Reimagining Medicaid on a Unicorn, Olive AI Platform

April 2, 2021

 – Episode #

65

Is there a non-EMR centric approach to designing and building a Unicorn in Health IT?  Sean Lane with Olive would like to find out.

This has been the premise of the Olive leadership for a while.  Well, now they’ve raised 50 million to find out if it will work.

There isn’t much information out there on Circulo the startup that will live on Olives tech, share a CEO and have as its mission to change the way payers, providers, patients and taxpayers experience Medicaid.

It’s a greenfield approach built on automation, intelligence and technology connection to eliminate waste, reduce denials and provide near instant payments to providers.   The goals are modest for this year but the ambition is big for the future.

I’m gong to keep an eye on this one. I love the concept, believe in the way it is being brought together and can see how the connectedness between payer / provider / and patient can lead to great benefits for all involved in this model.

What are your thoughts?

#healthcare #cio #cmio #himss #chime #healthIT

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Today in health. It, this story is Circulo a new approach to Medicaid. Using the tech of a digital health startup unicorn. Olive AI. My name is bill Russell. I’m a former CIO for 16 hospital system and creator of this week and health. It. A channel dedicated to keeping health it staff current and engaged.

Today health lyrics is my company. I developed a quarterly state of the health it report that I can deliver to your team. These insights can help your leadership team sales team. Even your development team. Stay ahead of the emerging trends in health. It for more information, check out health lyrics.com.

 

All right. Today’s story with 50 million Circulo we’ll tackle Medicaid insurance using olive AI’s tech. This is for mobi health news. It’s from February 22nd. I’m going back a little bit because this really just made its way to my feeds. And I’m starting to read some stuff about it. So let me give you a little context from the story. Circulo is still very much in its early days. It’s public presence so far is a sparse homepage.

That connects to a LinkedIn page and an email address for interested. Job-seekers. Billing itself as the future of Medicaid, the company said, and in its funding announcement, that it is looking to disrupt the Medicaid managed care space by bringing bold new approaches and internet scale technology.

To Medicaid, 75 million members. It goes on. What’s noteworthy about it is the startup is its connection to olive and artificial intelligence, unicorn that automates tedious high volume administrative tasks for healthcare organizations per the announcement Circulos business will be built on the back of olive AI tech platform.

Providing the young InsureTech company with automation, intelligence, network tools and AI co-worker technologies. All of Circulos initial investors already hold positions in olive. What’s more olives CEO, Sean Lane. We’ll also be holding the reins of the new tech driven push into the Medicaid space.

, Sean has been a guest on this week in health. It, we interviewed him. At one of the conferences and he is an engaging individual Circulo is going to use Olive’s unique platform to build the Medicaid insurance company of the future from scratch right here in Columbus, Ohio.

All right. That’s all from the article. And they’re right. There is a lot of stuff out there, which is interesting. You might wonder why am I even talking about this at this point? Because I think there is a significant, so what here? So let’s start with this. If you’re not familiar with it, olive AI, we did the show. We interviewed Sean. It’s a, it’s an automation platform at scale, right? So it started out build as an RPA platform and it automated these mundane tasks.

A lot around billing and those things, but then it sort of grew into other areas. Within the healthcare ecosystem. And they’re really integrated pretty tightly into the desktop, around the health care delivery organizations that use them. They’re about somewhere between 600 and 700, health systems around the country are using them. So they.

Provide automation at scale. What they did recently was they were able to pull the information of the health systems to create even greater leverage. And it’s not necessarily that the information gets shared and meshed together, but what they’re doing is they have a working agreement amongst

the organizations that are utilizing the platform to share intelligence. All right. So as the tools get more sophisticated, they’re able to find intelligence from the platform without sharing the data across. The various health systems. But they’re able to share that intelligence across the health system. So that becomes very powerful. You’re talking about petabytes of data, which is growing at a rate of about three terabytes a day. So this thing is going to get smarter and smarter. It’s at scale it’s already in about 700 health systems across the country, and it’s going all the way down to the desktop of the providers.

All right. So you have that platform and then what you have is. All of is billing itself as a platform that startups can use to build multi-billion dollar companies. And so they have a, not talked about much fun. Around that, where they’re going to fund some startups. But they really need to prove out the concept. So.

They come up with this idea of Circulo, which is a new company. Raises $50 million right out of the gate. Same. Set of investors. And what they’re looking at is can they change the way Medicaid has done from the ground up? And if the concept is to eliminate waste and to provide a high level automation, can you think of a better target than Medicaid to go after? , they are going to be able to really change the way that claims are done. The way that the automation is done, the way that a clearing house has done the way.

That, , the payers and providers interact. Around that transaction. So, this is a $50 million proof of concept, which is going to be really fun. They’re going to prove that. Olive can support companies and building out of companies on top of this significant amount of data at scale, with these technologies at scale, you’ll be able to scale your company up very quickly because of their scale. That’s the power of a platform.

I think this is interesting for me. Because we are always talking about. Developing breakthrough technologies on top of the EHR. And there’s so many limitations and there’s so many costs of doing it. And now what you’re looking at is a non EMR centric way of doing this, you know, Ex agnostic. It’s universal.

It can bring in information from a lot of different sources. And it layers on that intelligence, the, the AI and the machine learning, the, the, uh, computer vision and all the things that olive AI brings to the table. And

it’s a really interesting way for innovators to look at this instead of having to weave their way through. The maze that is the EMR and getting all that information and even building up a lot of that tech that we’re talking about, the tech is going to be there for you to build on, and you can go at solving the problems that are facing healthcare and the insurance providers as well.

And really start to fill those gaps that exist within healthcare with highly automated, highly sophisticated, highly intelligent solutions. I think the, so what around this is, this has the potential for being a game changer. Now we are. We’re probably about two years out from naming them as a game changer, but this is definitely one to keep an eye on and definitely a different approach.

To addressing the challenges of healthcare. I think if nothing else, it’s really interesting to take a Greenfield approach. At the challenges that face Medicaid, the growing costs, the shrinking budgets for States across the board, the growing administrative burden, the denials and all the challenges in terms of the experience.

It’s interesting to take a Greenfield approach at Medicaid and see if we can’t do something really exciting.

 

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