Episode Transcript
[00:00:02] Speaker A: Welcome to Align for Impact. I'm your host, Matthew Naylor. I started this podcast because healthcare and leadership both come down to the same thing. Alignment. When people, purpose and performance connect, real impact happens.
On this show, we'll talk with entrepreneurs, brokers and change makers who are challenging what is broken in healthcare and in business and find new ways to make a difference for companies, communities and the people they serve.
So, Ahmed, welcome to the show.
[00:00:41] Speaker B: Thank you.
[00:00:42] Speaker A: It's a real pleasure to have you here today.
You know, this is about alignment and impact.
I love what Handel Health is doing. I love, love, love young entrepreneurs and I love to start our conversation around just your journey, like, where'd you grow up?
You know, and let's just start there and then I'd really love to learn a little bit about how you built your career.
[00:01:04] Speaker B: Yeah, sure thing.
So I, I'm Middle Eastern by background, Egyptian. I was born in Kuwait and my father was actually a. I come from a family of pharmacists and my father was a sales guy for Roche Pharmaceuticals. And so I was exposed very early on into the healthcare ecosystem. We immigrated to New Zealand when I was about five or seven years old, something sometime around that. And at that point in time it was really about moving to a new country and like resettling.
And through that process I was able to make some fantastic friends and really embrace the New Zealand culture.
I did all my schooling there and ended up going to college in New Zealand to be a pharmacist because it was a rite of passage in my family.
I from there actually moved into an acute hospital setting, is where I started my career as a pharmacist. And I absolutely love being in that environment. And it gave me exposure to so many facets of how the healthcare ecosystem works, but also some of the failures of the ecosystem, like the fact that clinicians spend so much of their time not providing patient care and dealing with administrative inefficiencies. And so I was always attracted to trying to find ways to work smarter, to optimize how we treated patients and really focused on outcomes. And through that process that led me actually to go back to business school where I did a business degree with a focus on health management primarily. And through that process I actually ended up going into consulting for a small boutique consultancy, actually who was headed up by the former Director general of the New Zealand health system.
That's the highest non political post, who was effectively accountable and responsible for not only designing but also funding New Zealand's health system.
And so Stephen is his name and I learned so much from Stephen about his experience in running large health systems, but also designing entire ecosystems of physicians, nurses, really to focus on how do you create more effective care pathways with an emphasis on population health and really improving outcomes. And through that process, I feel like I learned so much in the three or four years that. That I was working with Stephen. And then we were actually acquired as a firm by Ernst and Young.
[00:03:26] Speaker A: Wow.
[00:03:27] Speaker B: And. Yeah, yeah, yeah. So I spent close to a decade of my career working with ey really, really focused.
[00:03:34] Speaker A: Did you stay in New Zealand or did you transition out?
[00:03:37] Speaker B: Uh, so I was in New Zealand for about two years after we joined ey, and then I realized that it was a global firm that had access to offices all over. All over the world. So I ended up doing a stint in Australia and from there moved to the UK for about four years.
[00:03:56] Speaker A: What did you do in Australia?
[00:03:57] Speaker B: Yeah, so I was. I did a. Funny you mentioned that. I actually, my first project in Australia was in a place called Rockhampton. They.
It's in Queensland and they're known as beef country.
[00:04:09] Speaker A: Okay.
[00:04:10] Speaker B: Farming. It was the first time I actually got to spend time at a rodeo.
[00:04:12] Speaker A: Really?
[00:04:13] Speaker B: Yes, I had steak at rodeo, which was such an experience. Yeah, yeah, that's great. Yeah. It. It gave me exposure, actually, to the challenges of working in rural and remote settings.
[00:04:23] Speaker A: Okay.
[00:04:23] Speaker B: And how important it is to invest in the appropriate healthcare infrastructure in that setting. And so the hospital there was struggling financially and so we came in and did a financial turnaround for them and I made some fantastic friends and managed to make my way all the way up to Hamilton island, which is a beautiful place just off of Cairns. If you ever go, I would highly recommend.
[00:04:43] Speaker A: Yeah, I've never been, but it sounds like a wonderful place.
[00:04:45] Speaker B: Yeah, yeah, yeah, it really was.
Anyway, so from. From Australia moved. Moved to the UK and with. With that, the NHS is such a fantastic healthcare system with a.
It's absolutely amazing to go to the UK and, and see how the British people believe so strongly in what they. What they do at the nhs, you know, and. And it's almost like it's built into the way they see the world, that it is important that you provide impact and give back to your community through healthcare. And so with EY in the uk, we actually did a full redesign of the entire healthcare ecosystem in Southeast Kentucky.
And through that process got to really understand what it meant to build hospitals, to close hospitals, to reallocate funding into community healthcare settings, to focus on prevention and primary care.
And through that process, I was getting really tired of the cold weather in the uk and a buddy of mine I met at the London office at ey, and he was asking me if I would consider moving to the US and so I said, you know what? As long as I can see the sun every day, I'll do it.
[00:05:59] Speaker A: Nice.
Little rainy.
[00:06:02] Speaker B: Yeah, yeah.
[00:06:03] Speaker A: The weather's a little iffy over there. I got it, I got it. Yeah. What part of the US did you move to?
[00:06:08] Speaker B: Los Angeles.
[00:06:09] Speaker A: Wow.
[00:06:10] Speaker B: Yeah.
[00:06:10] Speaker A: That's a big, big transition.
[00:06:12] Speaker B: Huge. Yes, yes, yes. But I got.
[00:06:15] Speaker A: So you got sun, like in London, maybe like three months of the year,
[00:06:18] Speaker B: four months of the year, maybe two weeks.
[00:06:21] Speaker A: You move to LA and you get sun every day of the year Besides, like maybe 60 days.
[00:06:24] Speaker B: Yes, exactly, exactly. So when I got to LA, it was rugby on the beach three times a week, touch rugby. Because I'm getting older and I can't handle those tackles anymore. But that was, that was really it. And so with ey, I spent about two and a half years really continuing the same, same sort of strategy that I had deployed across the nhs. But I learned very quickly that the US healthcare ecosystem, so different. Right.
And the challenges that I think America faces, being such a large country, but also having a private and public system and some of the perverse incentives that exist within the market were so eye opening to me. And my first encounter with the US healthcare system was actually for an annual physical and I received an $800 bill in the mail.
And so I asked my friend, I was like, why did I receive this bill and what's going on? And the response she gave me, my friend being my co founder actually was, oh, that's just American healthcare.
[00:07:24] Speaker A: Wow.
[00:07:24] Speaker B: And like, excuse me, what do you mean? Like, oh, we, we all, we all just know that the healthcare system will get you and it's just part of being. Huh. And yeah.
[00:07:35] Speaker A: And what was, you know, with Handle Health, you know, you worked in like a real big corporate setting, you know, very large E and Y is a. An amazing business, a very successful company.
They do a lot of wonderful things to go from EMY and the safety net of a large organization to deciding you wanted to put all your blue chips in and be an entrepreneur and build a business on your own.
Just share that experience. What did that feel like? What did it look like for you?
What happened?
[00:08:14] Speaker B: It's funny, when I talk about it, I. I always, always knew I wanted to start a company and believe it or not, I always knew I wanted to do it in America.
And people asked me why and I can't really give you a straight answer. I think partly I knew that the American healthcare system was so big, but there was also access to fantastic capital and resources and innovation.
And so my background in government settings is that you're always constrained by cash and so innovation becomes difficult to do. And so when I, when I made the decision to, to leave ey, it was largely because I had this burning issue with this bill that I had. And the more people I spoke to, the more they, they just shared the same sentiment that my co founder did. And I've always been somebody who is driven by purpose. I, I, I believe that if you wake up every day and can deliver 150% of yourself to something you feel extremely passionate about, that is, that is to me, nirvana. That is what I believe we exist for. And so with that said, I'll be honest, we didn't do much planning.
[00:09:27] Speaker A: Typical entrepreneur.
[00:09:28] Speaker B: I get it.
[00:09:29] Speaker A: You don't learn any of that in business school. You know, you're like, okay, we're gonna go over to the deep end. Here we go.
[00:09:34] Speaker B: Yeah, yeah, yeah. So being a pharmacist, I was used to writing research projects and research studies. And so the first thing I knew we needed was capital.
And so what we ended up doing was actually applying for a grant through the National Institute of Health under the SBIR program, Small Business Innovation Research. And not many people know about this, but it is a program designed to help folks who are, who are interested in scientific based businesses. And because we were interested in price transparency and it was tied to legislation, we were able to make a case that said, we believe that the data published under the transparency and coverage has the ability or the potential to fundamentally change the landscape of US Health care. And we think that that can benefit American enterprises and consumers at large. And so our commitment through that research was essentially to understand if this data had value and how it could be applied.
And the rest is history.
[00:10:28] Speaker A: And after you, you know, after you got that grant and you started getting things off the ground, you know, capital's important to continuing to grow businesses and invest in a business.
You know, did you do anything?
Did what was next for you?
[00:10:43] Speaker B: Yeah, yeah. So the next thing that, that we did after so doing the research was, was really comfortable, you know, and, and you're right, I had the, the history of, of working in a, in a big brand organization where actually opening doors for clients was, it was a breeze because people knew the logo at Handle it was completely different.
And I think the biggest wake up call I had was just understanding that Goodwill is built over time and credibility is so important. And so we wanted to speak to customers early and understand what experiences they had. But even that was challenging. Right. And so we actually ended up using our research as a mechanism of interviewing others and getting advice from our future clients on how this data could be applied to their settings. And I think the framing of, I'm not trying to sell you anything, I want to understand what your problems are and if there is anything that I'm focused on that might be helpful for you. That was such an enabler for us to get in front of the people that ultimately became our clients in the future.
[00:11:49] Speaker A: And Ahmed Handle Health is sitting at, I think, such an interesting intersection of the employer, health space and healthcare here in the US Your thesis around the business. What, what was your original vision, your goal, the design of what you wanted to build and why?
[00:12:09] Speaker B: Yeah, so through our research, when we talked to a, we talked to a variety of enterprises, but we also talked to a lot of consumers. And the one thing that kept on coming up was our, I wish somebody would just handle it for me. Hence the name Handle help. Right. And so our original thesis was actually, we'll focus on the consumer and we will create an integrated data ecosystem around that consumer.
And we want to empower them to become informed and active consumers of their healthcare. And we can do that by ensuring that everybody is able to access affordable healthcare that is ultimately going to drive better outcomes. So that was the thesis. Right.
What we ended up learning very quickly, however, is that the US healthcare system is operated by some very large businesses. It's a B2B ecosystem. Right. And so as consumers, ultimately we are hamstrung by our ability to make decisions based on the plans that we have access to and also the choices that the organizations we work for make around healthcare. And so we very quickly learned that we needed to move upstream in order to drive this idea of empowering consumers to access good healthcare and get good outcomes for a price that they could afford. We needed to move upstream and start to actually impact how plans were designed and how networks were configured. And so the vision became, what if we could make a platform that enabled custom health plans to become the mainstream? And when I say custom health plans, the industry knows them as alternative health plans or non traditional health plans. But the idea being focus on value, focus on consumer experience and remove the headache out of healthcare.
[00:13:56] Speaker A: Yeah. And so you're, Ahmed, you're not talking about ICRA minimum value plans, minimum essential benefits, like alternative benefit plans. You're. You're what you're really talking about is how do you develop, design and build a solution?
So a consumer that is in a major medical plan, self funded, level funded, a high performing captive program where they have access to data, access to information, and can make better decisions faster.
[00:14:23] Speaker B: Exactly.
[00:14:24] Speaker A: So what are, you know, what are the three or four pillars of your business? What differentiates you from everybody else?
[00:14:31] Speaker B: Yeah, so we start with a data foundation, and that data foundation includes a number of key pieces. So obviously the transparency legislation and all of the contracted rates. So every doctor, every network, we're able to tell you what their negotiated rate is with the insurance carrier. So what is the unit price that they pay? And what we've done is we've overlaid on top of that quality information about the provider. But what we've been able to do is link that quality information not only to that individual doctor, but also the places that they work.
And people often ask me, well, why does that matter? And I say, well, if you look at the data, the data will tell you two things. There isn't necessarily a correlation between a doctor's quality and the cost that you end up paying. Nor is there an awareness that a doctor who is excellent in terms of their quality of care can work at two locations. And that can cost your employer four times as much as.
[00:15:26] Speaker A: How is that?
Can you explain that?
[00:15:28] Speaker B: Yeah, of course. Yes. So it's all got to do with how healthcare is billed in America.
You have your professional services, right, which is the physician fee, but then you have your facility fees. And as you would expect, a hospital has high overheads. They have ICUs, cardiology units. So if you go and receive care at an outpatient hospital department, this is not always the case, but most often you'll end up finding that you'll be looking to pay somewhere between two to three times more for the facility charge.
So if that exact same physician provided that service or procedure at a lower cost setting or lower acuity setting, like an ambulatory surgery center or an office or similar, you're not paying the large facility fee. So we, we found something that we thought was not difficult to necessarily implement and it could actually create hard $roi pretty immediately.
[00:16:22] Speaker A: Sounds like it's hard to implement though, on a standalone basis.
[00:16:26] Speaker B: Yes, yes. And so the pillars of handles platform really come back to how can we support the ecosystem? When I talk about the ecosystem, I'm talking about brokers, who we see as the orchestrators of health plans and administrators, whether that's a TPA or an insurance carrier, who we see as Ultimately, the executors of the health plan vision. Right? And so we power both of the segments, call them, with an analytics platform that supports evaluating networks and providers as well as connecting that into a navigation experience, which allows our broker partners or our health plan partners to really design plans that are focused on value. And what I mean by that is, how might I tier my benefits, how might I innovate my plan design? How might I provide different financial incentives like a dynamic copay or $0 deductible to make it easy for members to navigate the ecosystem, but most importantly, to understand that if they go to a certain location over another, there is either going to be a nice carrot where they pay nothing, or they need to be also partly accountable for the fact that the employer, the plan sponsor, does pay different depending on where they go. And so we've forced this education mechanism through that second pillar, which is all about how you connect your navigation to your plan design.
And the third pillar is really all about monitoring. How can you ensure that the plan design that you enacted is actually creating the change you intended? But most importantly, linked to that, how do you ensure that you are only paying reasonable plan member expenses? The fiduciary hats that employers wear today are significant and they are required by law to make sure that they are judicious about how they spend money. And so we have a repricing engine that is able to, in real time, as claims come through, reprice those claims and not only tell you, did you pay according to contract? But also tell you, is your plan design actually creating the change that we intended it to? And so through that process of iteration, we're actually able to re tier providers. If we believe that an initial provider was operating really effectively, but actually the treatment patterns change, we're able to retear them without changing the plan design because the plan design is already tiered. Right. And so this continuous cycle of learning and iteration has been one of the most important parts, because I think you always go out with a thesis and you must iterate very quickly. And historically that only happened annually and we've been able to do it much more frequently than that.
[00:18:58] Speaker A: And Ahmed, how many people do you have on the team today? You know, as an entrepreneur, it's like you start out with yourself and maybe one partner and you have this little idea, maybe you have some little problems, and then all of a sudden you're like, wow, kind of getting on a flywheel here. Where is the business today?
[00:19:13] Speaker B: Yeah, so I think we just hired our 31st person. So we're 31 people all up, which is crazy to think, right? And we have some. Some pretty exciting plans this year to scale our team to about 60.
And part of that is just investing in our growth and making sure that we have the brand awareness out there in the market. But the most important part for me is actually the technology. The technology and the service that we wrap around it to make sure that the intended goal is achieved.
[00:19:42] Speaker A: And as a young entrepreneur and an aspiring person, to build a business that has real alignment and real impact.
Where do you see the business going? What does success look like for you if you look at a year, two, three, four, five years from now?
[00:19:56] Speaker B: Yeah. It's funny, we often talk at Handle about what is the North Star? What what is. What is the. What is the place that we want to take this company? And for me, I want Handle to be the universal platform that is used by every broker, every health plan, tpa to design non traditional medical plans at scale. We believe that non traditional medical plans, alternative health plans, should become the status quo because everybody cares about value and it's difficult to enable today beyond that. However, a lot of people call me crazy for this, but I think there is a world whereby we will create such a connected data ecosystem that we can actually personalize health plans down to the individual person.
So my plan design might actually be different than yours because my.
The ecosystem that supports me understands the medical conditions I have, the medical conditions I may be prone to. My preference is around how to engage with care.
And so we think that through the use of AI, there is a world where actually you can have dynamic plan designs that are tailored to the individual. And so that's, that's, that's the goal I have.
[00:21:06] Speaker A: I love it. I love it. Ahmed, what questions did I not ask you?
[00:21:11] Speaker B: Oh, I think you did a fantastic job of actually covering off all questions. So I have. I have nothing further to add, but thank you.
[00:21:19] Speaker A: Well, I really enjoyed having you on the show. It's been a great time and I'm looking forward to continuing our relationship.
[00:21:23] Speaker B: Thank you so much. Thank you for having me.
[00:21:28] Speaker A: This is Matthew Naylor. You've been listening to Aligned for Impact.
