Casino Loyalty Programs And The Healthcare Experience On The HCbiz Show

Vishal Argawal, co-founder and Chief Product Officer of “Care Cognitics,” appeared on HCBiz show, a podcast dedicated to unraveling the business of healthcare. He was interviewed by host Don Lee in Lee’s final onsite interview at the HITExpo in New Orleans. Here is their conversation about Care Cognitics’ relationship to the gambling industry and new technologies that align provider and patient needs, lightly edited for clarity:
Vishal: Hey! Thank you so much for having me.
Don: So, I’m going to give you a wide opening starting point, sort of… Could you just tell the audience what does Carecognitics does, and who they do it for??
Vishal: Yeah, so at CareCognitics, we are applying concepts from industries outside of the healthcare sphere, such as the casino industry,  in particular their loyalty concepts and gaming technologies, to help save lives–and to enable chronically-ill patients to lead a  healthier life.
Don: Ok, interesting. That’s obviously a complaint that we hear coming up a lot, that healthcare needs to look to other industries or solutions to the problems that we are facing internally. I haven’t heard of anybody coming in from the casino industry, so this is a first for me. So, what can the casino industries’ loyalty programs teach healthcare?
Vishal: Well, let me give you an example: While working in the casino industry, we realized that I can fly someone a thousand miles, get them to Vegas, have them lose money, and have them still return home happy and wanting to come back to Vegas again.  So, if I can do that for the casino industry, then why, in health care, can’t we get someone to show up at their doctor’s office for a free annual healthcare visit, which is actually good for them? That was the question we were asking ourselves. Or to look at another industry,
If Amazon can send me an alert today that says, “Hey, your dishwasher is going to run out of liquid in five days,” why can’t I get an alert from my doctor that says, “Hey there’s something wrong with your health, you should come and check it out
or something like that? Or, you know what? Did you ever miss a flight?
Don: Yes, of course I have.
Vishal: So, looking at the airline industry… Could you imagine if Southwest never sent you an alert that your flight  running late, and you showed up at the gate, and the flight was several hours delayed? What would your reaction be?
Don:  I would not be very happy. And,, I think there would be a lot of angry people at the gate there with me too.
Vishal: Yeah? Well, when was the last time you went to the doctor’s office?
Don: Oh, I’ve had bad experiences waiting at the doctor’s office, for sure.
Vishal: Were there angry people out there?
Don: Yeah, everyone tends to look pretty harried when you get into a doctor’s office waiting room.
Vishal: Has that changed, ever?
Don: No…
Don: Yeah, everyone tends to look pretty harried when you get into a doctor’s office waiting room.
Vishal: No. Why?
As patients, we don’t have a lot of options.  If we need care, we kind of get to a point where we kind of have to get it the way we can,  and sometimes this is the only way it’s available.
Vishal: Yeah. Right. So, as patients, we are at the mercy of healthcare.
Don: Exactly.
Vishal: I think that has to change. Every other industry has changed. We forced the change. People forced the change. The technology is there; if Southwest can send us and alert that says, you know what, your flight is four hours late, then why can’t we get a similar alert from a physician’s office? I’m pointing out each of these things coming from an outside industry. We solve for a lot of these problems in the context of a casino. And what is very interesting to us is that the population that goes to casinos–especially in markets like New Orleans, which are outside of gaming centers like Vegas–has an average age of 52 years.  Fifty-two years old, and very digitally savvy. They all have their loyalty cards, they are playing and engaged. So, the profile is of the average casino goer is similar to the average consumer in the Medicare healthcare space.
Don: I was going to ask you if you know what that average age is. Fifty-two is probably pretty close to average I would think, right?
Vishal: Yeah, especially once you leave the destination markets like Vegas and Atlantic city. If you leave those aside and look at the frequency market, as we call it, atthose casinos, the average age is pretty high. The local people coming there love to game and gamble, and they’re an older population. And, just like in healthcare, everyone is subject to luck–which you can’t change. But, casinos have very sophisticated technology. When you walk into a casino, they know, “Don loses maximum 100 dollars a day.”
Don: Right.
Vishal: And if we detect that Don just lost 300 dollars, you would think that we are happy. The casino should be happy: “Hey, we made more money!”
Don: But you’re probably worried that I’m unhappy, because now I’m not going to come back and lose 100 bucks three more times.
Vishal: Exactly! You’re going to say, “This is an unlucky casino.” And from the casino’s viewpoint, that’s not good. That means I’ve lost you, Don.
Don: That’s interesting. I’ve never thought of it that way.
Vishal: I can’t afford to lose you, right? So, what we do through casino loyalty programs to address this in real time–not five days later, nor five months later–we see, “Oh man, Don just lost 200 dollars more. He’s probably feeling unlucky.” And someone will pop up to you and say, “Hey it’s your lucky day.” We give you a free show ticket that’s probably worth 200 dollars or more (and that, in any case, would otherwise have had empty seats.) So, we’ve just switched your experience. I can’t change your luck, but I at least made your experience pleasant. Now you’re thinking, “Well, I lost 200 dollars, but I got 300 dollars of value. Maybe it’s still my good day–still my lucky day.”
Don: So, how do you take a concept like that and take it into healthcare? Because, you know, I can compare and contrast the experience here: If I’m going to gamble, it’s because I enjoy it, and it’s this fun thing, and there’s some risk and the potential for reward, and there’s all the things that we like as people, right? But there is almost nothing I like about going to the doctor. So, you are starting in a different spot. So how do you take that–you know those concepts–and apply them in a healthcare setting, which is a situation wherein I’m going somewhere that I wish I didn’t have to go to.
Vishal: Yeah, you’re right. What we are doing is this: Just like how in the casino, I can’t change your luck, but I can change your experience. We are focusing on chronic conditions.
When it comes to chronic conditions, even a physician cannot change your chronic condition.
They can only best manage it for you. Like, if you’re a diabetic, unfortunately, you can manage it, but you can’t cure it. It’s lifelong. People come to a casino to have fun but why would they go to the doctors office? Can healthy behavior be just as positive as a casino? So just like I cannot change your luck, I cannot change your medical conditions–but at least I can make your experience more pleasant, so there isn’t a barrier to care. You hate going to the doctor partly because the experience is so poor. Do you like to wait on a phone call for at least  5 minutes before you get to the front desk for your doctor’s office? Then you have to wait until you and COME IN to have any resolution? Can you imagine if you called up Comcast or AT&T and you had to wait for as long as the doctor’s office to have help? You would be pissed. We are not used to quick resolution and the convenience we expect in other industries for the physician’s office. Ironically, this is perhaps a situation where it is even more important to reach someone and have help quickly. It is more important to treat or manage illness than get your cable turned back on. So, we are bringing in the concierge services that you are used to in an entertainment environment, like a casino, and applying them to healthcare. So, through the physician practices and providers that sign up for our service and make it available to their patients, we offer and manage concierge services to people–to those providers–so that their patients can actually call us. We offer same day appointments; we offer 7-by-24 service. We learned that from the casino industry.
Don: So how are you providing those services? You are providing access to those services for your customers who are the doctors, or do you also have clinicians that are part of your team?
Vishal: What we do is this: Our customers are the physician practices. We offer our service to the physician practice, and for the physician practice we offer in-between office visit care for chronic patients. Chronic patients are where the cost is the highest and they need the most care. And most of their problems happen in between office visits. That’s when things go wrong. We provide a service that is a combination of a technology platform and a medical assistant team that we have on our staff.
Don: These people on your team answer questions and do the little check-ins in between and stuff like that?
Vishal: Yes. 100%. Physicians sign up and our team manages the services and patients can sign up. And where our loyalty concepts come in from casino is that we offer incentives to the patients to make healthy choices, right? These incentives are very carefully crafted. You know if you offer a free gym membership to someone who is obese,chances are they are not going to use it much. But that’s what we see in healthcare–it’s a “spray and pray” approach. It is not customized.“Hey, let’s give this benefit to everybody.” Guess who ends up using those gym benefits? People who are already fit.
Don: Yeah, what’s funny is–not to go off on a tangent–but that health plan that offers a free membership is designed so the people who go to the gym self-select into that plan. They are actually building a plan for healthy people.
Vishal: Exactly. That’s always been the case. The people who aren’t already inclined to go to the gym  need different types of incentives. They need incentives that they value. In a casino, what we realized very quickly was that the best incentive costs to the casino zero dollars. Do you know what that was? To be told happy birthday on their birthdays.
Don: Oh yeah, people love that. People love to be recognized.
Vishal: That’s it–and, it didn’t cost anything.  It wasn’t, you know, a free coupon to a buffet.
Don: So, I love the concept. What is something–I mean I guess they could just say happy birthday–but what is an example that is applicable in the doctor’s office that you recommend to your people?
Vishal: Same day appointments.
Don: Same day appointments? Okay, so how do you get the doctors to do that–like they are going to have to keep space in their schedule?
Vishal: Yeah–you’re totally right. They keep designated space in their schedule.
Don: So that’s got to be a big leap for a lot of them;not to fault doctors, but it’s like the system is kind of designed to grind them into these 15-minute appointments, which itself  makes clients wait in the waiting room so that there aren’t any gaps. Everything is kind of stacked against the patients and the doctors in this scenario, so how do you get the doctors to create space in their schedules?
Vishal: So, there’s a two part answer, right? One, when we offer this service for the providers, we actually don’t charge physicians any money. We piggyback on a Medicare program for chronic conditions which allows for reimbursement of great care; it’s a chronic care program that offers incentives to the physicians. So, through our service, we are not only able to facilitate better care for their patients; we also make money for the provider’s office. They are already providing the care and able to meet requirements for treating chronic conditions. I think it’s the best alignment that we’ve seen. So that’s the business model that we follow.
In terms of offering these incentives to the patients, even in the casinos, not everybody gets all the benefits. People who have the need get those benefits. So, we “right size” these benefits to people who are really in need.
The example that I gave you: even though that is a base benefit, we ask the physicians to create some space for the patients who sign up in this program.  The physician’s office doesn’t have to do any additional work. We do that work for them. We manage their patients. We do things on their behalf, but in return we do ask of some things from the doctors to enable this–and that includes, if one of our MA’s calls in and says, “You know we need you to see this patient,” then they make time for that patient. Many a time, there’s a human touch that is missing because everyone is so burnt out. With our system, if we can’t get the same day appointment, we call back the patient and say, “Hey I’m sorry, I can’t give you that today, but it’s available tomorrow, all right?” Nine times out of 10, they are fine with that.
Don: I would be thrilled if I could see my doctor tomorrow.
Vishal: Yeah, but just getting a call that saved you the trouble of waiting 5 minutes to speak to a doctor,  just to get to a receptionist who says, “Yeah please come in four weeks”—it’s just a very broken experience that we’re trying to improve upon.
Don: I just had an experience where I had to wait two months. I’m not a chronic patient–I’m going for like my routine checkup–but I’m waiting 2-2.5 months to get my appointment. Which is madness.
Vishal: Exactly- and we are not in the business of fixing everything. We can’t be. But we do think that as a company we can make a difference, both in terms of our business model that aligns incentives between the physicians and patients, and the physician benefits that are gained, because we are helping them increase their revenue. And the patients definitely benefit from it because they’ve got a personal concierge who is looking out for them every month, seeing what their needs are and reminding them of things. And in the process, there’s a reason why we’ve seen great adoption from our patients; we’ve broken MIPS and 78-year-olds are engaging with us digitally, which we didn’t think would ever happen.
People want to be in the program because it is based on their personal needs and improves their health care experience. Physicians want to be part of it because we are not adding additional overhead or work for their staff or for themselves.
I think this is a great program for Medicare, and I think it’s driving great alignment for us. It is about organization since you already see those patients, but this way the physician practice is proactive about their care rather than reacting with bad scheduling delays.
Don: Yeah, I love how you tied the concierge approach on top of the chronic care management and the Medicare code because you’re not funded. It would have been, I imagine, a very difficult sale to go into a doctor’s office and say,“Hey, you’re going to pay us to go and offer this concierge service on your behalf, and oh, by the way, you’ve got to create a gap in your schedule every day because we are going to be sending you same day appointments–cool?” I don’t think that would have worked. So the face that you were able to piggy back that onto the 99490…there was already some demand being created. Physicians are already aware of this; they want to take advantage. I love the business model of basically saying, “Doctor, you don’t have to do much other than coordinate with us and agree to let us come in on your behalf.” You’ve got to create trust.
Vishal: Exactly.
Don:   And once they trust you–the barrier to them starting off with this service to their patients is pretty low. Right? Am I missing something?
Vishal: No, I think that is exactly right and I think you know we’ve designed our service to be exceptionally patient-centric. Everything that we do and bringing incentives onboard–you know, providing care–we didn’t have to do any of that. But we are doing that because at the end of the day what we believe is that showing value every month to those patients are critical. There is a copay involved in this right? And even though it’s a low copay, it’s still eight to ten dollars.  That’s the cost of a Netflix subscription. We consider it that way. We are competing for that 10 dollars that you may use to sign up for a Netflix so that you can be entertained every minute of the day. Can I show you enough value to stay in this program? Because it’s not just about sign up and getting the patient enrolled. It’s about getting patients to feel that, month after month, the program is really helping them.
Don: Yeah, it’s about getting them to keep spending that 8 bucks every month–and to a lot of people listening, I’m sure that doesn’t sound like very much money, but to some people that’s actually a question that they ask themselves every month, particularly those who already have an expensive chronic condition.
Vishal: Absolutely, they do.
Don: It’s like,do I want to redirect those funds to gas for my car, or is this still worth it? So yeah- that’s important.
Vishal: And we believe that:
For the population that we work with–health is important. For the Medicare population, health is a top priority. And we believe that strengthening that relationship with their primary care is the right thing to do.
There’s already trust in that relationship. It’s just that as you said at the start of the podcast–we don’t think of our physicians until we really are sick. And if we want to turn the tide of rising healthcare costs and improving the life of our members, that has to change. We feel that the change starts by strengthening that physician-patient relationship by removing barriers, by making it more personal, by making it more timely, and making it more rewarding for the patients. Incentivizing them with the right things. It’s really those 4 things that we are offering through our service and hoping that we will be able to make a meaningful difference.
Don: No, it sounds great. Now how long have you guys been at it for?
Vishal: We launched our service last March. So, it’s fairly new but we’ve got good traction. We’ve got about 2000 active patients on the platform in 4 states. We’ve got a pool of about 20,000 more Medicare patients that we are in the process of signing up.
Don: Awesome. And do you have any particular success stories you can point to? Even if it’s anecdotal, like a story you heard about this one patient. What can you share about what is happening?
Vishal: Yeah, last week one of our medical assistants just dropped a note on our internal communication channel, telling us that one of the patients had said,  “Oh my God, if that’s the kind of service I’m going to get, I’m going to get my husband to sign up with this program too.”
Don: Oh, there you go. That’s your net promoter score right there, right?
Vishal: Yeah, and you know, that’s great! You know it’s awesome. But again–there is also the other side. People who have dropped out of the program. And they’ve dropped out of the program because they didn’t get full participation from the providers.
Don: So, you basically weren’t able to deliver the whole service in that scenario, I imagine.
Vishal: Yeah because as much as we take the burden off of the providers, this is still a partnership. At the end of the day, we are coordinating care. We are not providing care. The providing of care still happens at the provider side. If we want this person to come in because we’ve detected that this person is at risk, but if the physician’s office didn’t make space, or didn’t follow through for some of our care coordination, then the system breaks. So, what we are learning very quickly is that there is a profile of providers that work better with us and a profile of providers who don’t work as well with us.
Don: Are you going to have to be really picky about who you work with? Because otherwise, if someone signs up but there is no follow-through, then it will make you look bad.
Vishal: Exactly. So as we grow as a company, that’s our learning. Trying to see who we partner with on the provider side–who is going to really make at least some level of changes, so that when we have a recommendation for a certain patient, or if we say,  “Hey, this patient needs to come in tomorrow,” you know we get that support from them.
Don: That makes sense.  Awesome. Lastly, where can people go to learn more about you guys?
Vishal: You can learn about us from You can even follow us on Twitter–and please drop us a note. We are looking to partner with family practices from about 5 primary care physicians to about 99. Again, our services don’t cost anything to the providers–we help them raise their revenue while providing coordinated care for their chronic patients.
Don: Awesome. I’ll add that, so you guys can find that nice and easy, and that’s it. Vishal, thank you so much for spending the time today–it’s really fascinating stuff.
Vishal: Thanks, Don.

You can listen to the episode HERE.

Are you a physician’s practice that wants to meet with our team? Please CONTACT US HERE.
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HIMSS Highlights With Sunny Tara, CEO Of CareCognitics

Our founder, Sunny Tara, and some of the CareCognitics team attended HIMSS2019 from February 11-15 in Orlando, FL. It was our mission to speak to physicians about transforming patient experience and loyalty and learn more about what pain points physician practices care about. Sunny went with the mission of learning and connecting. Here are some of the presentations he thought were exemplary for being on the vanguard of Health IT, and espousing optimism and creativity for the future of the industry:

1)   Dr. Richard Milani, from Ochsner, did a session on Monday, February 11, at the HiMSS physicians executive symposium, which was excellent. The session was about the epidemic of chronic disease; it presented simple, practical ways to engage patients, and shared outcomes that were remarkable. I applaud the work Dr. Milani is doing and hope he becomes an inspiration to his fellow physicians.

2)   The opening keynote on Tuesday, February 12, was a breath of fresh air: it allowed attendees to witness two democratic and two republican healthcare bureaucrats jointly complement the work done by the previous administration and talk about how it can be used as a stepping stone to build upon to make healthcare better. They discussed some of the positive new regulations passed by the Center for Medicaid Services to advance interoperability and give patients access to health data via my health data initiative.

3)  The SOMOS presentation on February 12, by Dr. Ramon Tallaj and Tongue Yaman, MPH. It was very impressive to see how they integrated 300+ practices on different electronic health records within their first year of operation. In doing so, they were able to reduce avoidable hospital admissions by 25%, which resulted in a $33 million distribution to the physician network after the first DSRIP incentive payment. Financial rewards and better records working are great to see in action.

4)   Exhibition booths. Some of the best presentations are found on the exhibition floor. As always, there were very impressive vendor booths–but two that stood out for me were:

  • A) The Israel booth at the HiMSS exhibition–I was very impressed with the innovative digital solutions coming out of Israel, which are very promising; I look forward to working with a few of the companies in the near future.
  • B) The Intermountain booth– It stood out by being very different from the rest, which forced you to have the conversation, which I thought was very innovative. It had an open floor design with projections reminiscent of Utah Nature. While the bear was slightly distracting, he was also a sort of proud mascot of HIMSS.

5)   The HiMSS keynote address, in which Cris Ross, CIO of Mayo Clinic, shared his touching and very inspiring personal story.  It put all of the work we do as members of the healthcare IT industry in perspective, and at the same time made us all reflect on the work we have ahead to improve the patient care & experience. “Are we seeking to transform or are we merely coping?” This is a question we ask ourselves at Carecognitics. Learning at a conference like HIMSS is part of this learning process.

Industry events can inspire learning and highlight success. It was an honor to learn from physician leaders and drive our mission of better patient loyalty through personalized technology. We can do so much more and look forward to continuing our mission of learning and growing.

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Equality And Loyalty

How Loyalty is Impacted in the Workplace

Janae Sharp

In order to improve productivity, employers should ask themselves what a diverse workforce is looking for. Diversity is a strategic imperative with a strong business case. Diverse perspectives make companies stronger and more profitable. So what are women loyal to?

I am loyal to people who allow for freedom and demand hard work.

I am loyal to a boss that acknowledges my work and trusts my input. I want all of my employers to succeed. When I say I will do something, I do it. I expect an employer to have that same drive. Part of that is understanding what is expected of me. One of my best workplace experiences was with a boss that shared what they thought my strengths were and what problems they needed help within the company. Then they listened and let us come up with ideas. This wasn’t revolutionary, but listening to us was. They tried the ideas that employees came up with.

Respecting diverse input and being willing to try is something I am loyal to. That employer was willing to trust their employees.

I spoke with a few Women in Health IT about what impacted their workforce loyalty.

Kirti Sharma

Loyalty is impacted not only for women but any person at the workplace due to the value he or she gets at his or her workplace

When it comes to giving value to someone we are talking about giving value to one’s opinion, perspectives, work, and personality. Every person is unique and we must value the uniqueness in others. When people get value at the workplace they tend to be more motivated and loyal to their work.

Loyalty is also impacted by how balance is maintained at workplace

A woman will be more inspired and motivated at work if she feels that she is treated equally when it comes to gender. Her opinions and ideas are considered and appreciated irrespective of gender and other factors.

Elena Ivanova

What builds Loyalty?

Two words that come to mind are recognition and flexibility. This isn’t necessarily gender-specific. People don’t (always) leave companies, they leave their bosses. I think recognition is one of the most important parts of management that’s often overlooked. People want to feel appreciated, heard, and empowered to do their jobs. They want to know that their efforts matter. Let’s face it – men or women – we’re all human. We want our work to be recognized by our bosses and colleagues. I think women can empower each other, rather than be threatened by one another, especially at the top.

Since the workweek has historically been designed for men, women, especially working mothers, need flexibility beyond the traditional nine-to-five, especially while raising small children. That means being able to work remotely part-time or when needed, along with flex hours. When I leave work during the days I’m in the office, I sometimes joke around with colleagues “Have a good night, everyone. I’m off to my other full-time job.” I try to leave a few minutes early to pick up kids from daycare on time before getting the penalty fine for being late. From that point on until bedtime, there’s no break – unpacking school bags and repacking them with snacks for the next day, dinner, dishes, bath time, and storytime. All parents know the drill. It’s exhausting, but I wouldn’t trade it for the world. After the kids’ bedtime, I often catch up on work I didn’t get a chance to get done during the day.

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For Patients:

Missed opportunity to implement interventions that could PREVENT complications

For Primary Care:

Missed opportunity to coordinate care for patients with multiple conditions; under-achieving on a performance scorecard

For Payors:

Missed opportunity to reduce costs associated with preventable complications

The concept of the annual wellness visit is the classic “no-brainer” – one of the rare instances in which a concept is favorably received by all parties without any negative consequences.

What’s not to like?

  • Patients like the comprehensive review of their medical problems including all the measures necessary to improve their condition. As such, the Annual Wellness visit also represents an opportunity to mitigate the “fragmentation” of medical care that is associated with multiple providers.
  • Primary care physicians like the extended time that helps to coordinate and prioritize all the health measures and help to ensure that their interventions are compatible and non-duplicative. As such, the Annual Wellness Visit is the antidote to the typical clinic visit which by necessity is focused on one problem.  Moreover, reimbursement levels are commensurate with the extended time in the office.
  • For Payors, the comprehensive assessment is the best chance to create an intentional, coordinated, and pro-active game plan for the patient that has the chance to PREVENT complications and hospitalizations.

I regularly review Annual Wellness Visit reports from primary care physicians – the notes are beautifully constructed and provide a comprehensive assessment of the patient along with recommendations to help improve outcomes of the different disease states.

BUT, what typically happens next is that the summary gets filed and the lack of progress is noted on the next follow-up visit.

With all these positives, why does the Annual Wellness Visit break down?  Why doesn’t the Annual Wellness Visit lead to the better outcomes that it was designed to produce?

In my opinion, the most important reason is the lack of a system to help the patient implement the action plan.   We expect patients to implement the action plan but they need coaches.  Doctors are not coaches and should not be expected to be coaches.

The typical Medicare patient is given a paper or electronic summary of all the measures that need to be actuated – the information is simply overwhelming for the patient with multiple chronic diseases.  How does the typical patient increase the intake of fruits and vegetables, exercise three times a week, lose weight, stop smoking, get a screening mammogram/colonoscopy/bone density scan, monitor blood pressure, take all medications, and get a flu shot in the Fall?

But what if there was a SYSTEM to help the patient implement the recommendations, in the correct priority, in a fashion that was tolerable, sustainable, and scalable?  What if we had a system and a coach who could help walk the patient through the implementation of the plans that are outlined by the Annual Wellness Visit?  Here are some ideas of what the system could look like:

  • An electronic communication platform so that the patient can communicate with the primary care office without depending on the telephone.
  • An automated system that helps the patient implement the care plan, as directed by the primary care physician, in the correct sequence.
  • Primary care offices should be automatically notified if there are lapses in the communication or if plans are not being implemented.
  • Patients are sent regular reminders and follow-up messages that serve to reinforce and encourage the correct behaviors.
  • Patients can identify key members (family and friends) who can help the patient – these key members should be included in all communications.

I believe that such a system could transform the Annual Wellness Visit from a “one and done” visit to the start of the comprehensive health plan that it was designed to be!

Click to View the Full Size 5 Points InfoGraphic


 Spencer Kubo, MD

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by Sunny Tara, This Post was Originally Published on MedTech Boston on June 10, 2019
The 2019 Prime Health Innovation Summit in Denver, Colorado, got something big right: Organizers brought together the innovation and entrepreneurial spirits. And if healthcare needs anything to move forward right now, it’s more of that drive.
I attended the Prime Health Innovation Summit last month in Denver, Colorado, to learn more about innovations in digital health nationally and in Colorado. I was impressed by several things, including the team that Prime Health assembled, which should serve as an example and inspiration for others who want to make a difference. As usual, the conference had a good mix of entrepreneurs, domain experts, providers, health systems, payers, and policymakers from the government.
But this year, the summit was different. What stood out for me was that most people, particularly keynote speakers, didn’t simply make a guest appearance and then leave immediately after. Instead, most of them stayed, interacted with participants, and were noticeably there to a difference. Hence, I felt compelled to share my top five takeaways from the innovation summit.

1. It’s Time To Deliver Value-Based Care.

Chronic disease is the biggest driver of cost — and yet, still, the greatest cause of death — within the U.S. healthcare system. Today, 85% of our total spending and 75% of deaths are caused by chronic diseases. We need to re-engineer our healthcare system to be tackle chronic illness both effectively and cost-efficiently. Many experts consider value-based care, with more emphasis on primary care, to be the answer. But somehow, we haven’t seen widespread adoption of that one would expect.
What grabbed my attention at Prime Health was the joint announcement from UnitedHealthcare and Centura Health, which are partnering to create a different health plan for employers. The plan includes unlimited access to primary care with no copay for PCP visits, urgent care, or online doctor visits for its employees. Two very positive things that caught my attention:
  • Employers and the government account for a lot of healthcare spending. The Centers for Medicare & Medicaid Services (CMS) is the largest payer, which means it has leverage. Employers can also play an influential role in making this change, as they are major funders of health plans and have the most to gain from keeping a healthy workforce. I would really like to see more employers follow this path.
  • Centura shared its plan to eliminate copays for primary care visits and make virtual care available. Its decision to focus on improving primary care for employees by working with United is a step in the right direction. Centura’s decision to create this plan is a bold and forward-thinking move, given that its implementation might directly impact emergency department (ED) visits (one of the most profitable revenue centers for hospital systems). This is extremely encouraging, and it shows Centura’s commitment to leadership in the field and to patient-focused solutions that aren’t simply about maintaining a bottom line. We need more hospital systems willing to innovate in this manner.

2. Embracing Diversity In Ideas Alone Is Not Enough.

We all agree that we need to be open-minded to embrace new ideas, but it is equally important to create a forum where one can challenge existing ideas to make them better. Ruth Benton, CEO of New West Physicians, was not shy about putting UnitedHealthcare executive Marc Neely on the spot regarding the fact that some the reimbursements don’t even cover the cost incurred by New West.
Benton served as a voice of honesty from the physician’s perspective on the panel, emphasizing the need for better data interoperability and the free exchange of information from the electronic health record (EHR). She questioned why “it still takes 90 days to move EHR data from one place to another” and explored how that lag impacts care delivery.
“We haven’t been good at collaboration, and that’s why we have runaway health costs. We don’t want to all be employees of the government,” Benton said.
This was met with jeers from a table of leaders from the federal government, but the exchange accurately reflected the natural market in healthcare and the importance of doing what we are good at. It was direct and honest and informed my personal mission: Let physicians be physicians, let innovators create, and let regulators enable our entry into healthcare to solve the problems of leaders like Benton. It reminds me of my days at Harvard Business School, where I learned that there is always a better way of solving a problem. But to find it, one must create a safe place for people to debate and challenge ideas to create better solutions.

3. Policymakers As Partners In Change.

I had the opportunity to interact with so many high-level policymakers from various government agencies, and I was thoroughly impressed with their energy, passion, and commitment to help make our healthcare better. Ed Simcox, chief technology officer for the U.S. Department of Health and Human Services, spoke about being an entrepreneur. As an entrepreneur, I was inspired by government-led efforts to partner with creators, such as through a new federal entrepreneur-in-residence program. Paula Braun, who holds that role at the Centers for Disease Control and Prevention, spoke about her work and argued that the most important public health efforts are led at the local level. The connections that we have with individuals in our local economy matter. Each area has a different population, with its own barriers to healthcare and different access to services. In Colorado, Prime Health has invested the time and effort to welcome innovative ideas and programs.

4. No “I” In Team.

Sarah London, senior principal with Optum Ventures, described what she looks for when investing in companies. “You can have a great business model, but a good team will get you through the bumps in the road and the trenches,” she said.
Here’s what a great startup team looks like to London: “We need trust, a real team, curiosity, accountability and data-driven [work].”
As I’ve started companies, I’ve realized that the importance of one’s team cannot be over-emphasized. The team will determine the success or failure of the company. What resonated for me was London’s background as a successful entrepreneur in the healthcare startup world. She could relate to the challenges faced by entrepreneurs and was direct in highlighting the unique nuances in healthcare, such as long, typically 18-month sales cycles, regulation, and so on. That acknowledgment of the realities of the healthcare sphere can only come from having boots on the ground. We need more people like Sarah London in the investor world.

5. “We Can, We Must, And We Will…For The Health Our Nation.”

Health-tech entrepreneur Mike Biselli epitomizes the sentiments, vision, passion, and commitment he brings to this cause. Having had the opportunity to tour the Catalyst HTI building with Biselli, the founder, I can say he has built something special and inspirational in Colorado. His vision of cooperation, bringing together different stakeholders, and building a space for this activity has created an ecosystem. I plan to return to his state — to see what Nevada can learn from Colorado, to create a Catalyst HTI in my community, and discovering pathways for CareCognitics to contribute to the success of this movement.
Sunny Tara is CEO and co-founder of CareCognitics.
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Sunny Tara, CEO of CareCognitics was interviewed on the Harvard Alumni Entrepreneurs podcast to share his journey from Casino and Gaming industry executive to healthcare IT.  Here’s a short preview of the podcast:

“Can we take a loyalty-based approach or relationship-based approach that allows physicians to extend the care outside their four walls and connect with patients while they are in the comforts of their own homes?” This is the question that Sunny Tara asked himself in the process of creating CareCognitics, the innovative digital platform that drives improved health outcomes for patients using the same techniques and technology used in the casino, retail, and hospitality industries.

In this episode of HAE Invites, Denise Silber speaks with fellow Harvard alumnus Sunny Tara about how he came up with the idea of applying the things he learned from working in the casino industry to the healthcare industry. They discuss why he sought to improve the healthcare industry, the challenges he faced in the process of establishing CareCognitics, and the program structure and revenue model he imposed that makes healthcare a lot more beneficial for both the physician and the patient.

Listen to the full podcast embedded below or on the Harvard podcast page:



Learn more about CareCognitics use of casino loyalty and data science principles applied to healthcare at:

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As healthcare struggles to deal with the pandemic, I hurt as I see how many healthcare organizations are struggling, but I also look at the tremendous opportunities that are available for healthcare to do so much more for patients.

Coming from the hospitality and casino industry, it was easy to see how many of the customer experience principles from those industries could be applied to healthcare.  However, it was also astounding to see how many healthcare organizations didn’t need to worry about the patient experience.  While this may still largely be true for some healthcare organizations, the winds of healthcare are changing and those healthcare organizations that don’t create a deep relationship with their patients are likely going to struggle in the future.

More importantly, I see a great opportunity for healthcare organizations to step up their relationships with patients as a benefit to the patient and healthcare organizations.  Let me share just one simple opportunity that’s available today: Flu Shots.

At CareCognitics we’ve been working with our customers to help facilitate the flu shot experience for their patients.  What’s interesting about the flu shot in 2020 is that we see patients getting them in record numbers.  Whether it’s concern because of COVID or something else driving patients, we’re seeing patients show up for flu shots beyond what’s happened in the past.

While this has been great for patients, it’s also been a great opportunity for healthcare organizations to show their patients what kind of vaccination experience they can provide.  How are they handling patient check-in for a flu shot?  What are the wait times?  How is my healthcare organization going to communicate with me about the flu shot?  As you can see, the flu shot is the perfect opportunity for a healthcare organization to build trust with their patients so that when the COVID-19 vaccine is ready, they already have a relationship with you and you know what to expect.

Maybe even more importantly, we see healthcare organizations using the flu shot to open a channel of communication with their patients.  Why is this important?  Every healthcare organization should be thinking about their patient communication strategy when it comes to the coming COVID-19 vaccination.  Does that patient prefer text or email?  Do I have that information to be able to communicate with them effectively?  How can I ensure that they trust us to deliver the COVID-19 vaccination in a safe manner?  Do I have a way to analyze which of my patients should get the COVID-19 vaccine first?

There are answers to all of these questions, but you have to start investing now in a solution that captures this information about your patients.  Otherwise, when the COVID-19 vaccine arrives, you’ll be wishing you had the answers and the communication channel needed to connect with your patients.  Plus, this channel of communication is going to be even more important since many of the coming vaccinations require 2 doses to be effective.  Making sure you have a platform that can be used to invite and motivate your patient to return for the second dose will be an essential part of a healthcare organization’s strategy.

While there’s a great opportunity to use the flu shot as preparation for the coming COVID-19 vaccine, creating a digital relationship with the patient will be useful to a healthcare organization well beyond vaccination.  As healthcare continues its shift to value-based care, having a way to inform, engage, and motivate the patient will be essential to future reimbursement.  Plus, these tools provide a positive patient experience which is valuable in the current fee-for-service world.  Not to mention efforts such as wellness visits which have often been skipped during COVID-19.

Certainly, we’ve all had unique struggles amidst the pandemic.  However, there’s also a huge opportunity for healthcare organizations to rethink the patient experience and build trust and loyalty from their patients.  Every flu shot and every digital check-in is an opportunity to build that trust or not. Investments of time and energy to make these experiences great during COVID-19 will not be forgotten by patients.  Plus, it’s not only the right thing to do for patients but the smart thing to do for your business.

This article was originally published on Healthcare IT Today.

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CareCognitics, A Platform That Uses Casino Loyalty Technology And Data Science To Improve The Patient Experience And Transform Behavior, Today Announced That The Unlv Medicine Has Successfully Launched The Company’s Mycareally™ Solution.
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