For Millennials, “healthy” doesn’t just mean “not sick.” It means a daily commitment to eating right and exercising. This mindset stands in stark contrast with that of prior generations, who care less about lifestyle and more about simply avoiding bad health outcomes. The rise of fitness trackers like Fitbit underscore a massive public interest in taking ownership of health and wellness.
For Millennials, Health = Lifestyle
Source: Brookings Institution, Goldman Sachs, Nielsen
When it comes to products, Millennials are non-committal. From homes to cars, music, and luxury goods, they are reluctant to buy, turning instead to an expanding marketplace of on-demand “sharing” services.
Not surprisingly, the same dynamics have played out when it comes health services. The 2015 PNC Healthcare Survey found that while 80% of Baby Boomers visit a primary care physician, only 60% of Millennials do. And for those that have a regular doctor, 40% wouldn’t recognize them on the street. Millennials are just not inclined to commit to a single care provider, which implies limited scheduling options and a fixed location for service.
As the next generation of healthcare companies emerges, we are seeing innovation sparked by Millennials — digital natives that are demanding personalized, on-demand, and socially-conscious services. Change isn’t going to come from the White House or the halls of Congress. It’s going to come from the entrepreneurs who are reimagining tomorrow.
To say that Americans don’t like health insurance companies would be more than a mild understatement. A 2015 survey by the American Consumer Satisfaction Index that asked consumers to rank their satisfaction with companies across 43 industries found that health insurers placed in the bottom five — ahead of only Internet service providers, cable companies, the U.S. Postal Service and fixed-line telephone services. Even banks received higher marks.
Companies like Clover Health are changing the paradigm by using data and mobile technology to reduce costs, improve outcomes, and deliver a superior customer experience. Backed by Sequoia and First Round Capital, Clover’s initial goal is upend the Medicare health insurance market, which is dominated by sprawling incumbents like UnitedHealth and Cigna, which have a combined market value over $150 billion.
Pioneers: Clover Health
Kris Gale, Co-Founder, Clover Health (Right) Interviewed by Phineas Barnes, Partner, First Round Capital (Left) at the 2015 GSV Pioneer Summit
Source: GSV Asset Management
To do this, Clover collects a range of patient data like lab test results, radiology results, and routine checkup absenteeism to get an overall profile of a person’s health and risk profile. It then uses software models to automatically identify issues — like patients not regularly taking a prescription — and intervenes early with nurse practitioners and social workers that are equipped for home visits. As Clover co-founder Kris Gale observed in a recent interview with TechCrunch:
If we know something is on a 30-day refill and we haven’t seen a claim in 35 days, we know they aren’t taking it regularly. We can reach out and intervene. This is info that’s available to us because we’re the payer… The doctor doesn’t know if they’re getting that filled unless they’re asking them regularly. That’s part of the data advantage.
The net result is lower costs for both Clover and its customers, not to mention better health outcomes. In 2015, for example, seniors using Clover Health had 50% fewer hospital admissions and 34% fewer hospital readmissions than the average group of Medicare patients in the New Jersey areas it serves.
Smart Services: Insurance + Health Benefits
Source: CrunchBase, GSV Asset Management
Next generation insurance providers include Oscar, Zoom+, Clover Health, Melody Health Insurance, and Beam Dental. In February 2016, Oscar, completed a $400 million financing led by Fidelity Investments, which valued the company at $2.7 billion. Last week, Oscar secured a key hire, naming Alan Warren — a former Google executive overseeing the Google Docs and Google Drive product lines — as its Chief Technology Officer.
A second key segment of related companies is purely focused on the buying, selling and management of health insurance. These include Zenefits, Collective Health, StrideHealth, GetInsured, SimplyInsured, Gravie, and Picwell.
Health-insurer and insurance-technology startups raised more than $1.2 billion in venture funding in 2015. That’s more than double the $570 million raised in 2014, and 10 times the $123 million raised in 2013, according to CB Insights.