People often ask how I got into Medicare. I get excited when people ask because it gives me an excuse to talk about my Grandma, who was my guardian, caretaker, best friend, and role model. She was an exceptional lady who was 63 years old on the day of my birth and who became a single mother at 66 when my grandfather died. A few years ago Grandma had a stroke. I remember the emotions I experienced that day. The concern for her well being, the weight of responsibility to manage her care, and the fear of the unknown. It was an overwhelming experience that millions of families face each year.
Of all the complexities of managing healthcare for a loved one, I was stunned by the complexity of the insurance. I remember thinking, “Grandma is on Medicare, doesn’t the government pay for everything?” No. I quickly learned the nuances of the system and the friction points Medicare recipients face. I struggled to get even the simplest questions answered related to her coverage.
I took a step back and thought about the other families facing this problem. I had worked in health insurance, after spending several years launching Oscar Health Insurance in California. I thought my experience working in the industry would position me well to manage this crisis, yet I still felt completely inadequate. I thought about other families facing the same situation and how difficult this process must be to someone without my experience. I knew there could be a simpler way for people to manage their Medicare. This realization was the catalyst for me starting EnterMedicare.
I view Medicare as a unique opportunity to have layers of impact that are both deep and broad. You have an opportunity to impact an individual, improving their quality of life by making healthcare more transparent and accessible. You can impact an industry, one that is saddled with legacy technology infrastructure and striving to keep pace with an increasingly consumer driven market. Unlike employer based insurance, the focus of the industry for decades, Medicare is a sale and service to an individual. This requires a complete redesign of the industry's technology infrastructure.
The legacy technology of the insurer impacts everyone. Technology limitations make it harder for consumers to understand their coverage and access healthcare services, making it harder for people to access the healthcare they need. This leads to lower quality of life and worse health outcomes. The insurer is also harmed. The outdated technology leaves carriers unable to drive process efficiencies and capture additional cost savings that result from efficiency. Cost savings that can be returned back to the consumer in the form of more robust health benefits. The end result is more cost for taxpayers, because these frictions in Medicare drive up cost of care.
But it doesn’t have to be this way. This was the realization I had while sitting at the side of my grandmother’s hospital bed. It was the realization that led me to call my cofounder and long time friend Brendan and tell him it was different this time. Starting a company in Medicare wasn’t just another crazy business idea we would banter about. We are creating technology that enables a modern flow of information from insurance carriers, through distribution networks, to consumers. We deliver information from the consumer back to the insurer, improving personalization of products and services. Creating modern two way information flows has the potential to revolutionize Medicare the same way these information networks have improved so many other industries.
We have now raised millions of dollars from venture capitalists to make our vision a reality. We have attracted luminary investors such as former Google Chairman Eric Schmidt, large insurance company partners, and world class team members to join us on this journey. We all know that if we are successful, we can have a lasting impact on people’s lives and overall well being, and in the process, create a very large, long lasting company. It has been incredible to watch these pieces come together. We now enter 2020 excited to continue our mission to improve healthcare for America’s 60 million Medicare recipients.