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This file was generated by Descript
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Kevin: Good to see you.
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Patrick, welcome to the show.
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Patrick: Thank
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Kevin: you.
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As you probably, as you probably heard
us just teeing up, we're excited to
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talk with you about, um, what y'all
up to it Withings, uh, the access
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model in particular, how you're
thinking about the opportunity there.
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So maybe let's start with that.
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I'd be curious as one of the, the
hundred 50th, 50 ish participants
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in the model, how are you
thinking about the opportunity?
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What gets you excited about the model?
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What led you guys to apply?
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Patrick: You know, I, um, one,
we're very excited and thank you
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Martin and Kevin, uh, for having
us on and talking about access.
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Um, look, I think access is like a
big moment for digital health and
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you guys spoke about it very well.
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Like, why hasn't digital
health come more to the table?
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Maybe like the role of the device is
like really important here, but the
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more that we got into the weeds of
access, the more we spoke with Jacob
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and company at CMMI, the more we were
like, actually this is a great model
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for a device company and all of our
exper expertise and delivering care and
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enabling care and the Medicare population.
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Um, and you know, what we think about it
is, look, the hardest part in all of this
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is getting a patient to use a device.
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You know, I think a lot about, like
the payment is fully contingent
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on a patient using a device for
the baselining, for the quarterly
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payment for the end of year payment.
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The device is core to all of this.
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And, um, and we also know that patients
love using our devices and that blend of
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like, consumer plus we have huge amount
of healthcare partnerships with ACOs,
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health systems, getting data back to PCPs.
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I could talk endlessly about it,
but we felt more and more that the
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people who were gonna succeed in this
model or those who have that consumer
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backbone, but also have the right
pipes into the healthcare system to
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have that coordinated collaborative
care approach for the patient.
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Martin: The main thing we've heard
from folks who are not participating
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is some complaints about the rates.
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Obviously, we're not looking for you
to get into your secret sauce here.
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Yeah.
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On, on how you did the math, but
curious for your high level reflections
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on how you interpreted the rates,
what you're sort of seeing as the
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opportunity here and how you're
thinking about, you know, leveraging
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AI to help make this stuff work.
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Patrick: Yeah, so the rates as they are
today are sustainable for Withings, but
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Withings we're kind of, and other device
companies were kind of unique because we
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own the main cost structure and this care,
which is the hardware required, uh, to
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be able to manage the patient remotely.
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You know, the way I think about it,
and you guys probably think about
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it the same way, but this is a
pilot and you know, we're coming in
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the first year, the first cohort.
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I think a safe bet is that this is going
to evolve as time goes along as well.
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So like, as the rates are today,
we're very happy with them.
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Uh, we're looking at a sustainable
business in access alone, but we're
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also really thinking about, hey, this
is the star of a pilot with CMMI.
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This is going to evolve quite rapidly.
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You know, I, you know, we were
talking about, um, we we're all
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rooting for this as taxpayers, right?
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For this to succeed.
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You guys were opening up with that
today, I think about MSSP, you
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know, like in 2014, you know, PCPs
were saying, we can't do this.
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Like, this is too low of a rate.
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We're not gonna, it's not gonna work out.
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And you fast forward a little bit and
you had these insurgent models, right?
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You had these enablers pop up because
they had the core technology of
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like pop health analytics, really
robust to enable that payment,
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enable success in the MSSP program.
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I think access is kind of the same way
where the incumbents, you know, this
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is difficult in the status quo, but
we're gonna have this insurgency of.
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Companies who have the right technology
in place, who can build for it.
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Um, and I think this will be
a very successful program with
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the right people at the table.
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Kevin: Patrick, I think most of
us think of Withings as connected
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device company, manufacturer
scales and blood pressure cuffs.
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Uh, people use them in their
homes to be part of this program.
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I'd be curious, are you
expanding scope of Withings?
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Like there's been conversations about
becoming Medicare provider, part B
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provider to participate in the program.
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What have you had to build on top of kind
of the core connected device offering
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for access in particular and how you're
thinking about that moving forward?
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Patrick: Yeah, so we are a
Medicare Part B provider today.
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I think of it as, you know, one, it's a
natural evolution of what we do every day.
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So with thing is, I mean, we have
15 million users around the world.
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Kevin, I know you're,
you're one of them as well.
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We have a medic, a million medical
patients being monitored today, anywhere
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from a million to a million and a half on
a given day with our healthcare partners.
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Like we know what works, um,
in managing hypertension.
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We know what works in
managing obesity, et cetera.
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Uh, so we have formed, um, you know,
our Part B, uh, medical group and what
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we're building out, and we'll announce
our clinical leadership as well.
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But what we're building out is a.
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A care model that's focused on
being this new layer of care.
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And this is where I spend a lot of
my time, Kevin and Martin, thinking
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about with our a CO partners, is
where does our care begin and where
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do we bring it back to you guys?
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And that, that's why I'm kind of
urging the full access cohort is,
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Hey, don't go at it alone guys.
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Because if, if we, if participants
start going at it alone, we're
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going to create friction with the
ACOs, with the health systems.
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And I think that's how the pilot fails.
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I'm like really urging participants to
really think about how you integrate
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back, how you coordinate back with
the ACOs, with the health systems.
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Martin: I, I think that's one
of the things that I'm most
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fascinated by is what, you know,
how ACOs are thinking about this.
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Yeah.
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How those conversations
with ACOs are going.
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Um, I'd be curious if you can
kind of give us any sort of Yeah.
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Initial reflections or
reactions from the, the sort of.
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Withings plus an a CO on, on
what this could look like.
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Patrick: Yeah.
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Uh, this is where I'm
spending like all my time.
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Uh, it's really exciting.
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I love it.
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I think it's like this is the evolution.
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Um, RPM was like a false start
in hindsight, uh, all things
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considered for this purpose.
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The, so today we have a number
of a CO partners doing remote
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management of heart failure,
hypertension, obesity, c management.
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Most of the conversation today is
how do we work together to avoid
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possible fragmentation of care?
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That's the number one
focus today, and we are.
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Operating from a place of,
okay, how do we ensure that a
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patient is one, has the choice?
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'cause this is really the core pillar and
as you guys, we didn't speak about this,
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but the thing I'm most excited about with
access isn't the outcomes-based payment.
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I think that's kind of table
stakes for this movement.
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It's patient choice.
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Um, the idea that a patient's benefits
isn't limited by who the payer has
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contracted with and is a complete
open kind of app store approach to the
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benefit, I think is transformational.
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And I think other payers
will probably follow suit.
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Um, but that patient choice
also means that there's a
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risk of fragmentation of care.
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For a PCP.
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Um, so you might have a, you know,
a patient panel if you're, you
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know, a thousand, 1500 patients
and then they're in, you know, a
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couple hundred different programs.
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Um, they themselves, right?
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And that's very complicated.
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So how do we preserve patient choice, but
also ensure that, um, we're coordinating
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back in a way that doesn't create friction
with PCPs and, and, you know, hinder
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the growth of the access, uh, pilot.
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Kevin: Picking up on that choice,
one of the, one of the prerequisites
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in that is awareness, and that's
been a big part of the topic of
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conversation with access, is how is
the program actually driving awareness
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of these decisions with patients?
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How with Withings in the installed
base you already have, I would
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imagine that creates a channel to go.
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Create awareness within that.
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But I, I'd be interested in how are
you thinking about driving awareness?
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Do you expect, like, are the 65 plus
population gonna be getting flyers in the
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mail starting on July 5th, being like,
Hey, you know, come use us in access.
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Or like, what does, what does this
feel like as a program goes live
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from an awareness perspective?
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Patrick: You know, I'll tell you, uh,
we're still thinking about the playbook.
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We're, we're, I, there's a lot of gray
area in Medicare marketing because a
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lot of it's been written for Medicare
Advantage and we're trying to get clarity
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and about, uh, what meets the intent here.
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But I'll tell you what we want to
avoid is, you know, the 9:00 PM you're
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watching, you know, C-N-N-M-S-N-V-C,
Fox News and you get a commercial
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for Whiting saying scan QR code.
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Like, we're trying to avoid that.
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'cause I think that's where
this pilot access model falls
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apart is that type of behavior.
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Um, you know, from an
awareness perspective.
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We're thinking about, you know, how
we can best serve our consumer base.
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We ran a couple surveys with our
65 plus population and you know, we
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have a, I think over a million to
2,000,065 plus in our consumer base.
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And, you know, the number one
thing they're looking for is
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actually hypertension management
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Martin: really.
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Patrick: And that's across,
you know, scales, blood
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pressure cuffs, uh, wearables.
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They're looking for help
with their hypertension.
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And that's great and we can offer that.
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But we also think about it like,
hey, the number one most impactful
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intervention for a patient.
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Sure.
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Coming into access is great.
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We need to get you to a PC.
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You know what I mean?
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Like, we need to get you in front
of A PCP and we can help you with
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that and then come into access.
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So I, the more we think about this,
the more we think it, that the point of
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access is for tech companies, like with
things to come to the table and have,
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you know, place our chips on the table.
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Like, hey, we're at risk on the outcome.
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But this only works if we have other
stakeholders at the table saying,
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Hey, I am accountable to total cost of
care and I'm thinking about the full,
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you know, care plan of this patient.
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We think we have to come at it, uh,
as a team with the rest of the market.
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Martin: One of the things that I find
fascinating about the access model
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is CMS has lined up a bunch of payers
in the commercial space and Medicaid
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space and ma space to commit to, in
principle, to a similar payment model.
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I realize that the access model hasn't
rolled out in the original cohort yet.
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I'd be curious though, you know, you
mentioned one or 2 million on, uh, on the
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65 plus, but there's also probably a lot
of commercial folks and when I look around
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my gym, I see folks with livings watches.
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Uh, what, what, what, how are you thinking
about the commercial market for this?
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Patrick: If I'm a payer,
why would I not do access?
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Obviously it has to be successful, right?
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But it's inherently deflationary, right?
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Um, and you're solving for a huge burden,
which is contracting for benefits.
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Um, if I'm a payer, this is
very attractive, I think.
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I think a lot of this comes back to,
is it gonna work from a, you know,
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how does, how do access participants
work with a provider network?
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Um, and I think it's gonna be a lot
of the, a lot of the relationship.
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Um, yeah, I mean we, we obviously would
invite this to grow to other payers.
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Um, and it'll be the same approach, right?
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Where we have an embedded consumer base,
we have, you know, uh, partnerships with
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health systems ACOs, who are also managing
commercial ACOs, managing employer
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sponsored programs, and being able to, um,
to, you know, do the access model there.
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But we're really thinking about
the first participation period, the
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first period performance period.
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And, you know, coming back to, we wanna
ensure that the full model is successful.
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I think another thing that's like
piggybacking access really closely,
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and maybe this is the, the true purpose
of access in the market is gonna be.
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You know, CMS balance and the
expansion of GLP ones starting July.
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I know Kevin, we spoke
about this a few weeks ago.
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Two, and you know, as we can anticipate,
you know, why distribution of GLP
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ones to a senior population that
has frailty and risk of falls and,
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and other adverse events, things
like access might be part of the
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infrastructure, um, for that population.
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I think of remote monitoring and
technology, device centric care as
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being great with paired with medication
management paired for medication safety.
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So I think there's a lot of value in
the commercial population, but I'm
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really, really focused right now on
that first performance year and what
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is access as a new layer of care.
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'cause it really is something new and
defining that with the rest of the market.
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Kevin: I am curious to go back to
the survey you mentioned, Patrick,
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and the data you talked about on, on
patients and I, I, um, I'd be in, so
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hearing that there is such an interest
in, in hypertension management, I
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immediately start to wonder what is
the relationship with A PCP like today?
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Yeah.
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Like I, I, I hear, you know, one of the,
the veins of pushback I hear against
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access and, and thinking about using
technology in this way is displacing
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the relationship between somebody and
their PCP and concerns around that.
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And, um, what that all implies.
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But when I, when I hear that from
the survey results, I'm like,
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how close are relationships do
these people have with PCPs today?
00:13:35.625 --> 00:13:37.665
And what does that really look like?
00:13:37.694 --> 00:13:41.174
I, I'd be, I'd be curious, any
reflections from the survey, things
00:13:41.174 --> 00:13:45.734
you heard from that, lessons learned
about what the state of that actually
00:13:45.734 --> 00:13:48.974
looks like in the Medicare population
using your guys' devices right now?
00:13:50.354 --> 00:13:53.174
Patrick: Yeah, that's a great, we
don't have that direct data, but that's
00:13:53.174 --> 00:13:54.584
where we need to be thinking about.
00:13:54.584 --> 00:13:55.184
Right Kevin?
00:13:55.184 --> 00:13:58.004
It's, you know, and I think that's
how we're trying to, at least
00:13:58.004 --> 00:14:03.884
Withings is access participation
is being defined by how we augment
00:14:04.304 --> 00:14:07.274
as a new layer of care for the pcp.
00:14:07.844 --> 00:14:08.024
Kevin: Yep.
00:14:08.144 --> 00:14:11.924
Patrick: And I think this could, I
think access is also kind of like a, a
00:14:11.924 --> 00:14:17.294
new tool in the toolbox for an A CO to
be doing a better a CO lead program.
00:14:17.354 --> 00:14:20.924
Or if you're doing ambulatory
specialty model, here's a layer of
00:14:20.924 --> 00:14:23.354
digital care you can add on top of it.
00:14:23.354 --> 00:14:26.219
So I really think of it as
being more like a utility.
00:14:26.219 --> 00:14:30.134
Like I think the core principle,
at least what gets me excited every
00:14:30.134 --> 00:14:34.064
morning, I'm up every morning just
ready to go because I think of it
00:14:34.064 --> 00:14:39.224
as like we're providing patients
this new, always on level of care.
00:14:39.254 --> 00:14:42.134
The assumption is that everyone
with a chronic condition should get
00:14:42.134 --> 00:14:44.354
some level of support day to day.
00:14:44.354 --> 00:14:44.364
Mm-hmm.
00:14:44.924 --> 00:14:47.954
And much like we give people
electricity while their heat.
00:14:48.374 --> 00:14:52.364
Let's get some, give them a layer
of care that's gonna be with them
00:14:52.454 --> 00:14:54.884
and, but we can't replace the PCP.
00:14:55.364 --> 00:14:58.424
Um, that's, and that's, I think
it's really important that the, the
00:14:58.424 --> 00:15:02.384
broader access cohort, um, uh, be
respectful of that relationship.
00:15:04.124 --> 00:15:06.314
Martin: Patrick, this
has been hugely helpful.
00:15:06.584 --> 00:15:09.434
We will definitely have you
back once things get kicked off.
00:15:09.434 --> 00:15:09.554
Awesome.
00:15:09.554 --> 00:15:11.114
So you can share how things are going.
00:15:11.294 --> 00:15:12.074
In the meantime.
00:15:12.104 --> 00:15:15.824
If I lead an a CO and I wanna
work with Withings, what's the
00:15:15.824 --> 00:15:17.204
best way for me to get in touch?
00:15:18.014 --> 00:15:18.914
Patrick: Yeah, always.
00:15:18.914 --> 00:15:20.204
Um, visit our website.
00:15:20.204 --> 00:15:23.444
We have a professionals page as
well, but otherwise, feel free
00:15:23.444 --> 00:15:25.484
to reach out, uh, to me directly.
00:15:25.724 --> 00:15:28.454
Uh, first name, last name,
Patrick amp winnings.com.
00:15:28.934 --> 00:15:31.544
Uh, you know, very transparently,
I think what the mar, what
00:15:31.544 --> 00:15:32.894
ACOs are enjoying about.
00:15:33.224 --> 00:15:37.034
Talking and working with things is that
there's no playbook that's been built
00:15:37.124 --> 00:15:39.344
and we are trying to build it with them.
00:15:39.434 --> 00:15:43.514
Uh, and um, it's been a very
exciting few months to say the least.
00:15:44.084 --> 00:15:44.864
Martin: I can only imagine.
00:15:44.864 --> 00:15:44.984
Sure.
00:15:46.244 --> 00:15:47.924
Thanks so much, Patrick.
00:15:48.434 --> 00:15:48.524
Kevin: Yep.
00:15:48.524 --> 00:15:48.824
Patrick: Thanks guys.
00:15:48.824 --> 00:15:48.914
Kevin: Good.
00:15:49.724 --> 00:15:50.114
Patrick: Take care.