Facing a new payment model and the ongoing shift toward value-based care, home health providers must deal with change on a regular basis. And Nashville, Tennessee-based predictive analytics company Medalogix is positioning itself as a changemaking guide.
Led by CEO Elliott Wood, Medalogix is working to bridge the gap between data and action, helping home health providers succeed in today’s constantly evolving reimbursement landscape. Encouraging innovative discussions around patient care is among the company’s top priorities, according to Wood, as is multidisciplinary collaboration.
As someone who thrives on change, Wood has big plans for the future of Medalogix — and for the home health care industry as large.
HHCN: How is Medalogix trying to change how home health and hospice providers have traditionally operated?
Wood: There are a few different ideas that are interconnected here.
Obviously, home health and hospice agencies are constantly evolving. On the home health care side, especially with OASIS and all of the time nurses and therapists spend in the home, providers are collecting a lot of data. And we believe, in the future, we’re trending toward more care happening at home, with more technology being placed there. So there’s a lot of data now, but there’s going to be even more data moving forward. Medalogix is all about taking that data and finding value — and finding constructive ways to use it.
One of the biggest questions we consider is: “What are you doing with data that creates value and changes the potential outcome for a patient for the better?”
So that’s one idea. Another idea is helping providers navigate some of the more sensitive decisions in regards to delivering care. We’ve seen a lot of this play out with the utilization management discussion with our Medalogix Care solution. There is a fine line between clinical decision support and using data as a dictator. We have always tried to educate and discourage our clients away from the idea that data alone will tell you what to do. Data will give you an opportunity to enhance or strengthen clinical decision support.
We’re trying to create conversations that maybe haven’t happened before. For example, clinical leaders using Medalogix’s capabilities might see data intelligence as an opportunity within their organizations to encourage conversations between nurses and therapists, bringing those clinicians together to best care for a patient. We’re really big on this idea of multidisciplinary collaboration — and think data can be a great facilitator.
And then the third idea: We are very dedicated to the discipline of measurement. There are so many cool technologies out there, but not all of those technologies work, right? Some might be used ineffectively. So for us, it has always been of critical importance to not only provide great data science, but then also supply measurement to the executive stakeholders of a client. We want to be able to say, “Hey, this is how well your team is using the product that we’re providing you. Here is a statistical perspective on the impact for your patient population.”
After working in health care and tech all my career, I’ve found not everyone does that, so that’s something we’re working to change.
Without even looking at the COVID-19 virus, there’s a lot of change happening in home health care. The Patient-Driven Groupings Model (PDGM), for example. More value-based care opportunities. How does Medalogix fit into all of that?
Whenever organizations decide to leverage data or utilize data science, they’re making the decision to practice care better. A byproduct of this strategy is the discovery of inefficiencies. Sometimes, those inefficiencies are related to systems that have existed for a long time, which in turn, leads to a sensitive changemaking conversation.
As far as PDGM is concerned, we have really been looking at utilization management. We’ve been exploring what utilization patterns have existed in home health for a long time. And what we’ve seen is utilization patterns are not always optimized to the needs of the patient. You often have cases where patients aren’t receiving enough visits. Maybe they are receiving too many. We provide recommendations on both sides of that coin.
There are a lot of different reasons for inefficient utilization management. For instance, I think there was certainly over-utilization of certain types of disciplines because of the way agencies were paid in the past. At Medalogix, we don’t rely specifically on payment or diagnosis. We have been heavily reliant on each unique patient’s characteristics to help us determine the appropriate plan of care.
So, this idea of utilization management is how we fit into PDGM and current industry changes. I also think there’s a real opportunity with other services we provide, like identifying patients close to hospitalization. Medalogix offers the ability to use technology to increase touch points with those patients. We have the ability to proactively identify people who are not well-suited for home health care. That also means proactively identifying people who are right for hospice. If we can get those patients to hospice sooner, that’s obviously what’s best for the patient.
In a PDGM world, too, those patients are typically high utilizers of home health services. And those high utilizers of your services may not be getting a ton of value for that utilization.
We’re trying to make sure that the care that’s delivered is optimized to every patient. We want to help make sure that every patient gets the right plan of care for their needs.
How has Medalogix itself changed since launching?
We’ve gone through multiple changes as a company. When we first started out, we had a risk-stratification tool, where we identified how at risk a patient was for going back to the hospital. We had somebody who would wake up every morning and run our model. He would basically copy the results of the model into a Word document, convert that into a PDF and then send that PDF to our client.
So visualize this: You had this PDF going to a nurse, who saw all this info about every patient on his or her census and their likelihood to be rehospitalized. There was very complex information and probability stats in there, these numbers that probably didn’t make sense to anybody. So we would send these reports and then, naturally, the nurse on the receiving end is like, “Okay, this is interesting, but now what do I do with it?” I think our first change as a company was primarily thinking about how we help provide a path, or some action that a clinician can take to try to impact patients.
As for me, I was in product management and had a background in informatics. It was very apparent to me that I was not the person to determine what those clinical actions needed to be. And clinical people didn’t really want to talk to me. So about five years ago, we hired our first clinician, and she is still with us as our chief clinical officer. We realized that clinicians want to talk to clinicians. So all that fits into change No. 1: helping people act on data and foster that clinical perspective.
Medalogix has also changed in terms of its firepower and investment support. Today, you’re supported by two of the largest home health businesses in the nation.
Our original backer was Coliseum Capital Management. They are still with us today. They are still the majority shareholder in the company, and they’ve been a great partner because they have been very patient with us as we have evolved. Now, we also have investment from Amedisys and Encompass Health. Obviously, having two big players who are each at the forefront of innovation has been fantastic. They’ve both helped us think through different opportunities for evolving what the company does, for finding different ways to create value for home health providers.
This is kind of tangential to our conversation, but something worth noting: I think one of the things that we’ve seen that’s very unique about the home health industry — and I’m speaking from experience — is how collaborative providers are. I spent a lot of time working in the hospital and acute care space. Hospitals are cutthroat. There’s a whole lot of infighting and hatred among hospitals, especially within similar markets.
The home health industry is much more of a collaborative community. There is a lot more sharing of best practices. There’s a willingness to talk about what new products are needed, to team up to support innovation.
There’s a lot of discussion across the industry about Medicare Advantage opportunities. I think our work with Amedisys and Encompass Health reflects that spirit.
Do you consider yourself somebody who thrives on change or somebody who’s maybe a little bit more cautious?
Well, it probably depends on who you ask. I would say that I definitely thrive on change. And I get a lot of energy from change. I’m always looking for ways to improve upon what we’re doing at Medalogix, so I think it’s the very idea of change that propels me, personally. But I think that can get on my leadership team’s nerves a little bit. A lot of times, they might keep me in check in a good way. You can change too frequently or not often enough. At the end of the day, I’d like to think that I’m closer to the middle.
I’m a creator, not a maintainer. I get my energy from that, but I would say there are people out there who are more frenetic.
Along these lines of change, how do you think that you’ve had to change as a CEO? You’re somebody who rose to that position, correct? What was that process like?
I’ve had three different jobs at Medalogix. I started as SVP of product, and I loved that job. Then, I moved into the COO role, so I was the No. 2 decision-maker. Then I moved into the CEO role. During that time, I think the biggest change for me was going from COO to CEO. The very nature of what the company needs you to be is different.
When I was COO, I functioned as an integrator and a support system for everybody. So whether it was on the tech front, whether it was on the customer front, whether it was on the product front, whether it was for the CEO, I was the one who really put the pieces together and implemented the vision. In a lot of ways, as COO, you are the problem solver, the person tasked with getting things done. You have to keep people marching forward.
Now, CEOs have to be problem solvers, too. But you’re steering the ship, so you’re creating some of the problems, or opportunities, your team has to tackle. Sometimes, the COO and CEO positions can be at odds in a very healthy way. When you’re a COO, you’re in the car and trying to make sure the car doesn’t go faster than it’s able to go. And then when you become a CEO, your job is to push the car to the limit.
There has to be this switch that flips to, “Well, how can we go even faster? How can we do more?” You maybe have less regard for if the car is going to break down. You kind of have to allow your other leaders to become that safety mechanism for you. That was a big shift for me. It took some time for me to truly feel comfortable in this role.
What are some changemaking efforts that you’re especially proud of, either in your personal life or your professional life?
Let’s go back to the company I was at before Medalogix. We had an incredible technology that was used by hospitals. My team was tasked with providing some insight into how well our customers were using that amazing technology and where there were opportunities to improve. I was able to learn a lot from my boss at that time, take a lot of that history and experience and implement some of that strategy and process at Medalogix. So I’m proud of that.
That all goes back to being more than just a data-science company — it goes back to Medalogix evolving to provide actionable insights that highlight how well a customer is using the technology; it goes back to the fact that we’re not satisfied with just providing a cool widget. On a very personal level, you feel really good when you’re a part of something that yields a positive outcome — so, in our case, a positive health outcome for the patient that might have otherwise not happened.
I think another changemaking effort I’m proud of is more cheesy and personal. It’s just being a parent. Everybody is a first-time parent, at some point, right? And so getting to watch the change in your children happen, being able to be a part of that — there’s really nothing better.
What’s a changemaking effort that didn’t go so well for you in the past?
I have several. A personal one: I played guitar in the jazz combo in college. And I decided at one point in time it would be a really cool idea to bring a talkbox — so like a Peter Frampton-style talkbox — into the jazz combo. That was not a good idea, and it did not inspire any change. In fact, probably the opposite.
In my previous company, I started as the director of marketing. I was really trying to change the culture of marketing there. I came from a very results-driven marketing background. There’s a great book out there called “Your Marketing Sucks.” I was trying to implement some of that stuff when I think they were looking for more glitter. I was probably 24 hours away from being fired from that job because I made the founders and the CEO, at the time, very unhappy with me. Looking back, it probably wasn’t as much about the change I was trying to make as much as it was about how I was going about the change.
Do you think home health providers run toward change — or run away from it?
I think generally they run toward it. I think this is true in most of health care, but change and the adoption of new things takes time. I have, at least in the segments of the industry that we work with, seen providers very willing to change.
Now, I’ve also seen a lot of change forced on the industry, as well. I think CMS (Centers for Medicare & Medicaid Services) drives a lot of that. I think the way payers have evolved over the last several years drive a lot of that, too.
What’s next for Medalogix?
I think there are a few opportunities for us. I think one big opportunity for change is finding more partnerships to help us accelerate the adoption of data science. And whether that’s integrations or commercial partnerships, all are on the table. We have some great conversations going with some really cool companies. The other is just keeping our eye open regarding how we can evolve into other parts of health care.