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      How Do you Tailor Healthcare Affordability?

      Healthcare Rethink - Episode 78

      Healthcare Rethink, a FinThrive podcast, addresses the pressing issue of healthcare affordability. Host Brian Urban engages with Srulik Dvorsky, Co-Founder & CEO of TailorMed, in a discussion that unpacks the practicalities of reducing the financial burden of medical expenses on patients and providers alike. With a background in medical devices and a personal connection to the healthcare struggles of loved ones, Dvorsky provides a business-oriented narrative of his shift to developing TailorMed’s innovative platform.


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      Brian Urban:
      Yes, this is the Healthcare Rethink podcast. I'm your host, Brian Urban. And today we are talking all things tailoring healthcare affordability. Who else to do that better than the CEO of TailorMed, Srulik Dvorsky. Srulik, thank you so much for joining our little show here today.
      Srulik Dvorsky:
      Great to be here. Thanks for having me, Brian.
      Brian Urban:
      This is going to be a lot of fun. I haven't had too much time to get to know each other, but I'm familiar with TailorMed. I think a lot of people are, because you have so many amazing pieces of evidence out there in terms of case study, the impact, to affordability for medication for individuals, and how you're really helping a lot of pharmacies across the whole space really have a big trust impact with the lives they serve as well. So we're going to get into all of that today.
      But first, let's start from the top. Who is Srulik Dvorsky? Who are you? Why did you co-found TailorMed? Give us the story of your background here.
      Srulik Dvorsky:
      Yeah. Who am I? Well, I am Srulik and I have a funny name that a lot of folks here are finding it very hard to pronounce, but you got it right, Brian. I'm the father of two, an 8-year-old son, Lyor, and 5-year-old daughter, Shira, and married to a graphic and fashion designer, Michal. And we all now live in New York, although we are originally from Israel and this is why I have this interesting accent that you all hear now.
      I co-founded TailorMed about six years ago with Adam, our CTO and my co-founder. I spent about a decade prior to that in the medical device space. So although healthcare related, couldn't believe how far removed it is from what we're doing now. I used to run an R & D team that developed a new treatment modality for ischemic stroke, an implantable neurostimulator. So it was a different decade in my life, a very fulfilling and challenging one, but very different than what we're doing here at TailorMed. But definitely part of the reason that I started the company.
      I think that having that experience in healthcare from the deep technology side. But alongside that, I had a lot of experience in healthcare for the wrong reasons. A lot of my family members were diagnosed with critical illnesses. I was the caregiver of six of them, including my parents. I think it got to be almost unfortunately second nature. I was working in medical device during the day and I was handling a lot of those challenges as a family after hours to the point that I wanted to combine the passion that started to build inside me to hopefully take technology and do something good with it to help remove barriers to care. That's the backstory of TailorMed. It all started in Israel, which is a very different healthcare market.
      But we can talk more about how I got from there with that idea into the US complicated healthcare ecosystem. But that's the backstory of that.
      Brian Urban:
      Very complicated US healthcare system, indeed and so many unique players from a technology and a care delivery standpoint that are needed. So love what TailorMed is doing and turning into. And thank you for sharing that, Srulik. It seems like you share a common thread with a lot of other executives we have on the show here that have experienced the challenges of a healthcare delivery system, whether in the US or abroad, and you wanted to make a bigger contribution to it. And building your own company, and growing it to a successful point pass traction, what better other way to do that? So it speaks to who you are as a person, a father, a leader. So I absolutely love to hear that and I think our audience will as well.
      So let's start with more of the background of TailorMed and who you are today. So from an outsider perspective, Srulik, I'm looking at TailorMed and I say it's a payment assistance model, helping drug makers, retail pharmacy have better access points for the lives that they're serving with their therapeutics, and helping the affordability of it. But there's so much more to it than that because you have a really cool analytics stack on top of not just that model. So we'll get into that in a moment. But tell us more about TailorMed and who you are today as an organization and the culture.
      Srulik Dvorsky:
      Yeah, so I think that you're spot-on. We are very much focused on finding ways to make medication more affordable to patients. It is a different form of payments because we're not necessarily helping them simplify the way they pay, but actually offset how much they need to pay to other third party financial assistance resources and so forth. We started in a very specific area. So back in 2018, first few pilot sites, what Adam and I saw is that there is a need for a software solution for what is called financial navigation. We saw cancer patients suffering from a term called financial toxicity, which is something that was pretty new for me to even realize. It's like another side effect of the diagnosis that they have. And healthcare providers, mainly cancer centers and community oncology practices trying to help their patients by finding ways to reduce their out-of-pocket cost.
      So our first software solution was exactly for that, give them the first tool to use instead of doing it Post-its and Excel spreadsheets, and just Googling financial assistance for whatever the condition the patient has. And that's where we started. But if you need to ask me where we are today, it's interesting, we're still doing exactly the same, but it is very much expanded from where it started. So I think cancer is definitely still a core area of need for many patients.
      But over the years, TailorMed went throughout the first two, three years of its, I would say journey expanded to be completely disease state agnostic. And we did it because we saw needs in other therapeutic areas. So first all other specialty areas, whether it's arthritis, or multiple cirrhosis, or GI conditions like Crohn's and colitis, but even more so for your chronic illnesses like diabetes, and COPD, and heart failure, and so forth.
      And we expanded the platform to support all of those types of medication encounters that really allowed us to not only serve cancer care providers, but providers as a whole. So we expanded to work with some of the largest health systems and IDNs in the country, and be able to support every medication encounter they actually see in their day-to-day clinical lives. I think in 2021 when we saw the need and actually some of the success we had with pharmacies that are part of our systems, we started supporting the specialty infusion in retail pharmacies that are outside of the provider setting. So we started to work with independent national pharmacies to be able to then look at a bigger population. And over the course of those years, eventually we reached, I think last year, more than 10 million lives that are prescribed individuals that we can actually assist.
      I think the concept of the TailorMed affordability network was born. It took us some time to learn what does it mean to have a network and what is the value of having more than individual nodes of that network. But I have to say something was unlocked last year and I think that that was the introduction of our network and its collaboration with manufacturers. We can speak more about that, but we have an affordability network now that can see patients everywhere. They are prescribed their medication, dispensed, refilled, and then see them throughout their entire course of treatment and remove that financial barrier.
      Brian Urban:
      Wow, that is amazing that you have that line of sight in terms of that the individual level and now you're connected to those that are actually producing these therapeutics, the drug manufacturers themselves, pharmaceutical manufacturers. This is really exciting because that's not one thing I had been able to see in detail. So this is a little bit of a newer headline for TailorMed.
      But speaking of headlines, a really cool thing I saw come out in early February for you all, you were named in the top 100 digital health organizations by 2024 NY Digital Health 100. So a quick congrats on this.
      Srulik Dvorsky:
      Thank you.
      Brian Urban:
      These are one of many other accolades that you have seen in the past since just the young, six-year existence of TailorMed. But tell us what have this recently meant to the team there at TailorMed?
      Srulik Dvorsky:
      Yeah, so I think it's always humbling. And I think it's just a way for our team to get some outside recognition of the very hard work that everybody is doing. We've been able to put together a team that really shares a common mission that we call internally Moving Mountains for Patients. That's what we have in every one of our internal meetings. That's the reason that we come to work. I think it's not by chance something about the culture that started six years ago, eventually across from Tel Aviv where restarted to the US and having team members who are all sharing a mutual, I would say desire to remove those barriers for patients. Mostly because they have some experience at their household, whether it's their immediate family or some close relative. And putting a bunch of very talented folks together is not easy, but it's easier when they share something that is just bigger than what we are doing now here. I think that having that recognition is great, but I think that having the benefit of seeing patient stories that are benefiting from what we're building is even more powerful.
      Brian Urban:
      It really is. Those patient stories, some of it might be anecdotal in nature. But accumulated, it's really the impact being highlighted of what your technology is doing downstream for individuals that need to be able to afford medication to simply manage their conditions and live longer, not even necessarily more of a quality life. That's just the one component that you're helping with, which is very critical.
      So I got to tell you something I had found amazing and I alluded to it earlier, is the cool analytics stack that you actually have on top of your model. And this is really neat. So the patient information I think is really a foundation. You have scheduling, you have a centralized management, which is really neat. But I think the real deep differentiated value here is when you put all those things together. So it's not just affording a medication to an individual, but you're informing the retail pharmacy, the drug manufacturer. So tell us a little bit more about your analytic stack here, your whole end-to-end model, Srulik.
      Srulik Dvorsky:
      Yeah, I think that you hit right in the head, spot-on. The challenge a lot of times is how do you get the data that will then simplify the user experience? And then how do you connect all of those data points to something that is very simple and actionable that will drive higher adoption? And for us, it's all starting there. I've seen a lot of point solutions where you have a great slick user interface. It is very frictionless, you just sign up and start working with it. But then you are reliant on a user that will start typing in every patient they need to work on.
      Brian Urban:
      That's something.
      Srulik Dvorsky:
      We've insisted and that took us, I don't know, a lot of years. But also took a lot of years out of my life, of making sure that every one of our provider customers, our pharmacies are sending data feed into their own instance. So when their users are coming in the morning, they don't need to do the manual work of saying, "I'm going to type in the patient name that I need to work on now." Everything is there, prepopulated, so they can start their experience with actual value from the start of your day. You talk about stack, that's been the core area we invested in and continue to invest in. And that means agnostic to the EHR that the provider has. Agnostic to the pharmacy IT system, the provider or pharmacy has.
      And by the way, a lot of times they have more than one and the burden is on us to make sure that we're connecting those data points. So when the user comes into the system, their insights are already there. I think that's the foundation.
      On top of that, you need to build a lot of automation. And listen, Brian, you won't be able to get to the full end-to-end automatic workflow, you want to. It's going to be incremental, but you need to cross a certain critical mass of manual tasks that you are eliminating. So you're changing the way that they're working with TailorMed, or with whatever software that you are building to what they're doing without it. I think that we crossed that, but you have to continue refining it and enhancing it because otherwise that's going to be another stickiness barrier.
      Once you have the data, I have to say it's not enough, and it's maybe not as sexy as to say as just talking about software. The most important thing you need to do is you need to make sure that your stack also includes deep subject matter expertise of how your users are doing their work. And it's not one user and one user workflow. We are working with small community oncology practices. We're working with some of the largest specialty national pharmacies. We're working, as you said, with retail pharmacies and with large health systems.
      Those workflows are different. And if you need to build a product that will simplify all of this complicated process and data, to one easy to use software, that's where a lot of the know-how lies, and this is where we're making a lot of the investments. And that's an enabler to get a lot of folks on your platform. So you can build a network, but once you have it, this is where the network effect starts. Because once you are able to start creating an interconnected network, so pharma integrates with you, and you integrate with the EHR and you feed back into the pharmacy system. All of the things are eventually creating, I would say the value that we're trying to build here for the last few years.
      Brian Urban:
      I love what you said in terms of the approach as well, flexible. And I think when you're looking at a system that has multiple EHR vendors, you have to be flexible and you also have to be empathetic because these were probably adopted at different times in the system's history with different leaders in place. So you coming in and being flexible, and also being user-friendly, so it's not just more manual work on the output, it's really, really thoughtful strategy. And obviously you learn as you've gone along here, and I think it's so interesting that you're really starting to partner the deep subject matter expertise side of what you just noted through.
      I think it really comes alive in a lot of the case studies, so if you just look at TailorMed online, you Google it and you don't even go on the website, you can actually see a lot of different case studies that pop up with a lot of different oncology groups. So cancer patients is a big focus of the application of your technology. But you have Munson, Augusta, Highlands, Advocate, Aurora Health, Moffitt Cancer Center, I love that one. You have so many different proof points of adding value back into the organizations and really unlocking more cash to be able to use for pilots and studies to advance care and affordability.
      Of these, what stands out to you? Or is there some new studies that are coming out on the horizon that you could tease us with as well?
      Srulik Dvorsky:
      Yeah, I would say both. First of all, I think that the ability to have success stories that are not only an anecdotal patient story, which means a lot to us as a mission driven company, but also the aggregate impact on an organization is critical. Because working with large healthcare organizations is never easy. But if you can associate what you are doing not only with the community benefit for patients, but actually things that have a quantifiable, financially impactful metric on their balance sheet, that's where you can see greater adoption. It's hard because you are measuring against something that is very hard to achieve. But once you do that, you unlock the opportunity to then have relationships with the executives of the health system, not only with the user, which is critical. Nothing happens without that relationship.
      But once you have the ability to now partner, and that's the word you used and I really relate to it. Because partnering is not only about, "I sold them a software, I gave them login and good luck." It is making sure that every piece of that experience is consistent, from analyzing their potential before you start partnering, to identifying their current state in terms of their processes. Are they even ready to take on this new platform? What will be the change management that needs to go into creating that adoption? Then over time, how are we creating alignment between what the users are doing to the value that is being captured across the organization? This is where we're spending a lot of our times with those case studies.
      And you mentioned oncology, we have bodies of evidence to make sure that everybody knows how to form a program like that and actually see the financial results. A few of the upcoming studies are actually going to be non-oncology related with specialty pharmacies. Because when you are thinking about other broader engagement that we are in with, so some of the private plans are with Walgreens for example, that's not only cancer patients. Unfortunately, financial hardships is also for patients with other specialty conditions and not specialty at all. So these are coming up soon. And again, it'll be how to form a program, how to onboard your team to it, how to measure the ROI, and that's always something that is a common thread of all of our case study.
      And the last thing I would say, the partnership is something that really is close to our heart. We're sometimes spending much more time on the nontechnology side to make sure that technology has the right path for adoption. That's something that our team really is passionate about.
      Brian Urban:
      I love that you just said that, we're taking a lot of time and resources and putting it on the nontechnology side to ensure they're having the best informed decisions on the tech build side of TailorMed as the organization's brain. I love that. That is so thoughtful in many ways because you're being open and aware to all the different maybe economic variables at play that might be impacting the world that you're in as well and the lives that you serve.
      So I do want to shift gears here for a moment. So a lot of the things that you're saying I think reflect the person you are, let alone the leader, let alone the impact you have to TailorMed balance sheet, your stakeholders balance sheets. And honestly, we talked to a lot of social anthropologists, epidemiologists, philanthropic innovators. You have that same vibe, Srulik, in a lot of ways.
      And the work that your core tech is addressing is affordability for medication. I look at this and I see medical debt implications that are probably tied to your work that you're putting a positive impact towards medical debt in the US. We've talked to a bunch of great folks on the show about that. There's a stat recently that was out about $88 billion is on consumer credit cards, which is insane. And one in three individuals in the US have a form in the thousands range of medical debt. It's just crazy.
      And when I'm looking at your work, are you seeing that there's going to be a notable impact in the economics of healthcare related to medical debt? Or have you started to look at how your work is alleviating medical debt, or helping avoid medical debt at the individual level? Is there any kind of view into that just yet?
      Srulik Dvorsky:
      Yeah. Listen, it's a very broad question, so I'm going to address it in a few different areas. On the individual level, we have a lot of data to show that that intervention that the provider or pharmacy's doing with our technology is making a huge impact on the individual life on their household. Because when you have a patient that has a new diagnosis and now they're exposed to a $3,000 out-of-pocket for whatever they are prescribed, for example, that is crushing and people are going bankrupt. I think an old study from I think 2016 showed more than 2.5 times more bankruptcy amongst patients with cancer than the general public.
      So if we are able once a day to change one family's life with securing financial assistance to alleviate that, I think it is a very good day. And currently we're doing thousands of those a day across the country. But that's on the individual level.
      On the more macro level, there are a lot of challenges to US healthcare system because of the structure, because of the forces, and because of the complexity of the interests along those different parties. You have manufacturers, and you have payers, you have providers, you have government. I think that all of those forces are trying to eventually make healthcare better in America, more affordable. I think there is a lot of legislation that is trying to do so. We're in election year, you are going to hear a lot more about it. But at the end of the day, the one party that always suffers and the one party that always is left behind is the patient.
      I think that whatever you design and whether it's a legislation effort or a technology platform, you need to make sure that it optimizes for the patient. Because sometimes you think you are doing something very good by patients and you are changing a benefit design, let's say as a payer, but there is a balancing effect. But that's going to impact other patients that now have higher premiums. Same to other cases of trying to do better.
      So I think that on the macro level, unfortunately, I'm not sure that I've seen our impact make something that will change drug prices as a whole in America, and come down. But I am optimistic because I think that we're seeing a lot of good strides towards that. I think that we're seeing that eventually the affordability impact that we're able to make on an individual level eventually is translated into access and adherence. And those are the holy grail. You want make sure that you are hitting all As, access, affordability and adherence, and then you're making a clinical outcome impact.
      And we already had a few studies that started to show a signal of efficacy around that. We partnered with Emory University for a few studies around multiple cirrhosis, cardiovascular conditions. And even one study that was recently released in the American Heart Association around the impact of having cost discussions with patients around, what's their out-of-pocket going to be and are there any different opportunities for them? And also the one we did for multiple sclerosis patients with Emory, showing early signs of impact of clinical outcomes and adherence. So I think that you cannot detach the affordability from eventually why are we doing all of that? It's not only for the financial health of patients, but actually for their own health.
      Brian Urban:
      I love that. First of all, spoken like a true leader. I love that you were transparent in saying, "I don't think we're seeing the impact directly from TailorMed to changing the cost of drugs straight up." But you're very optimistic in what the continued efforts will accumulate to the overall long-term impacts and shift that could happen. Because I think your work at TailorMed, the way that you approach it and the way you speak about it's very influential. I see a lot of other organizations, whether it's from a new build of tech, or a new giving of resources, being influenced hearing your words to do something, to make a contribution to this space. And it's so exciting to hear what you're working on, new partnerships you had mentioned with Walgreens coming out.
      Is there anything else in '24 that you're excited about, or anywhere in '24 and beyond that you're excited about in terms of new partnerships, or new studies, that TailorMed is contributing toward?
      Srulik Dvorsky:
      Many, some of which you'll need to wait until we actually pop out.
      Brian Urban:
      I thought I was going to get it out.
      Srulik Dvorsky:
      I'll tell you what's coming up next. I think that we crossed an inflection point last year where we saw, one, that we reached a standard scale of patients we're able to reach and actually reach directly and not say that we reach. We have them, we see their prescriptions, and we have the opportunity to intervene in critical points of their care, and that is unlock our ability to integrate deeper with drug manufacturers. So we are working with Pfizer for example, but there are going to be more announcements coming soon around new manufacturers that we're going to introduce to our network. That is just benefits to our users and our patients to speed up the enrollments of their programs, reduce the friction of realizing the value of those programs. I think that we're going to see that network effect expedited and accelerating in the next year and moving forward. So that's something that I'm extremely excited about.
      I think from a product perspective, we're going to have a very big year when it comes to actually impacting patients directly. That is something that will allow our users not only to do the work behind their keyboards, but actually engage with patients in a more proactive way. Which will create, I would say, empowerment of patients to take control when they can on their patient financial journey. So that's something I'm super excited about.
      And just in general, I think that as we are seeing the challenges that providers now have across the country and helping them financially to actually be more profitable, be more impactful, not only on patients but actually on the P & L of the health system, to keep the doors open. I think that that's something that will allow us to continue succeeding in this field.
      Brian Urban:
      I love that. Freeing up users to be more person, patient, member, whatever you want to say, focus with the other human that they're trying to help as the biggest thing that your technology can unlock. That is truly exciting because that's what we need now in healthcare more than ever.
      I'll tell you what, I am so excited to see what TailorMed turns into. So help me look into the future a little bit here. Let's go way beyond '24, let's go five years out. You're in the double digits now of existence. You're very much a mature organization. What does TailorMed look like? What will be your future big contributions to the healthcare ecosystem in the far future?
      Srulik Dvorsky:
      I'm going to say two things. One, as a person that just likes to have his head down and build, it's always frightening to give a five-year forecast. Because I'm usually and also encouraging the team to make sure that we know how we are going to execute this year, and then maybe early next year. But I think the vision, and I'm glad to see all of the pieces coming together, so I have a lot of conviction that we can actually execute on the bigger vision, is to continue scaling this affordability network to be the largest, fastest growing network in the country. Have the ability to solve for affordability challenges everywhere a patient is seeing any medication encounter.
      But I think over time, this affordability solution is a wedge in the patient journey that is very unique. And it allow us to have more solution that will address other barriers to cure not only their cost related ones, because we're solving for something that is not a nice to have. We are deeply integrated into the provider workflow, the pharmacy workflow, every type of pharmacy encounter, and patients themselves.
      So when people work with TailorMed, they'll be able to solve for cost. But then think about what happens after the patient starts treatment. How are they managing their side effects? How are they going about living with the diagnosis? And I think that the broad network of partners that we're building around us will demand that from us, and we're starting to see that already and that's where TailorMed will be going. I would say starting to strike off the word financial, from removing financial barriers to care, which is our tagline to removing barriers to care. That's where we'll be going.
      Brian Urban:
      I love that, Srulik, right there. You can't see it because I'm wearing long sleeves and basically the same shirt on every episode, but I did get chills there. Removing financial from it and removing barriers. Oh man, that is beautiful. I am just pumped up for TailorMed now. Sign me up, man. You should also run for office if you're not thinking about it. You address things so well. I'm so excited.
      Srulik Dvorsky:
      My wife will not allow that, ever.
      Brian Urban:
      I'll say, first leader on the show to do a name-drop of a spouse, that speaks volumes to you as a person as well. So she's definitely going to be happy with that. But so amazing to have you on the show. CEO of TailorMed, Srulik Dvorsky, thank you so much for joining us here today.
      Srulik Dvorsky:
      Thanks, Brian. It was fun. And thank you so much for having me.
      Brian Urban:
      And for more exciting excerpts and insights, please visit us at finthrive.com.

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