Becker’s: This is Grace Lynn Keller with the Becker’s Healthcare Podcast, and we are live at the 2024 Payer Issues Roundtable. I’m joined right now by Mihir Kamdar, who is the Chief Medical Officer at Tuesday Health. Thank you for being here. We’d love to have you start off by introducing yourself and telling us a little bit more about your role. Thanks.
Mihir Kamdar: Thanks Grace. So my name is Mihir Kamdar. I am a palliative care physician and serve as the chief medical officer for Tuesday Health. Tuesday Health is a value-based care supportive and palliative care company, and we really seek to provide comprehensive, supportive care for patients with serious illness, particularly in the last one to two years of life.
Becker’s: Wonderful. Well, thank you for taking the time. And let’s start our conversation here about growth goals. So from improving member experience and expanding value-based care to controlling costs, payer executives have ambitious growth goals for the rest of the year, and as we look into the new year ahead, so in your role, what is your top priority, and how are you planning to get there?
Mihir Kamdar: Yeah, it’s a great question. And you know, what we know about patients with serious illness is this is a really challenging population for payers. We know, particularly in that last year of life, Grace, there’s a significant amount of challenges with member experience that can spill over onto their caregivers. All of that leads to an exorbitant amount of cost, right, the cost of care in the last year of life is significant, and so what we’re trying to do is really be able to get involved earlier in the course of these patients, you know, 12 to 24, months before patients pass away, to be able to provide evidence-based palliative care, which we know can improve the quality and that journey for that member and their loved ones, but also significantly reduces those exorbitant costs of care in that last year of life and so, you know, we know payers are struggling with admissions recently. We know a lot of those admissions are going to be concentrated in that last year of life. We know that, you know, patient experience matters a lot. And so those are all things that we are in particularly focused on we’re a new company. We launched clinically just earlier this year. We’re fortunate to announce a $60 million initial raise. And so what we’re doing, we’re live now in Ohio, and what we’re really doing is delivering our care in our clinical model. Our priority for next year is really to be able to scale from there and create access to evidence-based palliative care and forge even greater payer partnerships. One other thing I think, for payers to keep in mind is we’re also anticipating at some point in the future that hospice will be carved back into Medicare Advantage. So that’s another thing, I think it really should be on the radar of payers as we think about growth.
Becker’s: Absolutely. Going off of that at an industry level, how would you describe the biggest barriers to effectively serving and engaging members? What opportunities do you see for large-scale improvements? How are you applying this in your current strategy?
Mihir Kamdar: This is another really important question. You know, engagement is critical, and it’s something we spend a lot of time focusing on at Tuesday Health. Our patients with serious illness have a lot of challenges. And it’s not just medical, it can be psychosocial. A lot of social determinant challenges. And so we think about, we really think about engagement in two ways. One is obviously, with the patient and their loved ones, their caregivers are critically important to engage as patients get sicker, oftentimes, the caregivers making the decisions, you know, at really key moments in their journey, for their loved one, but also for providers. And you know, supportive care, study after study shows you can be incredibly helpful, but sometimes the biggest barrier is some of the stigma associated with supportive and palliative care. People confuse it with hospice and so what we really try to do is go and market and hire both provider and patient engagement specialists to really understand the needs, understand where the pain points are, understand where we can offer value as it relates to both providers and patients. We really aim to solve a problem for both providers and patients within that you know, the first visit or two, so we can show our value, and we find that is incredibly helpful. We’re excited because we’re really seeing high levels of engagement so far with our clinical deployment.
Becker’s: Switching gears slightly to the leadership side of things, keeping pace in today’s dynamic healthcare landscape is challenging. So what’s one piece of advice you’d share with peer leaders to grow their businesses while keeping members top of mind?
Mihir Kamdar: Yeah, I think it’s a simple answer. It’s exactly what you said at the end of that question. It’s really, how we keep the patient and also say their loved one, the caregiver, really as our North Star. People oftentimes forget about really thinking about that dyadic relationship, which I think is critical in healthcare. And I think the challenge for leaders is how you actually live and breathe that as an organization, instead of having it just be something that kind of sounds like a Hallmark card. And so for us, we really try to integrate keeping the patient and their caregiver first really into the fabric of our company. We start every meeting where we’re going to need to make important decisions with a patient’s story, and that, I think helps ground and center us. And I think what’s nice in palliative and supportive care, we have an opportunity where the Venn diagrams of doing the right thing for a patient and their loved ones also overlaps with being able to reduce unwanted medical spend, and oftentimes isn’t helpful. So we really try to, you know, keep that front center. We know if we can deliver for the member and their loved ones, everything else will fall into place.
Becker’s: And as we are wrapping up our conversation, I’d love to just visit technology quickly. So how is tech supporting value-based care, member-focused initiatives at your organization, and what’s most exciting for you here? And why?
Mihir Kamdar: Yeah, I love this question. It’s really interesting question to me, because a lot of people think a lot of palliative care clinicians, supportive clinicians, really see that field really built over the last 20 years on the humaneness of medical care, really that personal touch, really being with patients at the bedside in these in these challenging moments. And so sometimes thinking about technology can seem antithetical to that. But we really think about technology as something that we can harness to really pull in our clinicians at key points to be able to optimize care. One of the challenges that we see in palliative supportive care, is not enough clinicians out there. There are only about 5000 to 6000 palliative care physicians out there. We estimate by 2050 80 to 90 million people will need some type of palliative supportive care, and the needs are present now, so we use technology at several key points in a patient journey. One is, that we have a highly accurate identification algorithm. One of the challenges that a lot of parents experience is, how do we really identify the right patients who could benefit from this type of care. And so we start by using thoughtful predictive analytics to be able to identify patients. And then along the care journey, we also incorporate two important things. One is tele palliative care. Members of our team, we were fortunate to publish an article in JAMA showing that tele palliative care can be almost as effective, actually, as in-person palliative care. How we use that is, and think about the nuance there is really important, but we’re excited about our tele palliative care delivery to reach, you know, to really reach more patients in need. Another is how we think about continuous monitoring, and we published a study showing that we can use continuous monitoring in patients with serious illness to not only improve their care but also reduce hospitalizations. And then lastly, one challenge for clinicians is really knowing when someone is getting sicker and really getting into that end of the life phase. And so we also use technology to better predict as patients are getting sicker. So we can not only leverage greater resources to help with things like symptom management, keep folks out of the hospital, but make sure that we’re having those important conversations that oftentimes don’t happen. And in that way, we can really help folks, you know, transition to hospice when the time is right, not too early and not too late, and really help folks and their loved ones have a soft landing at the end of life. So we’re really trying to help folks from the point of identification all the way through that end of life journey, using technology at key points along the way.
Becker’s: Well, thank you so much for taking the time to join me today on the Bucker’s Healthcare podcast. Again, we’re live at the 2024 payer issues roundtable.
Mihir Kamdar: Thank you so much.
