I had the pleasure to interview Jason Rose, CEO, AdhereHealth. Jason is currently CEO of AdhereHealth, a leading healthcare technology company focused on medication adherence. With 25 years of experience in healthcare technology, Jason Rose is a serial healthcare IT entrepreneur, focused on launching disruptive products that drive digital health innovation and value-based care outcomes. His career includes several successful start-ups, including his tenure as Chief Strategic Development Officer and Executive Vice President at Inovalon. Jason’s career includes leading data-driven product development, corporate strategy, business development, strategic partnerships, technology implementation and solution portfolio commercialization.
Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?
In the mid-1990s, I was working in the George Washington University (GWU) Medical Center IT department and enrolled at GWU business school for a Master’s in Health Services Administration. From my vantage, healthcare was overwhelmed with manual processes, disconnected systems and a lack of outcomes focus. I had to choose a graduate program focus, but hospitals and government weren’t interesting areas to me. However, with all the technological advances in parallel industries such as banking and hospitality, I saw healthcare as a prime target for improvement. At the time, electronic health record technologies were nascent, and I considered the nearly unlimited opportunities that could improve care efficiencies and ultimately better care. I got special permission from the Dean of the GWU school to create a “healthcare technology” curriculum and thus became a pioneer in an emerging new space. After being on the CIO career track for the next decade, one of my mentors convinced me to deviate from that path by giving me an opportunity to develop and manage new technology-enabled products where I found great success. I continue to heavily rely on my process-focused technology management discipline to create disruptive new commercial products. I’ve made a career in healthcare technology by identifying areas of value, sometimes going against the grain to disrupt the norm that leads to better outcomes.
Can you share the most interesting story that happened to you since you began leading your company?
When I first joined AdhereHealth in March of 2018, I met with several of our client executives to ask their opinion of the company. The consistent feedback was they would like to spend more money with us. Of course, as the new CEO, that is terrific problem to have but it’s still a problem, nonetheless. Certainly, this became an interesting discussion about why these clients wanted to spend more money, but were having issues doing that — what was the problem and how could we fix it? The reality was our clients perceived tremendous value in our products, but we were somehow governing more value creation due to technical debt and investment in our clinical resource network. After much discussion with my leadership, we broke down the areas of improvement to be: 1) clearly identified goals for the company that forced team synergies; 2) hiring the right amount of resources to generate the value in a financially responsible way; and 3) transform the technology team into one that is fully aligned with the business. In my first nine months, we nearly doubled our growth with organic revenue, and we continue to generate strong profits at a higher value than ever before.
Can you tell our readers a bit about why you are an authority in the healthcare field?
I’ve been working in the healthcare industry for more than 25 years, focusing primarily on technology that enables value-based care and digital health. My career has spanned from large-scale multi-year transformation projects for some of the largest healthcare organizations in the nation to rolling my sleeves up in start-ups. After beginning my career as a technology manager, I spent over 15 years applying my skills to product development, sales and marketing. As former Chief Strategic Development Officer and Executive Vice President at Inovalon, I led the development, launch and expansion of the company’s product and technology presence across the healthcare marketplace and helped bring the company to a successful multi-billion-dollar IPO. I’ve had the pleasure of working for many innovative healthcare companies that are working on transforming healthcare for the better across all sectors: provider, payer and government. In my current role as CEO of AdhereHealth, our mission is to improve medication adherence by overcoming social determinants of health and leveraging technologies to improve outcomes.
What makes your company stand out? Can you share a story?
Medication adherence is a $300 billion problem for the U.S., which is about 10% of the annual spend on healthcare. For patients and their families, this equates to unnecessary physical and emotional suffering, financial loss and premature deaths. In the U.S., medication non-adherence accounts for 125,000 preventable deaths each year. These are someone’s relatives, friends or spouse. They’re real people and they’re going through hardship — or worse, losing their lives. This is the problem we at AdhereHealth are aiming to solve, ultimately saving lives through our vision of better health for patients through medication adherence.
While many companies are working to resolve gaps in care, AdhereHealth is unique in that it focuses on medication adherence using technology, overcoming social determinants of health, and taking full risk on our solutions. Further, AdhereHealth combines the mind of a clinician with the heart of a social worker. When we call consumers, we’re not telling them to take their medications. We’re calling to ask: Do you have food in your fridge? Do you have access to your doctor? Can you pay for your medications? Unlike other companies, we’re focusing on why consumers are not taking their medications.
In one case, a patient was contacted by an AdhereHealth clinician to discuss adherence to cholesterol, blood pressure and diabetes medications. During the conversation, it was discovered that the patient was diagnosed with cancer. He had been scheduled for chemotherapy with radiation to start the week before the call, but the hospital sent him home because the cancer treatment was not covered by the care plan. During our adherence review, the clinician, with the patient on the line, contacted his health plan’s customer service and pharmacy department. It was discovered that the provider filed two duplicate claims, one was approved and the other denied. The clinician asked the health plan representative to contact the hospital and explain the situation. Within hours, the patient had an appointment for his chemotherapy and radiation to begin the first week of April. Four weeks later, the clinician followed up with the patient. He stated he is on week four of chemotherapy and radiation treatments with two more to go. He is a caterer, can still work and is now taking all his maintenance medications.
Can you share with our readers about the innovations that you are bringing to and/or see in the healthcare industry? How do you envision that this might disrupt the status quo? Which “pain point” is this trying to address?
There’s a tremendous amount of data floating around the healthcare system: medical data, pharmacy data, eligibility data, hospital discharge data. Our Adhere™ platform combines analytics, high-touch consumer and provide engagement services by licensed clinicians. Through the combination of analytics in a clinical workflow, intentionally identifying and overcoming individual barriers of care and uniquely enrolling consumers in a closed-loop home-delivered pharmacy of choice, we can move the needle on outcomes.
If someone isn’t taking their medicine when or how they are supposed to, are taking multiple medications that don’t behave properly together or otherwise struggle to stick with the prescription schedule, that can have a significant, negative effect on their health. For example, we conducted a comprehensive medication review with a consumer who was taking two different blood thinners, which, when taken together, put him at risk of severe bleeding and other life-threatening complications. We were able to speak with the consumer’s doctor and immediately discontinue the second blood thinner. In another case, our analytics identified a gap with a patient who should have been taking maintenance medicine for high blood pressure, but had recently started missing doses, putting him at risk for a cardiac episode. After learning about the patient’s memory issues, we enrolled them in a multi-dose adherence pharmacy to assist in proper dosage throughout the day.
What are your “5 Things I Wish Someone Told Me Before I Started” and why.
It’s so important to set the vision of whatever business or initiative that’s being driven. This goes beyond personally understanding this vision, but consistently conveying this vision to the Board, company leaders, employees and industry stakeholders. When I first joined my company as the new CEO, I began this vision exploration process in the Board interview for the job. My opening statement was exactly what I wanted to implement: “This company is a leader in medication adherence technologies for improved healthcare outcomes.” Upon taking the role as CEO, I aimed to implement this statement as a vision for the new company. It included a full rebranding of the company and product portfolio. As part of bringing my vision for the company to life, we recently changed our name from PharmMD to AdhereHealth.
2. Value creation
There is only so much time in a day, a year and, ultimately, a lifetime. I have focused my entire career in healthcare technology. Innately, I have always sought to bring value to the healthcare ecosystem through technology innovation. This perspective goes all the way back to creating my Master’s in the Healthcare Services Administration program at The George Washington University School of Business. In the mid-1990s, there really was not a “healthcare technology” industry, despite the need for innovation in this industry. After gaining approval from the Dean of the school to create a program concentration for Strategic Technology Innovation in Healthcare, I started my career in driving value creation for a healthcare economy representing $3.7 trillion.
3. Go big or go home — one step at a time
Going beyond value creation, always focus on incremental steps to achieve it. Success doesn’t occur overnight but over years and years of hard work. Another old saying goes, “It’s not about the destination, it’s about the journey.” I believe this statement should also be applied to setting specific measurable steps to achieve a big goal. Also ask yourself, is the juice worth the squeeze? If not, find something else that is. I joined AdhereHealth to focus on an annual $300 billion of unnecessary medical costs based on medication adherence issues. The company’s focus and assets are rigorously applied to improving health outcomes.
Stemming from big ideas that create value, companies must be focused on a mission that’s more important than making money. Those companies that focus on their purpose will create employee and customer loyalty. At AdhereHealth, we take a balanced approach to defining our outcomes quantitatively and qualitatively. With our north star of better health through medication adherence by resolving social determinants and other barriers to care, our focus on outcomes must be based in a population’s statistical improvement. At the same time, there are rich stories in the people we help to avoid unnecessary hospitalization, disease complications and death. We seek to tell these personal stories to complement our relentless drive to improve population outcomes.
In Greg McKeown’s book, Essentialism, the word ‘essentialism’ is defined, “Essentialism isn’t one more thing; it is a different way of doing everything. It is a discipline you apply constantly, effortlessly. Essentialism is a mindset; a way of life. It is an idea whose time has come.” When Steve Jobs rejoined Apple as its CEO in 1997, the company was on the verge of bankruptcy with 30% declining sales in the prior year and loss of vision. Fortune magazine’s story was quoted, “Apple Computer, Silicon Valley’s paragon of dysfunctional management and fumbled techno-dreams, is back in crisis mode, scrambling lugubriously in slow motion to deal with imploding sales, a floundering technology strategy, and a hemorrhaging brand name.” Jobs is the perfect example of essentialism as he immediately reduced the number of products Apple sold by 70%. Jobs was quoted at the time stating, “Deciding what not to do is as important as deciding what to do. It’s true for companies, and it’s true for products.”
Job’s relentless focus on vision, value, big ideas, purpose and essentialism propelled Apple to be one of the most admired and largest companies in the world.
Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
- Use of technology with real-time data
- Social Determinants of Health (SDOH)
- Incentives and Motivation
Due to a variety of reasons, access to comprehensive and timely data is nearly impossible to see in healthcare today. Over the past three decades, information has become more digital but still remains siloed across different providers, managed care organizations and other locations. This lack of data impacts decision support, decision-making and, ultimately, outcomes.
Motivating chronically ill consumers to take positive steps toward improving their health remains an issue. Does the consumer understand the medications they are prescribed to take? Does the consumer understand their daily choices in exercise and diet directly impact their health? Can they afford their medications and physician visits? Do they have transportation to get to the doctor and/or pharmacy?
Further, a person’s health is affected by more than just their illness. Our socioeconomic status, including work, education, race, sex, geography and all the conditions in which we are born and live in play a major role in our health. In the healthcare industry, these are called “social determinants of health” (SDOH) and they can act as barriers to care. We’re starting to understand the full extent of these SDOH and there are tools, processes and social programs that can make a difference, but the U.S. still has a lot of work to do to help populations overcome these barriers. CMS has recently made advancements in allowing health plans to include spend on SDOH as a medical spend versus being an administrative cost. This common sense regulatory change should help health plans get to the root cause of why members are not adhering to their medications.
You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
- Timely access to consumer data
- Better use of technology
- Aligned incentives between providers and managed care
- Common sense regulations
- A higher focus on delighting the consumer
Aggregating data from multiple data sources in a timely manner and then making sense of the data with analytics is critical to outcomes improvement. Data examples might include medical and pharmacy claims data, eligibility, daily hospital or SNF discharges, consumer-reported and provider-reported data. Although many organizations have access to the data, they may not be taking advantage of using it to provide for analytics that identify gaps that need attention in a timely way. Going a step further is the clinical workflow that can leverage those analytics to have meaningful interventions with the consumers and their doctors about resolving these gaps. Technology platforms also need to be built to maximize regulatory requirements and related incentives in the workflow and reporting.
A remarkable gap that we’ve identified is that pharmacies typically have very little information about the consumer’s entire pharmaceutical regiment. Almost always, pharmacies don’t have limited access, if any, to the consumer’s medical profile. How can pharmacies provide the best care when they only have a fraction of the data and don’t know the consumer’s underlying conditions? On the flip side of this issue is care management organizations that strive to help get consumers to the right pharmacy but have no direct method to enroll the consumer into the right pharmacy, versus referring them to another siloed entity. AdhereHealth seeks to improve consumer engagement and overcome medication adherence gaps by helping consumers enroll in the pharmacy of their choice.
Identifying the underlying cause of medical issues may not be related to the medical condition at all. Moreover, their social determinants of health may be an underlying issue at the foundation of the problem. Unfortunately, often the consumer’s zip code is a strong indicator of population health. Someone living in a food desert isn’t going to have as much access to healthy foods and, as a result, we see an increase in chronic illnesses like diabetes in these populations. There are some diseases that could be limited by simply addressing the root cause before it even has a chance to manifest. Other issues could be the consumer’s health literacy of what their diseases are and what medications have been prescribed to address the condition. Ongoing health education can help overcome these issues.
Lastly, I’d like to revisit the story of the cancer patient I shared earlier. He told us that before the clinician’s call, he wanted to just “sit down and die” since chemotherapy was not going to be covered. After we were able to get him the care he needs, he told the clinician, “I give you my word, I’ll take these medicines and I am so thankful for your help. You are the reason I will be getting my cancer treatment.“ Not only is he going to receive the care he needs but he is also in agreement to take his medications now that he has a better understanding of why they were prescribed to him. A clerical error could have resulted in this man’s death. Further, our AdhereHealth clinician gained commitment from the consumer to be adherent to his medications and we enrolled him into his pharmacy of choice during our follow-up. Reducing these inefficiencies in the healthcare system is about more than just increasing productivity and eliminating waste, it’s about saving lives.
Thank you! It’s great to suggest changes, but what specific steps would need to be taken to implement your ideas? What can individuals, corporations, communities and leaders do to help?
AdhereHealth is accomplishing many of the issues described in this interview. I recommend any organization ask itself, “What is our medication adherence strategy?” Further, create a dialogue around how data, analytics, clinical workflow, pharmacy dispensing initiatives and outcomes-driven performance strategies can support a cohesive medication adherence strategy.
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I recommend reading biographies on business leaders and presidents, information on essentialism or simplicity, The Wall Street Journal and anything by Walter Isaacson. I always believe one can learn from history, especially those great leaders who have been written about. In particular, I truly enjoy reading about disruptive entrepreneurial companies or people that overcame adversity to be successful. Specifically, for healthcare, I read the Nashville Business Journal (given the expansive local healthcare economy), Modern Healthcare and Health Data Management. For a daily news feed, it is sometimes challenging to find a balanced stream of information, but I find The Wall Street Journalis a thorough and more neutral publication than most others.
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