Why Storm invested in CareSkore

Healthcare providers are struggling to adapt to value based care, where they are reimbursed based on performance — better health outcomes and lower costs. The Centers for Medicare and Medicaid Services (CMS) has laid out a number of criteria for measuring this performance. Unfortunately, many hospitals and physician groups have failed to meet these benchmarks. Adopting value based care has been very difficult because it requires providers to understand and predict the clinical implications of their actions over the long term.

CareSkore solves this tough problem by using machine learning and AI to develop a more holistic view of patients, predict clinical outcomes and improve those outcomes through personalized and timely intervention. We passionately believe that solving this issue will go a long way in realizing a vision of predictive health management and ultimately preventative healthcare. At Storm, we are excited to invest in CareSkore as we continue to back disruptive digital health companies to achieve this vision.

Rules Change

The healthcare system is undergoing massive transformation through the ACA, which seeks to drive better health outcomes and lower costs. The ACA achieves this through a system of incentives and penalties. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), accelerated this process by updating the formula for determining Medicare payments for clinicians’ services. The new rule will reimburse physicians based on four factors, grading them with a composite performance score based on quality measures (50%), resource use (10%), clinical practice improvement activities (15%), and meaningful use (25%). Starting in 2019, 4% of payments to physicians will be based on over 300 clinical measures of quality. Over time, this percentage will rapidly increase. The first measurement period is in 2017 and surprisingly over 50% of physicians are not prepared for these changes.

The key takeaway is that providers need access to a vast amount of data to compute and report measures of quality like readmission rates across various conditions and populations. They not only need to gather this data, but have to analyze it and act on it on a continuous basis. In addition, they need to communicate and coordinate with each other as patients with chronic conditions move between hospitals, homes, skilled nursing facilities and long term care centers. Unfortunately, the system is not setup for this.

CareSkore

This is precisely the problem that CareSkore solves. The platform has three main components.

1. Risk Assessment — CareSkore combines clinical data with other forms of medical and non-medical data such as lab, demographic, wearable and social data to give physicians a better understanding of the patient inside and outside the care facility.
2. Care Coordination — The platform continuously analyzes the data through machine learning and helps healthcare workers prioritize follow up, understand potential complications and get an early indication of any sign of trouble.
3. Patient Engagement — CareSkore also has an AI component that can reach out to patients automatically through email, phone or text, which lets the medical team monitor all their patients in real time and in a scalable way.

The platform is also fully integrated with current systems and is heavily metric driven, which enables the providers to understand, report and improve upon their performance without wasting valuable time that is better reserved for patients.

Finally, the team, led by Jas and Puneet, has an amazing background for realizing the goal of predictive population health management. The combination of healthcare, technology, leadership and strategy based experience has given them an excellent foundation to build the company and we at Storm are thrilled to have them as a part of our Enterprise SaaS family.