Conduce Health

Take a minute to learn more about Conduce Health, our newest portfolio company, from Co-Founder & CEO Najib Jai, MD, MBA. Conduce is transforming specialty care with a platform that predicts patient needs, matches them with the right specialists, and optimizes specialty care networks - helping providers, MSOs, and healthcare systems deliver better care. ?? Watch the video to learn more!

I absolutely love hearing the stories of how physicians make their way into non-traditional roles in medicine —and Najib Jai, MD, MBA's journey is no exception! From the early days of moving around a lot and studying Chemistry at Duke (without ever having taken chemistry before!) to now being CEO of Conduce Health, it's an incredible story. The technology that Conduce Health has built is nothing short of amazing. We are beyond excited about the potential of this company to really engage specialists in value-based care models and drive impactful change in healthcare. Can’t wait to see what’s next!

How can we bridge the gap to value-based specialty care? Najib Jai, MD, MBA, co-founder and CEO of Conduce Health, shares his insights on transforming healthcare delivery, improving outcomes, and driving innovation. Don’t miss the conversation on his background and the future of specialty care! Read the full interview here ??

Happy to have the support of Conduce Health as a HIStalk sponsor --> check out how it incentivizes value-based alignment, facilitates care coordination, and ensures timely access to high-quality personalized, and affordable specialty care: https://lnkd.in/e_2RqskP

?? A big shoutout to our Co-founder and CEO Najib Jai, MD, MBA for his terrific insights at Monday’s panel in Boston on Scaling Specialty Care Solutions: Navigating the CEO Journey in HealthTech! Hosted by aMoon Fund with support from LRVHealth and World 50 Group, the discussion brought together top leaders tackling the challenges and opportunities in scaling specialty care. Ellen Herlacher Kate Condliffe Yehuda Kogan Juliana Ekong

?? A big shoutout to our Co-founder and CEO Najib Jai, MD, MBA for his terrific insights at Monday’s panel in Boston on Scaling Specialty Care Solutions: Navigating the CEO Journey in HealthTech! Hosted by aMoon Fund with support from LRVHealth and World 50 Group, the discussion brought together top leaders tackling the challenges and opportunities in scaling specialty care. Ellen Herlacher Kate Condliffe Yehuda Kogan Juliana Ekong

What if you could replace expensive, low-value care with personalized, cost-effective solutions? High Needs ACO REACH has been making it happen. There was an overwhelming amount of good content at Health Care Value Week so… Zach Davis and I decided to review a few sessions and consider what this could mean for the ACO ecosystem from a specialty VBC (Geoff) and an actuarial (Zach) perspective. ?????????????? ???????????? #3 - ?????? ??????????????—?????????????????? ???????? ?????? ?????????????? ???????????????? Geoff: –Michael shared a story reflecting on the above and beyond, but non-medical, interventions that can change the trajectory of a patient’s health outcomes—in this case fixing a furnace. It was inspiring, and a reminder that organizations focused on serving individuals with complex social and health needs must meet patients where they are in the truest sense. –I want to have some shiny specialty VBC pearls, but it seems clear that comprehensive in-home primary care and support is the answer for high-needs ACOs. What do you think the most impactful role for specialty care is here? Zach: ACO REACH and MSSP are designed to hit the bulk of the population but there are subsets of the population that these don’t perform well in traditionally designed ACOs. ? High Needs ACO Reach was a game changer but more work is needed. ? ???????????? ???????? ???????? ????????: ? -- Concurrent risk scores (better alignment of care to costs) ? -- Alternative treatment options for a population that have significant needs beyond medical costs ? -- Data availability drives insights.? In a VBC arrangement, providers get all the data and can see the whole patient.? This drives insight that providers offering the same services can’t see under FFS arrangements.? ? ???????????? ???? ?????? ?????? ???????? ??????????: ? -- VA alignment in home ? --Waiving more cost sharing (the ACO is taking the risk, they should have more flexibility on if and how they get paid) ? -- Reducing complexity related to benefit enhancement.? Some enhancements are so cumbersome, ACO are choosing not to use them. ? High Needs ACO REACH has found a way to trade low value high cost services for high touch lower cost services.? How can we expand this program and extend considerations to other models? Health Care Value Week ended but the education, ideas, and inspiration will continue to resonate. Hopefully, those of us in the ACO space leave with fresh perspectives that will shape our approach to value-based care in the coming months. ? Check out all the replays at? - https://lnkd.in/ePqsHWv3

The data tells us more specialists in your ACO means less savings, but there’s more to the story… There was an overwhelming amount of good content at Health Care Value Week so…..?? ? Zach Davis and I decided to review a few sessions and consider what this could mean for the ACO ecosystem from a specialty VBC (Geoff) and an actuarial (Zach) perspective.? ?????????????? ???????????? #2 - ?????????????????? ?????????????????????? ???????? ??????????-?????????? ???????? ???????????????? Geoff - ?????? ???????????? ???????????????? ?????????????? ?????????? ?????????? ?????????????????? ?????????? ???? ???????? ?????? ?????? ????????????? — “24% of clinicians in an MSSP ACO are PCPs, while 45% are specialists” - Taking this stat in context with the observation of a negative correlation between high mix of specialists and shared savings, it feels like ‘Participating’ and participation can be two very different things. Hospital affiliated ACOs, especially, should take a closer look at how they can connect the right patient to the right specialist at the right time to unlock the value of their specialty care. – Hospital systems taking steps now to improve specialty care value and performance in existing ACOs will also benefit from early movement on the things required to succeed in the episode-focused TEAM model and AHEAD—the voluntary hospital global budget (HGB) model starting in January 2026. Zach: With the median ACO beneficiary count around 13,500 most ACOs don’t have enough bundled episode volume or administrative capacity to leverage the shadow bundle data. ? The more promising specialty engagement mechanism is the TEAM model.? ? Goal of TEAM =? patient focused for better outcomes, quicker recovery, quicker transition back to PCP care, and avoiding ED and re-admissions. ? For some episode bundles, the post-acute cost may only be 20-40% of the total bundle. If there isn't sufficient dollars to save on the post-acute side, this will force hospitals to look internally to create operational efficiency. ? The 5 mandated episodes only account for ~15% of most hospitals’ spend each year, but with a solid evaluation report (CMMI evaluates the performance of each program annually), TEAM could be expanded to more hospitals and more procedures quickly.? Hospitals should be watching this model closely.? Share your thoughts with us below, and stay tuned for the third post tomorrow. You can review the full Value Based Payments Summit here: (https://lnkd.in/eMmKjSVY)

If the past CMS and CMMI administrators are talking this much about data, we should be too! ? There was an overwhelming amount of good content at Health Care Value Week so... Zach Davis and I decided to review a few sessions and consider what this could mean for the ACO ecosystem from a specialty VBC (Geoff) and an actuarial (Zach) perspective ?????????????? ???????????? #1 - ?????? ????????, ?????????????? ?????? ???????????? ???? ??????????-?????????? ????????. Geoff: ?????? ?????? ???? ???????????? ?????????????????????? ?????????????????????? ?????? ?????????????????? –“As we simplify the chassis it’s going to let you go longitudinally and episodically (with specialty care risk)” -? I look forward to innovative and purpose-built specialty care models from CMMI in the years to come. Today, ACOs can more meaningfully incorporate specialists by combining better incentive alignment with specialists with technology to guide providers and beneficiaries towards personalized high-value specialty care. –“Even some reimbursement of the savings (to the patient), it would be awesome to get them involved” - Rewarding patient behaviors that lead to better health outcomes is a tremendous opportunity—and maybe one we don’t need to wait for policy to support!. The value-based entity (VBE) protections already allow testing of these types of incentives. I’d also like to see CMS remove cost-sharing for high value services in value-based settings—care management for example… Zach: ???????? ???????????? ?????? ???????? ?????????????? ???? ???? ?????? ????????????? –"Fast is better than perfect" - knowing a member had an IP stay 60 days ago is interesting, but knowing a member was discharged today from an inpatient stay is impactable.? ? –"Data from CMS is better than most data transferred from payers to providers taking risk in MA or commercial contracts." ? Yes, but we can't compare ourselves to the average and expected to get better.? CMS does provide good standardized data but we need it quicker.? ? –"ACOs interested in participating should get access to data quicker."? The final provider lists are due in September but ACOs starting a new agreement period won't start getting data until February.? The ACO starts the second CMS accepts the application not when the performance years starts.? Risk coding, patient segmentations, resource allocation can all be done before the performance year starts.? ? –"Put an AI tool on top of CMS data and open it up to? providers and their teams."? Each time a new model is released we learn how a new feature impacts ACOs. This process takes time.? If we open source some data (in a secure way!) we can iterate much quicker and we all learn from it! You can review the full Value Based Payments Summit here: https://lnkd.in/eMmKjSVY Share your thoughts with us below, and stay tuned for the second post tomorrow...

In case you missed it, earlier this month Conduce Health was named to the 2025 New York Digital Health 100 from Digital Health New York ?? Innovation in healthcare is what drives us, and we’re honored to be recognized among the most promising digital health companies. As our Chief Growth Officer, Geoff Matous, put it, "2024 was the year that quality and affordability moved back into the spotlight after years of teams pulling the risk-adjustment levers with all their might. That's a positive change and has the potential to refocus energy and innovation on what matters most-the patients we aim to serve." Read more about the year in healthcare innovation in DHNY's annual report here: https://lnkd.in/gcUA3J7Q