Caring for his mom after she was hospitalized for a serious lung condition gave Vijay Kedar a new perspective on just how fragmented home care can be. He co-founded Tomorrow Health with the goal of improving coordination between hospitals, insurers and companies that provide home care services.
With $25 million in new funding, he plans to start by making it easier for people to get needed medical equipment and supplies for home care.
“Today that is a category that is particularly complex and challenging for patients to manage,” Kedar said in a Zoom interview. “There’s tremendous variation across insurance benefit designs and coverage guidelines.
It can be difficult for patients to tell which device actually addresses their condition, and who carries it. For example, someone might get a prescription for a CPAP machine, but a person with chronic obstructive pulmonary disease might need a different machine than a person with sleep apnea.
Kedar experienced these challenges personally while caring for his mom, who spent four weeks in the ICU battling acute respiratory distress syndrome while she was being treated for cancer. Going home was a huge relief — but also a big transition. She needed a year of intensive home-based care, including portable oxygen, physical therapy and respiratory therapy.
“Despite being in healthcare myself, and growing up in a family of physicians, I could not have imagined how challenging that process would be for our family,” Kedar said.
One of the biggest challenges was that there was very little guidance on what was covered by insurance, and what equipment would be the best suited for what she needed. It took six weeks to get her the equipment that she needed, faxing forms back and forth, getting prior authorization from insurers. During that waiting period, she had to be readmitted back to the hospital.
Thankfully, her cancer is in remission today.
Kedar, an early employee at insurance startup Oscar Health, saw the same challenges from a different viewpoint when he returned to work.
“I often found it was difficult to coordinate medical equipment, supplies and services patients needed, especially when we were discharging folks from the hospital,” he said.
To start, Tomorrow Health is building out a platform to streamline the process of getting those services. It gives people a list of suppliers based on their insurance coverage, location, and product specialization, and hires care advocates to provide additional support.
Since Kedar launched the platform a year ago, it’s currently available in 29 states. So far, Tomorrow Health has struck partnerships with 125 health plans and hospital systems. In January, the company began working with Geisinger Health Plan to provide medical equipment and supplies to its patients across the state of Pennsylvania.
Andreessen Horowitz led Tomorrow Health’s recent funding round, with participation from Obvious Ventures and BoxGroup. Julie Yoo, a general partner at Andreessen Horowitz, will join the company’s board.
In the long-term, Kedar’s goal is to coordinate a broader range of home-based care services. Other companies also see a similar opportunity. Earlier this year, WellSky bought care coordination software company CarePort for $1.35 billion, with the goal of smoothening the handoff between hospitals and post-acute care providers — including home-based care services.
“This past year has seen a tremendous increase in the need for home-based healthcare,” Kedar said. “The challenge that has persisted is the fragmentation… Our overarching vision is that a patient like my mother could be discharged from the hospital, and turn to one trusted partner like Tomorrow Health for the full breadth of home-based care needs.”
Photo credit: SDI Productions, Getty Images
Correction: This article has been updated to reflect that Tomorrow Health’s platform is available in 29 states.
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Source: https://medcitynews.com/2021/04/after-his-own-experience-tomorrow-health-founder-looks-to-make-home-care-easier-to-navigate/
