Key Takeaways from my Conversation with Awell and Astrana Leadership
- Astrana Health and Awell is the first ever true partnership to bring CareOps to value-based care at scale.
- Astrana is one of the sole organizations at that scale that is able to move as fast as they do as well as experiment as they do. And the partnership with Awell accelerates that even more.
- More care delivery organizations need to find a way to design and continue to improve their care processes at scale and closer to the speed of software companies.
- In healthcare, for sake of conservatism but also as a result of the slow movement of information, process improvements take months or years, but we can do better. If a new method of taking care of patients is proven unequivocally better, it needs to be rolled out as soon as possible.
- Organizations that iterate and learn what works and what doesn't for their markets and populations will win over time. Awell enables this iteration in a no-code, flexible way and works with several care delivery organizations leading the way in CareOps.
Awell, Astrana, and the Emergence of CareOps as a VBC Differentiator
Imagine you've built a product so good that your customers don't want you to list them on your website as a partner, because it would give away the source of their secret sauce.
Awell works with some of the most innovative care delivery companies in the game, and they're far and away the leading organization in Care Operations - CareOps - defined as the process of combining agile, efficient software with clinical expertise to create the best possible clinical workflow. High quality, high efficiency. And this mantra aligns closely with the objectives of value-based care, where Astrana Health is busy building and scaling a market-leading asset.
I recently chatted with Astrana's CEO Brandon Sim, and Awell's Thomas Vande Casteele and Rik Renard about their recent partnership announced on August 25 along with their thoughts on what's going on in value-based care.
So with that introduction aside, here's how Awell is supercharging clinical workflows for Astrana, and how Astrana is staying ahead of the value-based care game by leveraging Awell's platform at scale in the first ever partnership to bring CareOps to value-based care.
Awell will be a household name (in niche healthcare corners of the world) in short order. Astrana is one of the most underrated companies in healthcare And today I'm excited to tell Hospitalogists more about both of them.
The 18-Month Long Partnership Journey that Started with a Tweet
When he's not too busy closing deals or working with existing partners, Rik Renard at Awell finds himself on X (formerly known as Twitter) networking, but also posting hilarious healthcare memes. Well…you never know who's going to come across your profile on any given day. The algorithm giveth, and the algorithm taketh away (I should know).
On this particular day, when Astrana CEO Brandon Sim started following Rik, little did he know the algorithm would give Awell an enterprise-level partner 18 months later.
So while I'm not necessarily advocating for business development through memes in healthcare, it DID open the door for a conversation between Brandon and Rik to talk about ways Astrana and Awell could work together.
How Awell and Astrana Formed a Successful Pilot around Strategic Priorities
After initially touching base on Twitter in January 2023, Rik messaged Brandon to congratulate him on Astrana's results one quarter, and that conversation eventually led to a meeting of the minds. Astrana had early interest in Awell's model from the beginning, but timing became right in the first part of 2024. At that point, Awell and Astrana began talking about a potential pilot between the two parties.
Something that differentiates Awell is their team's unquenchable thirst to drive results for their partners and their desire to 'prove, not tell' the value they bring. Awell wants its customers to look badass - not them. To this end, Awell took inspiration from Palantir's boot camp concept and applied it to healthcare.
In forming the pilot, including which workflows to develop, and what KPIs to track, Awell's team flew out to Astrana's HQ and asked Astrana for hard problems they could solve together. Workflows that were manual they could automate. Tough value-based care functions that were headaches to deal with.
From these conversations, Awell and Astrana landed on 10+ use cases surrounding transitional care management functions - an area overgrown with manual tasks as patients leave the hospital and require follow ups / discharge to appropriate care settings. In most care delivery organizations, it's difficult to improve these processes, which include tasks like contacting patients, following up, faxing doctors, and more.
The pilot sought to answer two primary questions:
- Can Awell help Astrana support more patients with the same transitional care management team (i.e., make them more productive)?
- Can Awell integrate well within the Astrana stack and drive efficiency gains elsewhere?
The answer to both of these questions was a resounding yes.
The pilot rolled out to Astrana's ACO population - 35k or so members. In most cases, Astrana trials new concepts or partners in their ACO (internally referred to as their 'sandbox' or an area to experiment more intimately prior to rolling out to other use cases and populations) because it's a more controlled environment. They work closely with their PCPs to understand processes and implement solutions to what they hear together. Then they expand to more complex phases where things are more hands-off or exert less influence.
Diving into the weeds, here are more specifics around how Awell implemented the pilot with Astrana for those who want to learn more about better pilot design:
- Awell first lands on a use case and from conversations with Astrana, the two then decide on transitional care management (TCM), the current needs in the area, and solutions therein
- Awell designs the v1 of the care flow and goes live with v1
- After a few days, Awell asks for feedback and - together with the care management team - Awell makes improvements to the flow. As an aside, as it sits today, Awell and Astrana are on v156 of this care flow within the pilot to prove how much they really do iterate processes with their partners!!
- Awell held weekly syncs with operating and clinical personnel on the ground to understand what's working and what's not - an important, underrated step. Although they are technically not the decision makers, they are an extremely important voice and Awell does everything they can to make them feel involved and heard so that they love Awell by the end of things
- Awell reported on KPIs to people on the ground + leadership every week and had a dashboard to help facilitate this reporting process and show progress
As mentioned, the pilot proved to be successful - time spent on TCM patients decreased by 75% as Awell automated several manual steps. After running for 2 months and seeing the results along with how Awell runs things in a partnership, Astrana made the buy decision and scaled the pilot quickly from there.
They're now running workflows across multiple use cases beyond TCM including ECM, SNPs, Post ED programs, Medication Reconciliation Post-Discharge, ESRD Coordination, ESPDT (Early and Periodic Screening, Diagnostic, and Treatment), with more on the way.
From this point, the partnership will expand to Astrana's Medicare Advantage population and together, the two can innovate much faster than other operators in healthcare and lead the charge in creating agile organizations.
Other helpful tidbits for setting up a successful pilot:
- Ideally you pilot in 2 different markets with 2 different leaders so you can compare results. Sometimes it's the market leader who influenced the results, not the vendor.
- In general you ALWAYS want to pilot in 2 states or more; because sometimes you can have bad software results simply due to the patient population not being receptive to it (or you are held back by certain bottlenecks like a poor point of contact at Location A, while the POC at location B is super motivated)
- Scope a pilot in time and align on outcomes from the get go (with your partner setting the targets) - More capacity, better quality, less burnout
- Define what success looks like. E.g., "if these results happen, then we will sign a contract."
That's it for part 1 - hopefully you found Part 1 interesting around how two disparate parties can come together through the power of social media to drive healthcare forward! Tuesday will be Part 2 and will contain more practical thoughts around VBC operations, so be on the lookout for that.
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