Helping Patients Navigate Their Health Issues
Private Health Management is a tech-enabled healthcare navigation service.
The service helps users get the right diagnosis for their illnesses, and guides them through treatment plans.
With resources including access to 15,000 physicians covering more than 350 specialties, and an Artificial-Intelligence-powered medical literature search engine, users can receive the best care and reduce unnecessary, ineffective healthcare spending.
To be clear, this company doesn’t provide health insurance or medical procedures. Rather, it helps members find the best in-network care providers, receive the most accurate diagnosis, and select the most appropriate care plan.
As an example, if a member has Blue Cross Blue Shield health insurance, and is in need of an orthopedic surgeon, Private Health Management would use its resources to:
• Confirm a diagnosis.
• Help the patient find the best possible surgeon in their health network.
• And schedule all of their appointments and post-operative care, including nursing and physical therapy sessions.
Simply put, Private Health Management helps patients “navigate” their health issues — from diagnosis to treatment.
Recently, other healthcare navigation companies have raised significant capital from professional investors. For example:
• One Medical, a membership platform for primary care, raised $532 million from Benchmark and Maverick Ventures.
• Accolade, an on-demand health solution for employers, raised $217 million from Andreessen Horowitz and McKesson.
• And Grand Rounds, a personal healthcare assistant, raised $106 million from Greylock Partners and Venrock.
These companies, along with Private Health Management, were created because today’s healthcare system is broken.
For one, it’s inefficient and error prone. 400,000 deaths a year in the U.S. are due to preventable medical errors. And 30% of care services are deemed “inappropriate” or “counterproductive.”
And healthcare is expensive. According to a recent report from the Kaiser Family Foundation, since 2008, the average family healthcare premium has risen 55%. Many families pay $20,000 a year or more in premiums.
Furthermore, patients generally have no idea what treatment options should cost, and prices vary wildly. In Texas, for example, the cost to treat pneumonia can range anywhere from $14,000 to nearly $40,000.
The thing is, getting the best care can mean the difference between life and death. For example:
• Patients receiving optimal care for treating prostate cancer are three times less likely to have the illness return after five years.
• Those who use top surgeons to treat a brain aneurysm have a survival rate that's 76% higher.
• And those undergoing lung removal surgery have a 40% higher survival rate if they get the top care.
Private Health Management was created to help high net worth individuals and company employees — those who can afford high-cost healthcare, but are unsure of how to navigate the system.
The company’s competitive advantage consists of two elements: an experienced team and proprietary technology.
Private Health Management’s team has more than 100 combined years of healthcare leadership and entrepreneurial experience.
Co-Founder Leslie Michelson was CEO of the Prostate Cancer Foundation and has served on the boards of 20 healthcare companies. And Co-Founder Gregg Britt has more than 20 years of experience in the healthcare, health research, and drug development markets.
With respect to its technology, Private Health Management’s platform includes resources powered by natural language and Artificial Intelligence. These help patients quickly find information about their illnesses, and help physicians more accurately diagnose ailments and diseases.
Essentially, Private Health Management’s platform offers six key features:
Personal Care Teams: These teams of personal care members work together to identify and assess a patient’s situation. They may also help create a treatment plan or refer them to a local doctor.
Physician Database: This is the network of more than 15,000 vetted physicians. These physicians help patients diagnose their illness and can also help guide treatment decisions.
Proprietary Medical Literature Search Engine: This state-of-the-art research engine enables the company to efficiently identify and analyze the most relevant publications and access more than 1,500 detailed, research-backed health reports. In other words, this search engine acts as a medically-focused “Google,” enabling patients and physicians to more easily find answers to health questions.
Clinical Rounding Process: Named after a common hospital practice in which doctors make “rounds” in the hospital to check on patients, this enables physicians to undergo patient case review sessions.
Physician Support System: If a patient needs to visit a doctor, physicians in this network can forward detailed medical history and communicate with them.
Integrated Systems: A customized workflow management tool and client records system tracks every patient’s key information for easier diagnosis abilities and referrals.
Private Health Management offers an enterprise version for companies, and two consumer-facing offerings.
The enterprise version for companies includes 24/7 clinical support, expert physician referrals, and custom health research reports. This version costs $1,000 per employee per year (minimum 100 employees), as well as a one-time initiation fee.
The first of the consumer versions is an Intensive Case Management Service. This is for high net worth individuals who need comprehensive care management for a serious, existing medical condition.
For between $55,000 to $100,000 for a set period of time (generally 4 months), patients receive access to top physicians, medical literature research, logistics coordination, and emotional and decision-making support.
The second of the consumer versions is a membership program, geared toward users who are generally healthy and simply want access to medical records management and personalized health research. This program is significantly more affordable, costing $10,000 to $35,000 per year, depending on a person’s age.
Between the 129 million full-time employees in the U.S., and 20 million high net worth individuals, Private Health Management’s total available market is estimated at $162 billion.
Since 2015, Private Health Management has achieved double-digit revenue growth each year. In 2018, it generated $6.5 million in revenue.
The company has 13 corporate clients, including a publicly-traded investment bank, a private equity firm, a hedge fund, and multiple management consulting businesses.
Private Health Management will use funds raised from this round for sales/marketing efforts and working capital.
Leslie has more than 30 years of experience in the healthcare industry.
Throughout his career, he has served on the boards of 20 companies, and was CEO of the Prostate Cancer Foundation.
In addition, he co-founded and served as CEO of a trio of healthcare-related companies, Acurian, Value Health Services, and Protocare.
Leslie is the author of The Patient’s Playbook, a book detailing ways to manage personal health that was a New York Times “best-seller.”
He earned degrees from Johns Hopkins University and Yale Law School.
Prior to starting Private Health Management, Gregg was CEO and Founder of Innovis, a company providing clinical development services to healthcare companies focused on in-vitro diagnostics, medical devices, and prescription drugs. He served as CEO of this company for nearly 15 years.
Before that, he was Senior Vice President of the Prostate Cancer Foundation’s Biopharmaceutical Research & Development Division, and prior to that worked with Leslie at Protocare.
Gregg earned a Bachelor’s degree in Psychology from California State University-Northridge.
In addition to his role with Private Health Management, Robert is a professor of Emergency Medicine at Rush University Medical Center, and Executive Chair of Emergency Medicine for hospitals in Cook County, Illinois.
His expertise is in the diagnosis and management of complex medical cases including chronic pain and orthopedic issues. Early in his career, he was the first Director of a surgical techniques lab affiliated with the UCLA Emergency Medicine Program.
Robert’s accomplishments have been recognized by the David Wagner Award from the American Academy of Emergency Medicine, and he was nominated for the Heritage Medal of Freedom by former President Ronald Reagan.
Robert earned his MD from Wayne State University and completed his residency in Emergency Medicine at the University of Chicago.
Debbie brings more than two decades of experience in senior level management positions spanning several industries including non-profits, entertainment, and retail.
Before joining Private Health Management seven years ago, she was Senior Vice President of Marketing and Development for EveryPenny, a fundraising company for K-12 schools.
Prior to that, she was Senior Vice President of Strategic Marketing for Mastro’s Restaurants chain.
Debbie spent four years as Chief Operating Officer with the Prostate Cancer Foundation, and was Executive Director of Growth Strategies for Ronald McDonald House Charities of Southern California.