The collision of healthcare & technology: A Fireside Chat with Rachel Neil, founder of Carex Consulting Group

Being part of the Value Prop Shop team allows us to constantly meet entrepreneurs creating products and services in the Healthcare IT space.  Recently we had the pleasure of chatting with one of these entrepreneurs launching a unique business model into the startup world, Rachel Neill, founder of Carex Consulting Group.  Rachel matches talent predominantly from the Madison health tech space with startups and later stage companies that need experienced resources that are often hard to find with simple job postings and network inquiries.

Rachel: As I work with talented job seekers coming from strong health tech backgrounds, what do you see as emerging areas in healthcare technology that have momentum and growth?

VPS: Ten years ago, most doctors (including us) would not consider treating patients without seeing them in person! Now, telemedicine makes up nearly one-fourth of the health IT market, which was valued at $15.6 billion in 2014 and is expected to increase to nearly $20 billion by 2019. Patients want convenience.  Three-quarters of patients indicate they are comfortable with the idea of communicating with doctors using technology instead of seeing them in person, and 37% of employers offered telemedicine as a benefit in 2015 with another 34% expected to add it by 2016/2017.  We are seeing significant traction in the asynchronous telemedicine space – which is different than the telemedicine model that requires video or phone conferencing.  Asynchronous visits are via secure messaging, and do not have to be real time – thus providing both the patient and the doctor a way to conveniently complete a visit, no matter where they are.

Rachel:  I have a couple rock stars I’m working with who are asking about automated appointment booking/insurance verification.  We’ve all heard of ZocDoc and other later stage companies in this space.  What are the trends and disruptions you’re seeing recently?

VPS: It’s amazing to watch how relatively simple aspects of medicine are changing.  Front office staff for so many practices still spend hours scheduling appointments, verifying insurance, and calling patients to remind them of their appointments daily.  Not to mention back office staff, at best, can collect 60% of copays for visits.  Now electronic appointment scheduling with prepay is taking center stage as it’s estimated that by 2019, 66% of health systems will offer digital self-scheduling and 64% of patients will book appointments online.  This space is a win-win for the patient and the provider.  One of the trends we are seeing is companies, including our own clients, creating “closed” models, where patients only see and can schedule with their own provider or health system group when they download a scheduling app.  This is different than the first wave of appointment booking startups that allow patients to schedule with any provider they’d like.  This allows providers to have more control over their schedules to ensure that their existing patients are being prioritized.

Rachel: Aren’t EMRs handling all appointment scheduling?

VPS: EMR portals, at best, have about a 25% patient usage rate.  This is mostly due to their poor user interface that results in a bad patient experience and loss of engagement.  Startups are winning in this space by creating a superior experience with engaging and easy to use mobile applications.

Rachel:  I’ve been hearing a lot of buzz about the concept of PRM (Patient Relationship Management) software.  One of my clients is interested in this space.  What exactly is this and is it something I should invest time in?

VPS:  Yes!  We are seeing companies as big as Salesforce and as small as seed stage clients that we’ve worked with racing into this very hot space.  The concept of a PRM is a relatively new one, but it has gained enormous momentum in the past several years and is estimated to reach a $13.7B market by 2019.  As with most things in the healthcare tech space, there are no hard lines around product scope, features, and value proposition.  The PRM comes in all sizes and shapes, but loosely, it includes some of these key features: care team communication, patient-provider communication, scheduling, payment collection, patient experience, patient education and more. 

Rachel:  I’ve seen several companies looking for talent that are building tools around MACRA initiatives.  In a nutshell, what should these products impact to show enough ROI to incentivize decision makers to buy them?

VPS:  Basically, for simplicity’s sake, for 2017 the arm of MACRA called MIPS (Merit-based Incentive Payment System) program is where most ambulatory physicians will land. Clinician payments in the MIPS program are adjusted based on the clinician being compared to a performance threshold.  Doing well on this score in 2017 could mean up to a 4% payment increase in 2019. What’s great is that the payment adjustment for good performers could mean annual increases reaching a 9% increase in payments by 2022. The performance score is based on 4 factors: quality, resource use, CPIA (Clinical Practice Improvement Activities) and ACI (Advancing Care Information). For 2017 the highest weighted category is quality. So, any tool that automates, simplifies or improves physicians’ ability to deliver on these initiatives is tied to ROI and would engage a buyer. 

We wish Rachel and her team at Carex Consulting the best in their new business.  To learn more about her company, go to