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Finding the Best Care for the Sickest Patients: A Conversation with Grand Rounds' Owen Tripp at

I got the chance to talk to Owen Tripp, founder and CEO of Grand Rounds, at the HLTH conference in early May. Owen is well-known in health-tech and is simultaneously nice and no-bullshit (even winning Rock Health's Most Beloved CEO Award). He founded in 2006, growing that into a multi-million dollar company before launching Grand Rounds in 2011.

Since then, Owen has lead Grand Rounds to raise more than $100 million and to work towards their vision of creating 'a path to great health and health care, for everyone, everywhere.' Let's see what he has to say...

Hi Owen, thanks for talking to me today. To start off, why focus on complex conditions at Grand Rounds?

So at Grand Rounds we focus on complex condition management, and in addition to that product we also have a new navigation for the whole population (the front door to care for everyone). And really they’re related.

The problem was in the beginning we were changing diagnosis and treatment 67% of the time. So that means two out of every three people that came to Grand Rounds left with a materially different take to their disease or injury. So if you’re changing care 67% of the time you can keep doing that business and trying to take care of people or you could say ‘Something is fundamentally wrong with how these people are being taken care of before they get to us'.

So, Summit, our second product, was born out of necessity really, to help people match to higher quality care at the front end of their journey.

A big focus of Grand Rounds seems to be this idea that any given provider is never the best at serving every illness. Can you talk a bit about how that fits in to what you do?

Correct — It’s kind of impossible for me to understand why it’s taken us as a society to get to this — but, Grand Rounds for the first time has said: It’s not about the brand of the hospital. It’s not about the quality of the waiting room. It’s not about getting a comfy pillow to sit on while you’re there, but really it’s about the individual doctor who’s going to take care of you that predicts whether you’re going to have a successful journey or not. ​​

There are some doctors who know what you need and have spent their entire careers zeroing in on the specific thing that you are afflicted by, and those people are going to treat you at a much higher quality than someone who was just randomly selected. And unfortunately the way most people find doctors today is pretty random.

You’re serving employers in part to reduce the cost of their health care. Have you found that approaching these expert doctors plays into cost of care?

So we have. But, it looks different than you’d expect.

Most people would think ‘Well, higher quality doctors are higher cost and so, maybe you’re driving better experience but you’re at risk of driving higher cost as well’

It turns out the opposite is true. And if you think about the drivers of cost in care generally, the biggest problems are: overutilization, undertreatment, or inappropriate treatment.

So, if I get you to a higher quality doctor, whether or not that person is more expensive on a unit price of care, the probability of you getting better faster and spending less time in the system goes way up. So we get you out and we get you on your way.

— and just like you said on your panel, no one wants to stay in the health care system.

Right, and it’s intuitive. Traditionally the comparison has been ‘What’s the cost of this service at this specific site vs another site’. That stuff matters, but frankly explains very little of the total cost problem in the US

Everyone talks about new financial models of health care with Value-based care. At Grand Rounds you're improving transparency of physician quality as well as referral systems which could create a new incentive system for better care. Do you think that's true?

I think that’s an interesting angle, sure. I think if you simplify it a little bit and take out health care jargon, you could ask the question ‘Do people who are sick want to understand whether they’re seeing a good doctor or a bad doctor?’

"I think that Medicaid is going to be the story for the next ten years."

The answer will be very emphatically yes. So if we can answer that question in a way that’s easy to understand, and is actionable then we can make a lot of changes. Then I don’t think a lot of the other transparency questions matter as much.

It seems like you have some strong opinions on health care, is there any point of consensus in health care that you’re skeptical of?

Well I talked a little bit at my HLTH panel about engagement. I don’t believe that if you talk to people who are getting health care services every day in a hospital, that they’d want to spend more time doing that. Or that they had a deeper connection to that facility. I think they understand the role of the facility, but that they want it to be narrowed to the scope of get my healthy and get me on my way.

So, I do challenge the move towards pursuing health engagement, and I challenge that at a time when everyone’s really focussed on it. I think you can cross-apply this to a bunch of circumstances. A lot of the engagement conversation just applies basic consumer logic: a consumer want to get their goal done as soon as possible.

"Be aware that [in healthcare] there is more responsibility to be ethical, to secure data, to take care of people as you would take care of your Mom"

And you can extend the consumer logic front, like do you want to get your UTI treated in the same place where you buy your halloween candy or your Glade Air Freshner? I don’t think that makes sense and I don’t think that’s a strong consumer proposition. We sometimes justify these things all under the banner of ‘We want more engagement so we have to go where the people are’, but to me that’s equally as logical as saying ‘We should engage people in health care when they go to see the Raider’s game because there are a lot of people in the stadium’.

What other than employer health, what sector of health do you think is most interesting?

Medicaid. I think that Medicaid is going to be the story for the next ten years. Employers aren’t yet solved, sure, but I there’s a lot of oppurtunity to help solve these people. I would direct your readers to working there.

One interesting thing about employers, by the way, is that we get to work with a lot of those (Medicaid) populations. So a lot of people that are covered by Grand Rounds, out of the > 4 million people that benefit from our services, are the working poor. They’re living paycheck-to-paycheck. They have to think about financing care very differently than you or I might, and if they’re not employed then they’re probably getting care from Medicaid.

What do you think young people who are interested in health care should learn?

Get in! The water is warm

But, be aware that there is more responsibility to be ethical, to secure data, to take care of people as you would take care of your Mom, and that’s really different than the Silicon Valley companies of today where the code of ‘Move fast and break shit’ is thrown out as if it’s a virtue. In health care that’s not so cool.

Thanks Owen! Great to talk

Up Next:

A series of interviews with startup founders at HLTH: Check out the interview with Conversa's Chief Experience Officer on the value of automated conversations for care management

#interview #employerhealth #founder #hlth