second is reducing inpatient admissions. The third is reducing inpatient days. We ingest and analyze medical and pharmacy claims sets. With access to this data, we can analyze the health plan’s entire population and provide an analysis of focused opportunities. In other words, after deploying Vheda Health’s programs in these chronic condition areas, here is the projected cost savings and ROI.

What’s next for Vheda? Do you have a dream client you’re going after?

The dream client piece has already been answered. Our former employer is a customer. We have a really aggressive push over the next 12 to 18 months on sales and marketing. It’s time to get our name out there and to educate the rest of the health insurance world about our results. Our ultimate goal is to become the preeminent leader in member compliance among Medicaid and Medicare health plans.