Launch HN: Evry Health (YC W18) – Better health insurance for companies • Hacker News Board

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#51

Post by mjamilkowski » Wed, Mar 02, 2022, 9:27 PM UTC

pierre wrote: post #47

mjamilkowski wrote: post #31

Earlier quoted context omitted.

For B2B, it’s worth noting that most Americans still receive their health coverage through employers, and this is especially true for the 200-2,000 company size segment. Meeting the majority of people where they are seems to be a reasonably impactful way of starting change. We can make a considerable impact for companies with 100 employees. We can make a massive impact for companies with more than 400. We currently a…

Thanks for your answer. I'm not American so not really familiar with your health system. Agreed that B2B will be easier to scale given acquisition cost. However scaling with corporate client limit you in your ability to do good risk selection as I believe you will have to accept all employees.

Underwriting a whole group actually gives us protection from risk selection and creates a more population based risk which is more stable. Yes there will be individuals that have extreme expenses, which is why we have reinsurance. It is the principle of risk pooling and credibility.

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#52

Post by [deleted] » Wed, Mar 02, 2022, 9:28 PM UTC

pierre wrote: post #50

jstartz26 wrote: post #28

Earlier quoted context omitted.

Product comparison: that’s fair – only so much you can fit in an announcement post. We completely agree it is difficult to compare benefits (even for competent HR departments) but it is even more confusing for individuals. We try to make this clearer and transparent when working with employers during the quoting process. Benefit coverage gets boiled down to “actuarial value” and quantified as a number relative to the…

Regarding product comparaison it is possible to build a computable model of your policy and the major competitor, and from there automatically benchmark them to find key difference in coverage (what is the maximum delta) or running them through a set predefined claim scenario. It will however require ~3-5 day of work per policy to build the models. Beyond the marketing effort this models can also be reused for risk m…

[deleted]

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#53

Post by [deleted] » Wed, Mar 02, 2022, 9:29 PM UTC

pierre wrote: post #50

jstartz26 wrote: post #28

Earlier quoted context omitted.

Product comparison: that’s fair – only so much you can fit in an announcement post. We completely agree it is difficult to compare benefits (even for competent HR departments) but it is even more confusing for individuals. We try to make this clearer and transparent when working with employers during the quoting process. Benefit coverage gets boiled down to “actuarial value” and quantified as a number relative to the…

Regarding product comparaison it is possible to build a computable model of your policy and the major competitor, and from there automatically benchmark them to find key difference in coverage (what is the maximum delta) or running them through a set predefined claim scenario. It will however require ~3-5 day of work per policy to build the models. Beyond the marketing effort this models can also be reused for risk m…

[deleted]

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#54

Post by mjamilkowski » Wed, Mar 02, 2022, 9:29 PM UTC

pierre wrote: post #50

jstartz26 wrote: post #28

Earlier quoted context omitted.

Product comparison: that’s fair – only so much you can fit in an announcement post. We completely agree it is difficult to compare benefits (even for competent HR departments) but it is even more confusing for individuals. We try to make this clearer and transparent when working with employers during the quoting process. Benefit coverage gets boiled down to “actuarial value” and quantified as a number relative to the…

Regarding product comparaison it is possible to build a computable model of your policy and the major competitor, and from there automatically benchmark them to find key difference in coverage (what is the maximum delta) or running them through a set predefined claim scenario. It will however require ~3-5 day of work per policy to build the models. Beyond the marketing effort this models can also be reused for risk m…

Yes it would be possible - and I know of a couple of benefits consultants that have tried to do this, but bias and independence is a vexing issue. Keep the ideas coming!

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#55

Post by aquaphile » Wed, Mar 02, 2022, 9:42 PM UTC

erehweb wrote: post #44

You say that MFA on its own may not be enough. What would be enough? What do you think we're missing that other countries have?

Chris here. Medicare is the current lightning rod, but in the US we have several federal health plans: 1. Medicare, 2. Medicaid, 3. Federal Employees Health Insurance Program, 4. Department of Defense / TriCare, 5. VA

Personally, I’d love to have what we had as kids in DoD. As a kid in a US-military household, I had the benefit of full healthcare and dental care and vision care. Our great healthcare was paid for by taxpayers who funded the DoD’s budget. Each child, irrespective of their parent’s income/rank/station/race, received great care. Personally, as a society, I wish we could all agree that every child and young adult should receive healthcare without obstacles or payment fears.

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#56

Post by mjamilkowski » Wed, Mar 02, 2022, 10:04 PM UTC

randomsilence wrote: post #39

Harvard Business Review on the disbanding of Haven, the venture to disrupt U.S. health care formed by Amazon, Berkshire Hathaway, and JPMorgan Chase:[1] >Perverse incentives. We still live in a world where the larger portion of hospitals’ beds that are utilized, the more they get paid. Consequently, the U.S. health system is focused on treating sickness rather than preventing illness in the first place. It seems like…

I have a different take. Haven was an attempt to get 3 large, very different, groups to reach consensus on some very contentious issues. It was akin to asking everyone at the Thanksgiving dinner table to agree on a political issue.

Were they able to come to consensus on anything? There was going to be winners and losers if they changed benefit plans to be on a common platform across all 3 organizations. Maybe one organization had more losers than winners.

Then Haven made the Great Vaporware Mistake with a huge public relations and marketing campaign before they actually did the hard work.

Then reality set in.

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#57

Post by jstartz26 » Wed, Mar 02, 2022, 10:45 PM UTC

erehweb wrote: post #44

You say that MFA on its own may not be enough. What would be enough? What do you think we're missing that other countries have?

I wouldn't necessarily say we're missing something that other countries have. Each system has strengths and weaknesses. Reform on this scale is difficult to do correctly even if your major political parties can compromise and work together on something.

Personally, I'm more excited about the potential of MFA than Mark; however, I'm equally frustrated by the national conversation around it. It's a political battleground and the public debate lacks nuance or depth. MFA, in my opinion, solves a set of problems and introduces a set of unknown problems while doing nothing for certain root issues (clinical variation, potentially avoidable events, etc.). The focus on who pays and taxes is a very small part of a much larger conversation and many of the voices talking about it lack industry knowledge or experience. But the same can be said about a bunch of different controversial issues right now and I'm off topic.

To actually get to your question - it's MFA+Medicare reform+a whole bunch of other reforms related to the delivery of care. MFA is not enough because it's just one piece of the puzzle. If we're missing anything as a country, is a political environment that would make this sort of widespread societal reform possible because it truly isn't as simple as switching to single payer.

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#58

Post by slashtom » Wed, Mar 02, 2022, 11:08 PM UTC

aquaphile wrote: post #24

slashtom wrote: post #18

Curious on your medical and pharmacy trend combined, how does it compare to other insurance carriers like Aetna, United, Kaiser Permanente, etc. There is only so much you could do on the administration/retention side of the cost puzzle, I believe for KP it's around 3-4% of the total PMPM, a lot of the cost savings will come from 1) not participating in the government programs (medicaid, medicare, aca), which the comm…

Thank you! Medical + Rx trend: Our trends are a little lower than the published trend figures because of the shifts we are creating through embedded telehealth and telemedicine solutions. For competitive reasons, we cannot disclose exactly how much lower but it is substantial. Admin cost savings: A regional Blue Cross Blue Shield plan typically spends 12-15% of their revenue on general and administrative expenses (G&…

Super interesting, really awesome stuff. Congratulations and looking forward to some much needed disruption!

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#59

Post by mgkimsal » Thu, Mar 03, 2022, 3:09 AM UTC

mjamilkowski wrote: post #49

mgkimsal wrote: post #45

Earlier quoted context omitted.

> We are operating within the system but are looking to change it. What we can change is how you, as an individual, receive value from your insurance company But only if this is something an employer pays for. I understand it's a big problem, and you'd like to make changes to the system. I wish you good luck in your efforts :)

We are embedding several programs into the benefit plan and still charging a lower price. We think its the best solution to the employer demanding positive ROI on the disease management and telehealth based solutions

> We think its the best solution to the employer demanding positive ROI on the disease management and telehealth based solutions

Just rereading this one line - again, I'm pretty sure your motives are noble, and perhaps you can move the needle a bit. But... why should employers be demanding positive ROI on something that isn't their core business? "Employers" as a whole, having to learn about various 'insurance' options and dedicated people to help guard their investments in Human Resources - something about this troubles me greatly. It's... as if... unless I'm somehow 'good enough' to warrant the protection/benefit of a 'good employer'... I'm less than worthy of good health, or access to necessary care. And... once that employer has no more use for my services (or someone else can provide them cheaper)... I'm essentially on the scrap heap (someplace we'll all be, metaphorically, at some point, sometimes through no fault of our own).

Again, I wish you the best of luck, but "employer provided health insurance" is just something that really is past its sell-by date, even if you can squeeze out some savings for employers and provide some good for the select few special/lucky enough to be employed by a company so forward-thinking as to engage your services.

Re: Launch HN: Evry Health (YC W18) – Better health insurance for companies

#60

Post by analyte123 » Thu, Mar 03, 2022, 4:13 AM UTC

I’m a big fan of any and all alternatives in health care payments. The ACA is a massive influence here that isn’t being discussed though. The free mental health services discussed in the comments by Evry seem generous and excessive on their part, until you realize that the mental health parity rule can easily and casually stick them with $50k or more of bills for in-patient treatment, where over-admission frequently happens to the detriment of the patient in some cases [1] and merely the insurer in others [2,3]. Getting ahead of this and trying to divert patients from this wasteful system is a fantastic and profitable idea for the insurer. This seems to be a success of the ACA and what insurance is supposed to be doing. But this is somewhat of a cat and mouse game in the long term because they ultimately can not choose they cover.

[1] https://www.buzzfeednews.com/article/rosalindadams/intake [2] https://fee.org/articles/how-obamacare-created-massive-addic... [3] luxuryrehabs.com