Here's Our Solution To Health Insurance's (Mostly) Broken Incentives

?? Why does health insurance make it so hard to get mental health help and see a therapist?

We know people are struggling with mental health now more than ever. We know therapy leads to better mental health outcomes. So, what's the deal?

I’ve been exploring health insurance, how it works, what it covers, and what it doesn’t cover for the past few years since I sold my last startup, Greatist, and learned a few things.

The biggest learning? That health insurance co’s today (Medicare & Medicaid aside) aren’t financially incentivized to keep you healthy long-term. Just the opposite, in fact—they only care about reducing sick care costs in the short-term.

Unfortunately, this actually makes sense for them. It turns out the average customer sticks with a health insurance plan for 3 years. (Mostly because it’s tied to employment, more on that later.) Essentially, then, any dollar spent on keeping you healthy in year 4 is like gifting money to a competitor. ??

In other words, health insurance plans rarely end up paying for preventative care because, well, what’s in it for them?

The effect of this is big and sad and tragic. We KNOW for a fact that certain things help people be healthy long-term. Exercise, eating healthy, therapy, acupuncture, physical therapy, even Vitamin D are all things your health insurance likely doesn’t really pay for. And, if no one helps people pay for these things, the wonderful world of wellcare becomes unattainable to everyone but those that can pay out of pocket— and our entire society gets sicker and less equitable because of it.

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So how do we fix this? We need a health insurance-like solution where the incentives with consumers are completely aligned. Something where if someone stays healthy long-term, everybody wins. ??

We’ve started building this at Ness. ?? We know it’s hard—and that an ambitious vision of a better health insurance (in an unbelievably entrenched, profitable space) means we need to take a very unique approach….

We believe the way in is bottoms-up, consumer-first—YOU first. Deliver an extraordinarily experience that helps normal consumers actually afford wellcare (the more people pay for it, the cheaper it’ll get) and bet on a future (it’s coming) where health insurance is increasingly de-coupled from the employer (and you can choose to stick with whatever solution you want.) Look at QSEHRAs & ICHRAs, for example.

Our first product will actually be a consumer credit card (with amazing benefits and partners built in) that rewards you for spending on wellness. ?? The more you spend on wellcare, the more points you can use to get more affordable care in our network... and the more people can spend on wellcare in general, the more affordable the entire ecosystem will get! ??

?? Imagine seeing a therapist every week on the points you earn from the spending you’re already doing. (We’re building a network with therapists, health coaches, etc...) Imagine anytime, anywhere answers to your health questions. (We’re building AmEx-like concierges for your health.)

Imagine everyone ultimately being able to afford to get and stay healthy.

Over time, we’ll add medical benefits, coverage, and essentially everything you’d look for from a health insurance plan in new credit card tiers. ?????? Eventually, we’ll build a better health solution (with an amazing consumer experience) to serve a better world. ??

This is what we’re building at Ness. ?? And we’re doing it with an unbelievable diverse group of stubborn visionary folks. But we can’t do it alone. We’re actively and aggressively hiring people who can help us, no matter whether we’ve got a job description written or not. Help us build something that turns the whole system inside out for the better!