There’s been a growing movement towards outcome-based healthcare payments as we look to value-based care and providing the best care possible. This starts with selecting quality providers. Garner Health is a technology-driven platform that analyzes aggregate medical data to determine who the highest-quality physicians are by specialty, procedure, and geography. Employees of companies that are partnered with Garner Health are able to go through this curated selection, filtered for availability and network considerations for upcoming medical visits. The platform also features a concierge service available through phone, chat, or email to provide additional guidance, if necessary. If the employee opts to use one of the preferred providers, then employers will cover all or a portion of any out-of-pocket expenses. The incentivization of employees in the short term to visit quality providers results in lower costs for the employer in the long term, amounting to savings the company’s estimated to be at least 10%. Garner does not maintain any commercial relationship with healthcare providers and its determinations are completely on the basis of past treatment data, eliminating any bias or impropriety in the recommendations.
AlleyWatch caught up with Founder and CEO Nick Reber (prev. Oscar Health and Bridgewater) to learn more about this innovative model to address rising healthcare costs, the company’s future plans, and latest round of funding, which brings the total funding raised to $70M.
Who were your investors and how much did you raise?
We raised $45M in a Series B round led by Redpoint Ventures, with participation from Founders Fund, Thrive Capital, and Optum Ventures.
Tell us about the product or service that Garner Health offers.
Garner Health has built a new and more accurate way to use big data to measure the performance of individual doctors. We offer two products based on these data-driven insights: an employer medical benefit that helps employees find the best doctors in their community and get their out-of-pocket costs covered; and a provider-facing tool that helps doctors make more intelligent referrals. Taken together, Garner is able to create better health outcomes, lower out-of-pocket spending for patients, save employers 10% on overall health benefit costs and provide doctors with the tools to make more informed referrals for their patients.
What inspired the start of Garner Health?
Garner Health was created based on my personal experiences as a patient, and from managing healthcare costs while working in the leadership of a health insurance company. After a careful review of the data, we could see huge differences in how doctors practiced medicine. These differences meant that many patients were getting low-quality and high-cost care, even at the most reputable hospital systems. Unfortunately, most insurance networks contain 95% or more of all the doctors. Therefore, it occurred to me that if you’re going to fix the root of the problem driving our country’s healthcare crisis, it was essential to create a new entity that would measure doctor performance and help patients get the best option for them.
How is Garner Health different?
Garner differs from other platforms on the market in that it is the only healthcare benefits solution that combines saving employers 10% or more on healthcare spending while lowering employee out-of-pocket costs, improving health outcomes, and doesn’t require employers to change their health insurance plan or medical carrier. The platform is also the first of its kind to leverage such a rich data set and over 500 clinically-validated metrics to identify which individual doctors are the highest performing providers in their community.
What market does Garner Health target and how big is it?
While many benefit solutions only target larger, self-insured companies, we are proud to serve employers of any shape or size and who have plans with any major medical carrier. We have also opened a new target market with the launch of our second product line, empowering providers to make high-quality referrals to specialists.
What’s your business model?
At the core of Garner’s product is the belief that the key to improving health outcomes and lowering healthcare spending is to drive individuals to high-performing doctors. To accomplish this, Garner utilizes the largest medical claims database in the U.S. and the nation’s most robust set of evidence-based algorithms to assess the performance of every doctor across the country. Garner then charges employers a small fee for administering an innovative HRA-based incentive account that is overlaid on an employer’s existing plan, giving employees clear financial incentives to see top doctors while saving employers 10% or more on their health benefit costs as a result of their employees receiving more effective care.
What are your post-COVID office plans??
While we will continue to have remote employees across the country, much of our staff is based in NYC, with most choosing to work from our office in SoHo. With the amount of hiring ahead of us, we will certainly be expanding our Manhattan footprint in the coming months.
What was the funding process like?
Reminiscent of our Series A, which was an entirely virtual process, almost all of our meetings for this round were done via video chat or phone.
What are the biggest challenges that you faced while raising capital?
While it’s nice to cut down on travel, having less in-person time with potential partners can make it a little more challenging to get to know someone. Thankfully, we ended up with an amazing lead investor in Redpoint.
What factors about your business led your investors to write the check?
In addition to increasing our customer base by over 10x this year, we were able to demonstrate some very compelling outcomes for our clients. For instance:
- We save, on average, 27% per visit for patients who use Garner.
- The average employer saves 10% off their health benefits and lowers employee out-of-pocket costs by adding Garner.
- We have an industry-leading 43% average employee engagement rate from first-year customers
What are the milestones you plan to achieve in the next six months?
Continuing to rapidly grow our employer customer base, while expanding further into the direct-to-provider space with our referral product. Additionally, we plan to hire at least 40 more employees across every department over the coming months.
Continuing to rapidly grow our employer customer base, while expanding further into the direct-to-provider space with our referral product. Additionally, we plan to hire at least 40 more employees across every department over the coming months.
What advice can you offer companies in New York that do not have a fresh injection of capital in the bank?
Don’t forget to check in with old friends and acquaintances you might have missed since COVID has started. Catch up and where possible find a way to add value to them. A lot of our best advisors and investors came from friends I reached out to over these past few years.
Where do you see the company going now over the near term?
Growing our impact even further as Garner extends to more employers, patients, and doctors in the coming year.
What’s your favorite outdoor dining restaurant in NYC?
Emmett’s Pizza in Soho.
