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

> We have [...] benefits that exceed the best plans from legacy insurers.

You claim that your product is better than some of the competition, but do not demonstrate it (here or on your website). At this point it seems to me that every insurer claim that they have the best plan with no way for me to know easily.

I think the key issue of the industry as a whole is that there is no way for client to compare insurance product beyond pricing. A product that could look better at covering lenses for example because it cover up to $2000/year vs another that cover up to $350 may actually be worse because of some widely applicable exclusion written into the contract.

What are your thoughts on this point?

> On top of that, we reduce premiums by up to 20% for employers. We can do this because we are a software company that owns an insurance carrier. We automate roughly half the tasks involved with claims, care coordination, underwriting and back-office operations. We aggregate data from disparate sources (claims, clinical, pharma, lab, and wellness data) to make superior decisions and aid patients. Our technology helps members identify and treat conditions earlier and more effectively. We also have a much better user experience—a single portal to access telehealth, care concierge, claims data, wellness plan, doctor lookup, rewards card, etc.

You claim to be able to reduce cost because of your tech, and I believe compare to legacy carrier, your IT / Process are cheaper to run today (I believe that legacy carrier spend ~5-10% of their revenue on IT). From my observation the insurance industry is quite bad at getting ride of legacy systems (for compliance, once you decommission a system you sometime need to prove that the new system run the old policy the same way, or just because to many process optimisation software has been build on top of the legacy system making it extremely costly to sunset). How do you plan to maintain this cost down once you extend to new states / product /over time, to keep this cost advantage?

> Since half of Americans get health coverage through their employer, we’re focused on companies to maximize impact.

I understand that B2B distribution is easier than B2C, but this can go against your mission of changing healthcare incentives for mutual benefits. You customer are the Employers, and their incentives are to reduce cost and to maintain their employee healthy short term, whereas employee would like to have better access to healthcare (higher cost) and to stay healthy Long term. How will you find balance here? What happen when a a major client as you to cut cost for their plan to the expense of the employee coverage and you need to keep them as a client to keep the company afloat.

“free mental health coverage” -> We combine our network of therapists and behavioral facilities with online digital health solutions that have their own providers. In person therapy is included as preventive care. No copay, no deductible, no limitation. We combine that with targeted digital solutions for specific mental health conditions (burnout, depression, stress management, etc.) These solutions, again, are made available to members usually without any costs (except for very specific programs). Engagement and participation is incentivized and rewarded with cash on their Evry card. We are making an effort to make therapy – of all kinds – accessible, convenient, affordable, and effective (whether digital or in-person).

How did we build our network of therapists? -> Same as the medical providers (see other Q&A in this post). It requires time and “boots on the ground” having conversations, building trust, and creating contracts that avoid the traditional games played by both sides. We’ve had good success getting digital networks to work on PHQ-9 type metrics and outcomes, sometimes with 100% of payment being tied to a tangible improvement by the patient.

What about allowing different employers to pay parts of insurance, and another employer pays another part, to allow the employee to get insured?

A person just needs to come up with any amount of employers willing to pay the amount that adds up to 100% of the cost.

Involving "employers" is one of, if not the primary, root causes. I understand you're building a business, and ... you're playing in the same space as others. That may make sense financially, and allow you to take away from business from legacy insurers and save some companies 20% on existing costs.

But this doesn't seem like it's getting at the actual root problem, which is most people aren't actually involved in buying or paying for medical care (or... not until it's overwhelming).

I realize this is a national political issue, and not something a startup can actually address. The large companies, which could affect real change, have no incentive to legislate themselves out of business.

This (employer-provided health insurance) seems a perpetually intractable problem and seemingly unique to the US (based on my limited understanding of the problem space).

As a self-employed person, I'm basically an outlier and generally get little day to day benefit from any 'health insurance'. I paid $900/month (2 people) last year. 2nd covid shot caused a blackout, and I was ambulanced to an ER (I was actually only 'out' for less than a minute, but in less than 5 I was being driven away). 3 hrs in ER - nothing obviously wrong, so I was released. I got multiple bills over the next month for $4000. Insurance company graciously 'negotiated it down' so I only had to pay $2000, on top of the $11000 I already pay for this 'deal'.