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

B2B is scalable for launch, giving us access to information and leverage that is not achievable in the individual space without significant expense and economic loss. Starting in this market segment gives us a profitable platform to expand into other coverage areas and consider adjacent market segments. That said, we believe our approach which is intensely focused on quality will drive cost savings that satisfy employers. The 3-year rate-lock option helps to demonstrate results and builds confidence in our approach without demanding changes to plan designs that may be injurious to the employee’s long-term health.

I’m not sure I completely follow your question about changing coverage to keep an employer to keep the company afloat. Our plans are approved by the state and we cannot change benefits during the year. We cannot slash benefits to reduce costs to keep a client. That would be detrimental to the employer’s business model too because it would severely impact their ability to attract and retain talent. Trying to reduce benefits would have the opposite effect and increase costs, like the delays caused by high deductibles.

There are models and mechanisms for multiple smaller employer groups to band together. For example, association health plans are common with professional trade groups.

While an interesting thought experiment, no, we have never thought about multiple employers combining and contributing to insure a single individual.

1) I can see how this model works with an EPO, but do you plan to build any products that would necessarily support OON like PPO/POS? How does the model work there once you have to integrate with the rest of the healthcare value chain that may not see eye to eye with you right now or for a while (at least until the government forces them to)?

2) How do you package the pharmacy benefit? Are you aiming for employers that carve out the pharmacy benefit anyways, or for employers that need it packaged into a fully insured plan (which is common at the 100 lives size)?

3) What approaches are you considering for go to market? Are you going to scale up direct sales to the employer (direct but costly) or consider other approaches, and if so, what?

I love seeing innovation in this space. You're right to call out the issues with self-funded programs for individuals/SMBs for not addressing the funny business in contracting. On the other hand, if you're building a provider network from scratch and not layering in someone else's, you are going to run straight into the existential risk of cold-start scaling up a two sided network, so I am curious how you are planning to avoid that.

>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 your root cause analysis is broadly known. Do you expect the market to shift quickly once your approach gains traction?

[1] https://hbr.org/2021/01/why-haven-healthcare-failed