This January, Transcarent announced they raised $200 million in Series C funding. Additionally, they have partnered with Northwell Health, Intermountain Healthcare, and Rush Medical Center in its mission to change the healthcare industry. CEO Glen Tullman outlined the vision of Transcarent and how they are in creating a quality care experience.
According to Tullman, Transcarent was built with urgency to solve an urgent problem in healthcare.
"Every day, people aren't getting the care they need. They're paying too much for the care. We're denying care. We have a broken healthcare system," Tullman said.
Today, co-insurance healthcare costs are the single largest reason for personal bankruptcy in the United States. People are having surgeries and treatments without understanding their personal obligations.
Concurrently, some of the largest payers in the country are making record profits and denying a record number of claims, he explained.
Acting in urgency, Transcarent had plans to raise capital in 2022; however, they did not expect it in the last two weeks of 2021.
An unsolicited term sheet offered 200 million dollars, and after speaking with other potential investors, Transcarent had four term sheets--allowing the organization to raise capital.
"There was tremendous interest. We have incredible investors and those investors span both financial investors and also some important strategic investors, partners, customers. But we were very pleased," he said.
Transcarent's aims to create a new type of healthcare experience for members, clients, and providers alike. They collaborate with self-insured employers or government agencies to connect two sides of healthcare: health consumers and those providing care.
This is how the organization's unique model for health systems and providers was created. Transcarent pays for surgeries in advance, offering a bundled price so providers know what they are getting paid. In exchange, providers must deliver a high-quality experience.
New investors like Michael Dowling, Northwell Health CEO, acknowledge Transcarent as truly valuing the high-quality work providers can offer--being the first to also pay them upfront for that level of care. This is an opportunity that all types of health professionals can partner with Transcarent for.
"The new model extends not just from the experience that we create for our members, not just for the unique savings and quality that we provide for our clients and self-insured employers, but also for the people who do the work," he said.
Health systems represent five of the top ten largest employers in every state. Transcarent is pleased to have many of these systems joining as customers of this model.
A broken system cannot be navigated, which is why Transcarent does not describe itself as a navigator.
"Navigators today spend 20% of their time talking about bills. We don't even have bills. Navigators spend time trying to figure out where you should go. We've invested millions of dollars to come up with algorithms that help us figure out what is the highest quality experience we can create," Tullman compared.
To ensure a quality experience, Transcarent considers if care is necessary, the best facility to send patients, and provider quality. Members receive this and get to decide what they want to do.
Transcarent puts health consumers in charge of their experience by providing unbiased information.
"We're giving you trusted guidance because nobody is paying us to send you anywhere; [we're] not taking rebates from not taking fees. We're simply providing you the best options. And then, last but not least, when you choose, we're making it easy for you to get that care," Tullman said.
Ultimately, Tullman and the Trannscarent team offer the future for healthcare, focusing on giving the best quality care and helping people get healthy.
After their Series C raised $200 million dollars, Transcarent focuses on transforming four specific areas of the health industry: prescription costs, surgical costs, care at home, and complex care.
Transcarent believes people are paying more for both co-pays and overall prescription costs. This is why the company is partnering with Walmart to change the way people access prescriptions.
Consumers often have prescription co-pays that cost more than the drug itself, Tullman explained. Transcarent is working to either eliminate co-pays in these situations or have consumers pay the lower of the two costs.
Another situation the company is working to identify is saving consumers money on overall prescription costs. However, it is not about the money to Transcarent; instead, it is a matter of accessibility. As prices and co-pays decrease, care is more accessible.
"This is an equity issue. We have to make healthcare more affordable," he said.
Transcarent has joined with BridgeHealth, which is a leader in surgical solutions. Already offering high-quality care options at lower costs, Transcarent is learning from a decade of experience.
The organization now presents consumers with local options for high-quality providers and different site options. The options available vary depending on the type of care a member needs.
In the end, Transcarent's main focus is quality, making it a company he trusts his family to use.
"I actually trust that our people will always put quality first. There may be cases where quality costs more, [but] so be it. We think, on average across the board, that quality actually pays. It's the right thing to do. And it ultimately results in lower costs," he said.
A significant amount of care in hospitals is deliverable at home. Patients often prefer home care but believe they cannot afford it. On average, at-home care with a private health professional costs 30% less and is safer, according to Tullman.
By offering care at home, Transcarent gives members more choices and options for quality care at a lower price--all while avoiding a hospital facility. The organization is partnering with local health systems to provide these services.
This is a primary way Transcarent aims to inform consumers better, which leads to a better care experience.