How Startups Can Help Shift America to a Prevention First Health System
The systemic disposition towards a treatment-first approach - focusing on managing illnesses - rather than a preventative-first approach is at the heart of many cost-related issues in the American health system. This approach tends to treats problems when they’re more fully formed, which can lead to higher costs and suboptimal outcomes. Slowly but surely, we are shifting paradigms - propelled in part by the rise of value-based care as well as a growing emphasis on preventative health. At the bleeding edge of this transformation is the startup ecosystem, redefining how healthcare is consumed and delivered.
What is Preventive Care
Preventative care focuses on what you can do to prevent diseases - rather than treating them after they occur. This is through several key factors, including: promoting health lifestyle choices to promote overall wellness, including physical activity, sleep and stress management; proactive disease prevention such as vaccines and prophylactic medicine; conducing regular screenings to detect diseases in their earliest stages, such as cancer screenings and other evaluations based on risk factors; providing patients with education to inform healthier decisions; addressing environment harms such as air, water and food quality; promoting access to high quality preventative care services; and more.
The Imperative for Preventive Care
Preventive care is a core piece of a sustainable healthcare system. By focusing on early detection and intervention, preventive measures reduce the incidence of chronic diseases, lower healthcare costs, and improve individuals' quality of life. According to the Centers for Disease Control and Prevention (CDC), chronic diseases account for approximately 90% of the nation’s $3.8 trillion in annual healthcare expenditures. Shifting to a preventive model is can change the fundamental calculus of healthcare.
The Rise of Value-Based Care
Value-based care (VBC) is a healthcare delivery model in which providers are paid based on patient health outcomes. This contrasts with the traditional fee-for-service (FFS) model, where providers are compensated for the number of services they deliver, often incentivizing quantity over quality (though this implies a growing reliance on actuarial and similar models, which can be difficult). VBC aligns financial incentives with patient health, encouraging providers to focus on preventive measures and holistic care.Key components of value-based care include .
Key components of value-based care include:
Patient-Centered Care: Tailoring healthcare services to meet the individual needs of patients.
Data Analytics: Leveraging data to track patient outcomes and identify areas for improvement.
Collaborative Care Models: Encouraging coordination among healthcare providers to deliver seamless care.
Startups Leading the Preventative Revolution
Startups are less beholden to the Innovator’s Dilemma, and are uniquely positioned to drive innovation in preventive care. These companies are leveraging advanced technologies, such as AI, telemedicine, and wearable devices, to create preventive solutions that are accessible, affordable, and effective.
Companies like Wellinks, a digital health startup focusing on chronic obstructive pulmonary disease (COPD) management, and Nutromics, a wearable sensor company focused on continuous diagnostic monitoring, is making significant strides in preventive care. Wellinks emphasizes proactive, preventive care to help individuals avoid exacerbations, reduce hospitalizations, and enhance overall quality of life, while Nutromics' technology helps patients monitor critical health biomarkers in real time, allowing for early detection of potential health issues and timely interventions - reducing the need for costly interventions down the line. These companies are taking a proactive approach to health management, reducing the need for costly interventions down the line.
Eleanor Health is another example of how startups are leading the preventive revolution. They provide value-based care for individuals with substance use disorders, focusing on more holistic care and addressing underlying health and social needs. By integrating behavioral health, medical care, and social support, Eleanor Health helps individuals sustain recovery and prevent relapse. Genetic testing company Color is also focusing on prevention by partnering with employers and health systems to provide affordable genetic testing and screenings. By helping individuals understand their genetic risk factors, Color empowers people to take proactive measures to prevent diseases such as cancer and cardiovascular conditions.
Navigating the Healthcare Ecosystem: Opportunities for Startups
While startups can help drive the important changes in the healthcare ecosystem, they must still do so within the context of the existing stakeholders, meaning patients, providers, payers and regulars. To make an impact, startups need to understand where they can integrate effectively and deliver tangible value.
Collaboration with Healthcare Providers: Startups can integrate their preventive solutions into existing care pathways by partnering with hospitals and clinics.
Engagement with Payers: Insurance companies are increasingly interested in preventive care to reduce long-term costs. Startups can work with payers to offer services covered by insurance plans and to structure pricing appropriate for their concerns.
Regulatory Compliance and Advocacy: Startups must stay informed about policies related to digital health, data privacy (e.g., HIPAA), and reimbursement models to navigate the ecosystem successfully.
The Future Landscape: Where Startups Can Make an Impact
Chronic Disease Management: With chronic diseases driving healthcare costs, startups offering innovative management and prevention solutions will continue to be in demand.
Artificial Intelligence and Predictive Analytics: AI can analyze data to predict health risks and personalize preventive strategies.
Social Determinants of Health: Addressing factors like socioeconomic status, education, and environment is essential for effective preventive care. Startups that develop solutions to tackle these determinants can play a significant role in improving community health.
As we look ahead, the opportunities for startups in preventive healthcare are enormous. Those who can navigate the complexities of the healthcare landscape while delivering meaningful value will not only find success but also contribute significantly to the well-being of society.
