The impact of the global pandemic caused by COVID-19 continues to threaten global health and well-being, and in the United States, people experience the worst health outcomes overall of any high-income nation. It’s no surprise that one of the fastest growing sectors for startups is health care, with many new entrants focusing on targeting specific health issues, improving the care experience, and changing the trajectory of health outcomes by changing how care is delivered today.  

At the center of these advancements is the city of Boston. Filled with world-class research hospitals and universities, it’s a mecca for health care innovators and investors eager to apply technology and artificial intelligence (AI) to improve patient care and outcomes. “It is our ecosystem,” says Dr. Michael Sherman, executive vice president and chief medical officer of Point32Health, the parent company of local health plans Harvard Pilgrim Health Care and Tufts Health Plan. “We have innovation in our DNA.” 

Partnerships in the system are at the forefront of innovation

Nonprofit MassChallenge, based in Boston, connects startups, experts, corporations, and communities to grow and transform businesses. “The city…is genuinely ripe for innovation,” says Erika Lozano, director of challenge program operations at MassChallenge. MassChallenge also runs a HealthTech program, which matches health tech-focused startups with experts and corporations like the U.S. Department of Health and Human Services, the American Medical Association, and Point32Health. 

Head of Acceleration for MassChallenge, Hope Hopkins, says these collaborations often have an inclusive lens on them, and target populations that historically have been left out of the health care system.

But Massachusetts’ thriving innovation community is not the only place to look for advances in health tech. Point32Health’s clinical innovation team recognizes there are talented startups well beyond their backyard. In addition to their local collaboration with MassChallenge, the team also works with the Techstars Healthcare, which is sponsored by Point32Health, Cedars-Sinai, UCI Health, and UnitedHealthcare. The consortium-led accelerator program will select 12 high-growth startups to participate in its intensive 13-week program. At the conclusion of the program, innovative startups may pilot their solution with Point32Health. Such pilots are supported through funding specifically dedicated to advancing healthcare innovation for their members.

Innovation to improve health outcomes

The clinical innovation team at Point32Health is made up of individuals from the health care sector who bring both clinical and analytical expertise to the table when assessing which startups to select as pilot partners for the organization’s health plan members. The team includes a nurse practitioner, pharmacist, genetic counselor, and a former NICU nurse. But the final decision on which startups to move on to the pilot step is ultimately driven by “really understanding the root cause of [our members’] health issues,” says Kate Wallis, vice president of clinical innovation at Point32Health, and choosing a partner who is proactively tackling that root cause through their product or service. What follows are the top priority areas for the team:

Behavioral health

As research continues to point to the direct impact that an individual’s mental state can have on their physical health, behavioral health care has proven vital to a person’s whole health and well-being. However, access and costs for behavioral health services continue to be an issue within the health care system.

Freespira, a Washington State-based behavioral health startup that focuses on panic disorders and PTSD (Post-traumatic Stress Disorder) was chosen last year as the winner of Point32Health’s first annual Innovation Challenge Symposium. Freespira’s medication-free, FDA-cleared digital therapeutic treatment will be part of a 18 month pilot program for 500 Point32Health members. 

Freespira has already treated more than 4,000 patients successfully, according to CEO Joe Perekupka. The therapy includes a care coach who guides patients through a 28-day program using a digital device that teaches them how to stabilize their breathing on their own. “We’re making the patient an active participant in their own treatment,” Perekupka says. Often, the physical symptoms of an undiagnosed panic disorder land patients in an emergency room. An outside study demonstrated a 35 percent reduction in total medical costs in one year while emergency room use dropped by 65 percent for patients who used Freespira’s digital therapeutic device.

Point32Health will cover the cost of the Freespira therapy for the members who participate in the pilot program. If defined goals and metrics are met and member feedback is positive, Point32Health will determine whether the therapy may be offered to their broader member population. 

The impact of social determinants on whole health

California-based startup, Wider Circle, which also participated in Point32Health’s 2022 symposium, has a focus on social behavioral determinants of health. “There’s tons of evidence in the literature that supports how community can affect outcomes,” says Dr. Claude Pinnock, chief medical officer at Wider Circle. Through technology enabled peer-to-peer engagement rooted in trust, Wider Circle aims to restore the community support network essential to managing better health, improving social determinants of health, and providing a better member experience. Wider Circle focuses on hard-to-reach members and not only engages with them, but also connects them to other individuals who have shared experiences within their own communities. Through a combination of in-person and virtual events, led by health workers from the community, connections develop that “empower members to take care of each other,” Pinnock says 

These community-based approaches specific to at-risk populations can help create better health outcomes. For example, helping people manage conditions, like diabetes, chronic obstructive pulmonary disease (COPD), mild to moderate depression, anxiety, asthma, even kidney disease, can help them avoid expensive hospitalization.

Maternal health equity

The Flourish Fund is a Rhode Island-based startup born out of founder Melissa Bowley’s mission to find a solution to improve maternity care in the US; and shift the spend to more wellness and less stuff.

Flourish Fund is the only experiential baby registry focused on wellness essentials for mom and baby, self-care, and support. In addition to the traditional baby gear, now parents-to-be can register for vetted support services, such as doulas, sleep and lactation consultants, yoga, massage and more. Bowley explains that after birth, she realized that the baby gear she had registered for was not going to help her tackle her real postpartum needs. “I struggled to find resources. And then in talking to other women, [I] found that that wasn’t unusual,” she says.

Bowley and the Flourish Fund are working with Point32Health to help make doula care standard for women in their Medicaid population – from pregnancy through birth and into the postpartum period. 

In addition to providing virtual and in-person appointments with doulas, The Flourish Fund also provides Medicaid-eligible pregnant mothers with a toolkit that includes a baby carrier, a breast pump, and postpartum pads.

Innovation sparks hope for the future of health outcomes

Point32Health’s Sherman and Wallis both express optimism when it comes to the rapid innovation that is occurring in the health care and health tech space, and while it may still be too early to call victory, how it’s shifting the trajectory of health outcomes. “I hope that we see a lot of these innovations… not as out there on the fringe, but part of what is used to provide better health care to all people throughout the country,” Sherman says. “I hope entities across the country see Point32Health as a model for what they should be making available to their members.”