Jennifer Schneider and the rest of the Livongo team learned a lot about what works and what doesn’t work when building a digital health platform.
That was before Livongo was acquired by Teladoc in a $18.5 billion deal in October 2020.
“We had built a beautiful business and had a great vision, and the team wasn’t quite able to carry that on,” Schneider told Home Health Care News. “When I left — and Amar [Kendale] shortly thereafter — we really put our heads together and said, ‘What is it that we really want to value, given what we’ve learned? Where’s the health care ecosystem really broken?’”
Where Schneider and the rest of her team landed on was rural health care.
“We started to focus on rural markets, which are not just ‘kind of broken.’ They’re like ‘really broken,’” she said. “And they’re getting worse.”
Last week, Homeward announced its official launch with a $20 million investment from General Catalyst. Homeward will be led by key executives behind Livongo, including Schneider as the CEO, Kendale as the co-founder and president, and Dr. Bimal Shah as chief operating officer.
Homeward plans to focus on improving access to primary and specialty care in rural communities, partly through a home-based care approach. Leaders of the company are calling it the first comprehensive provider to take on full risk in rural markets.
Schneider said that after identifying rural markets as the target patient population for Homeward, the next step was figuring out how to serve those patients. Through Homeward’s research and shared experience, technology enablement kept coming up.
“We really took this approach in rural care where we could look at owning that total cost of care and delivering a technology-enabled service because access is the biggest problem,” she said. “Without technology enablement, you won’t be able to give access to the people that need it.”
Additionally, technology is important because recruiting more health care workers to work in rural areas of the country hasn’t proven to be effective, Schneider said. There are nationwide health care staffing shortages, but rural markets have been hit particularly hard.
On average, there are about half as many doctors in rural communities and about an eighth as many specialists, Kendale told HHCN. Because Homeward is launching in areas that are less competitive, the initial $20 million investment will be used quickly and efficiently.
“What you’ll see us do is enter markets pretty quickly in order to start to alleviate that access gap and to put us in a position to really start to test and learn,” Kendale said.
The $20 million comes from General Catalyst’s new $800 million Creation fund. The Creation fund will focus on investing in company creation and helping entrepreneurs build businesses in General Catalyst’s core areas of interest.
One of the new ways Homeward plans to reach people in rural America is by using cellular data instead of broadband to connect with patients.
“It’s long been a bit of a fallacy that we can’t do anything for these rural communities until they have broadband. We reject that idea,” Kendale said. “As long as you can move the data to the right place and use that as a basis to drive action, cellular works.”
Schneider and Kendale’s experience in using cellular for device data collection and communication showed that the need for broadband was overblown.
Remote monitoring – an area of health care that has really picked up as a result of the COVID-19 pandemic – will be the backbone of Homeward. People don’t have to be convinced into getting quality care in the comfort of their homes, and the experts behind Homeward know that.
“That lets us immediately start to see that real-world information coming in near real-time to our systems,” Kendale said of remote monitoring. “We can look for trends — both positive and negative — when it comes to monitoring blood pressure, weight, blood glucose, all of those measurables.”
Homeward will also take advantage of the comfortability people have post-COVID-19 with mailing in lab results from their home. Homeward will also be able to help patients get medications in the mail.
“The other thing that can be done in the home is making sure people that have the therapies interventions that they need, that they can take on themselves. For example: medication,” Kendale said. “We’re still in a world where the majority of Americans aren’t getting their medicines by mail. It’s a great opportunity, particularly for rural communities, to take advantage of that benefit.”
The San Francisco-based company is not yet announcing where exactly it will start offering services. However, focusing on rural communities will be the consistent mission no matter where it might end up serving.
“The overall mortality in rural areas is 23% higher than people who live in urban areas,” Schneider said. “This is not subtle. It’s very real and again, it’s really broken. I think we’re at a time now where technology has proven that it can actually really improve clinical outcomes and reduce cost.”
Schneider and Kendale were also confident that Homeward will be able to grow and grow quickly. The advantage of having veterans of a company like Livongo is that they’ve done it before and know what works.
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