Sigal Atzmon, Founder & CEO, Medix Global explains the value proposition of their B2B2C healthcare management solutions model, their India strategy, how COVID-19 will impact the sector, and the kind of ventures their corporate investment arm Medix Ventures is partnering with, in an interaction with Viveka Roychowdhury
Across the world, healthcare costs are increasing and governments are working to reduce costs of medicines, as well as hospitalisations. What has been Medix’s business model as a medical management solutions company since its inception in 2006 over the past 16 years and how does it play into the overall bid to make quality healthcare delivery more affordable, accessible and improve clinical outcomes? Does it replace or supplement existing healthcare systems?
Medix’ primary business model which offers reach and also creates a wider impact through strategic partnerships with large health and life insurance companies, large corporates and employers and public health organisations. Since its establishment in 2006, Medix has been providing innovative healthcare management solutions that strike the balance of ensuring accessibility of quality medical care and better outcomes for our customers while also avoiding overuse and misuse of medical resources which in-turn are known to drive up medical cost inflation.
Unwarranted healthcare variations in care unfortunately exist between regions, countries, cities, hospitals and even between doctors in the same city or in the same hospital. By applying a holistic, multidisciplinary and structured prevention and disease management process which provides a personalised approach to each case, Medix’ services, help standardise and reduce these inequalities of care and create a more sustainable and affordable healthcare landscape, while increasing focus on quality. A win for everyone, patients, providers and payers alike.
Our unique business model allows us to provide services that are human and digitally enhanced, with a strong impact for the end customer while offering a significant differentiator, competitive advantage to our strategic partners an added value and competitive advantage. Since 2006 we are proud to have embedded a successful B2B2C model. We do not replace existing healthcare systems in any way but rather provide patients with customer centric added value services that empower them to best navigate their medical journey.
Which are the major markets for Medix, in terms of revenue share? What has been the CAGR and the targeted growth for this CY/FY?
Medix’ client base includes over 5 million customers spread across 90 countries. Our main markets are Europe, the Middle East and Asia Pacific. We have recently established our first office in India and see this as a very important and strategic market for us. We are planning for more offices across India.
What are the USPs of Medix, vis a vis other global telehealth providers?
First, it is important to clarify that Medix does not provide the typical, direct telehealth consultations but rather goes way beyond that. Our services range (depending on the region, country) from our Prevention & Early Detection Service which focuses on managing risks of developing cancer, cardiovascular, stroke and diabetes all the way to the award winning Medix’ Personal Medical Case Management service. In certain markets we also provide disease and rehabilitation management, mental health and home care. All of our services include the implementation of a process which is aimed to provide customers with tangible and actionable tools to manage their health.
If we look, for example, at Personal Medical Case Management, in comparison to a traditional medical second opinion service which is provided by many specialists locally and internationally, we can see how Medix’ Case Management is differentiated and more aligned with what customers expect and really need, when facing a serious medical condition.
All of our services have a form of Digital Health solution embedded in the service, yet alongside a remote human touch. More than ever people are looking for impactful, advanced health services that they can access from the comfort and the safety of their home. Medix has in the past years, well before the pandemic has spurred the demand for on demand, remote care, developed digital health solutions, along with having medical and operational teams on the ground in the many countries it operates in. This combination, with our long and proven track record in the healthcare space has put Medix at the forefront and fully ready to service our customers in over 90 countries around the world during these challenging COVID-19 times.
It is important to emphasise though, that Medix does not provide any form of physical treatment, nor replaces the patient’s treating physician but rather empowers the patient with the tools, the advice, support and information he needs, to make informed decisions and have access to the best care possible.
Medix has set up base in India, in July 2020. How has the COVID-19 pandemic impacted the launch/rollout of services and partnerships in India?
These are indeed challenging times yet Medix has seen tremendous growth and demand for its services all across our markets. Although the pandemic has a terrible impact on human life and economies worldwide, we also believe it represents a significant opportunity as COVID-19 has emphasised the importance and need for a refreshed view of healthcare landscape, of how healthcare is provided and consumed.
Between travel restrictions, overburdened healthcare systems and people simply afraid of going to see their doctor, patients in India and across the globe have been delaying or have not been able to access tests and treatments that can be detrimental to their health. Hence, we are seeing an increased interest and demand for services like personal medical case management. Prevention is also finally receiving its right attention. Many focus now on getting healthier.
Given the scarcity of doctors, the high out-of-pocket expenses and low health insurance penetration in India, what is the value proposition of Medix to patients, hospitals, doctors and the overall healthcare system in India?
Over the past 20 years, healthcare has seen tremendous advances in technology, treatment modalities, genetic research, targeted medicine an abundance of medical information and more. People live longer with many diseases, e.g. cancer, which has become a chronic condition for many.
But does this mean that everyone is receiving better care at all times? Not necessarily. We are also seeing more overuse, misuse and adverse events and of course a significant increase in spending (public and private alike). Medical cost inflation has become unbearable for governments, insurers and the people alike. Believing that access to care is a basic human right, as a society, we cannot let this happen. As health insurance penetration is still low in India, this is definitely an area that needs to attention.
Medix is fully committed to drive accessibility and quality medical care, along with penetration of health insurance. We do believe that we will start seeing higher penetration rates in the coming years and at Medix. The pandemic has also accelerated this process.
It is Medix’ opinion that all stakeholders in the healthcare industry need to work together and apply a shared value approach to ensure accessibility (quality driven accessibility) and sustainability (affordability) of the healthcare eco-system. Therefore, we are constantly seeking to develop and launch new and innovative services that will strike that balance; of improving accessibility and medical outcomes, while at the same time helping to lower costs and reduce medical cost inflation, making healthcare accessible to all.
As for accessibility which is a major challenge in the Indian healthcare landscape, we seek to address this by providing people with services that they can access from anywhere they are, be it at home or at work.
Medix operates in 90 countries, what are the learnings that can be applied to India, especially with disruptions due to the COVID-19 pandemic?
COVID-19 is still very much with us and we are seeing third and fourth waves from Hong Kong to Italy; the impacts and learning are vast. While certain countries, primarily in Asia have done very well in containing the virus by applying very strict social distancing measures, mask wearing and promoting personal hand hygiene, unfortunately, many countries are still dealing with impacts of the second or third waves. The denser the country, the more challenging it is.
Countries, specifically hospitals, should be better prepared and healthcare systems better budgeted in the future, as even if we will be saved by the upcoming vaccines that have already been approved by certain regulators, the world might be hit again other pandemics. On the preventative side, actions need to be undertaken, so that populations will be better prepared. One of the most significant lessons learned is the need to urgently further develop and implement digital health and AI based services that can improve healthcare services to masses at an affordable price, without burdening hospitals and clinics.
Walk us through a typical patient/care giver’s interaction with Medix from sign up, diagnosis, treatment plan, treatment to recovery. What are the costs of such services and the value add for patients?
We have various services for our clients at Medix. We can share an example of a previous client Mr. Chawla (name changed) and his experience with us for better understanding. Mr. Chawla was a healthy 61-year-old gentleman until one day he suffered from a sudden episode of weakness, cold sweats and dizziness. He was admitted to the hospital where tests revealed an irregular heartbeat, known as arrhythmia, which was thought to explain his symptoms. Further examinations also detected two incidental findings in his brain, a mild dilation of an artery known as cerebral aneurysm, and a small brain tumour called a meningioma that was most probably benign.
As the episode of weakness did not reoccur and Mr. Chawla felt fine, he was released from the hospital and was asked to return for check-up in three months. Upon return, he still felt as good as ever. Despite the fact that he was feeling better, the treating doctors suggested he undergo three major procedures: Gamma Knife surgery – a precise radiation treatment to his brain to treat his meningioma, an endovascular coiling – a procedure which involves reaching the brain via a catheter from his groin to treat his aneurysm, and an implantation of a pacemaker to treat his arrhythmia. Overwhelmed by the numerous surgical procedures recommended, Mr. Chawla turned to Medix for guidance.
Medix appointed a dedicated Personal Medical Case Management team to coordinate and serve as the focal point for Mr. Chawla’s case. After speaking with Mr. Chawla, they helped consolidate all of his medical information sent his imaging to a leading radiologist for revision. The medical reports and radiologist consultation were then sent to a leading cardiologist and an internationally renowned neurologist in order to ensure that a comprehensive and multidisciplinary approach is applied.
The cardiologist explained to Mr. Chawla that his arrhythmia was not life-threatening and that in fact, it can be treated by standard medication. The medication would also ensure that the weakness and dizziness episode does not reoccur, while allowing him to maintain his daily routine and to stay implant-free.
The neurologist reviewed all of Mr. Chawla’s information and concluded that the brain findings were completely incidental and unrelated to the episode. He explained that both the small aneurysm and the meningioma are long standing pathologies with minimal risk of complications.
He strongly objected to both recommended procedures, while providing updated medical literature and guidelines to show that they have limited benefits in Mr. Chawla’s condition – while the aneurysm had only a 0.4 per cent chance of rupture within the next five years, treating it would have a 5-15 per cent chance of complications.
Instead, the neurologist recommended that Mr. Chawla be monitored by an annual MRI to track for any signs of progression, and actively take precautions such as reducing stress and blood pressure.
During the entire journey, Mr. Chawla’s dedicated doctor and nurse were there to answer of all his questions, explain the options, empowering him to make the right decisions and access proper care. He was provided with on-going support during a period of a few months, and his side effects from starting oral medication as treatment was monitored.
One of the main gaps in healthcare systems the world over is a lack of a single point of contact, a focal point that will consolidate, ensure all options are evaluated and help the patient navigate through their medical journey and make the right decisions for them. That is exactly the gap that Medix’ Personal Medical Case Management fills.
Give us more details on Medix Ventures, the VC fund. What was the rationale for this venture? What will be the criteria for Medix to choose investees within the digital health space and who are the investees as of now?
Medix Ventures is Medix corporate investment arm, and was established after realising that investing in the healthcare and specifically the digital health space, is not like investing in any other industry. We constantly meet and interact with very interesting and disruptive startups who have developed amazing technology but don’t always have the operational medical setup and understanding of the intricacies of the healthcare landscapes which are a must when it comes to the healthcare space.
This is not a traditional VC fund but more of a corporate investment arm that invests in companies that have a strategic alignment with Medix’ healthcare, shared value vision and service offerings. We do not invest in medical devices or pharma companies as we do not have a specific added value there and cycles are very long. We are looking for innovative companies that apply data driven analytics and AI, to increase accessibility of care and patient engagement, health IT applications that can streamline workflows and increase efficiencies and technologies that allow for remote home monitoring and care provision.
We offer our portfolio companies more than just funding but also mentorship, guidance, support and the ability to partner with Medix and reach a very wide global customer base. We become strategic partners rather than just financial investors.
Health insurance is slowly seeing an increase in India, thanks to the pandemic. But how can this be more affordable for patients? How will it impact the bottom lines of hospitals? And is there a sustainable model for healthcare insurers?
As mentioned before, at Medix, we believe that healthcare is a basic human right and all stakeholders in the industry, need to do their respective part in order to increase accessibility and affordability. We are happy to see the increased penetration and believe that this trend will continue. Digital health will be a major driver of accessibility and affordability.
The Government of India has also recently announced various plans and a push towards digitising and advancing the healthcare landscape and this too will help drive the disruption needed. Given the complexities of the Indian market, insurers need to look very closely at product design to ensure relevancy and also affordability. The only way to have a sustainable landscape is through alignment of efforts and interests between payers, providers and regulators to ensure that all different patients can have the care they deserve.