Manifest co-founder Dr. Aaron Friedkin:
AF: We found that if we can bring that type of solutions and strategic consultation and support what was typically only available to the largest employers, we want to bring that down market to smaller employers. And to do that, we had to create some sort of density so that we actually had enough scale to make this work. And our approach was to focus on specific geographies where we could create a kind of ground swell of interest from employers that have common needs and work across the different insurance companies, work across the different benefits agencies by the whole idea of just creating demand. And then we could seek out high value, high quality providers that are in their local communities and be the facilitation engine to figure out how do we create those connections so that the employers can actually better partner with the providers that are in their backyard. What a lot of employers don't appreciate is they're purchasing health plans from the insurance agencies, and those health plans have these broad networks, and providers charge different fees within those networks. They have different quality within those networks, and the employers are somewhat removed from understanding the dynamic. Rick and I, given our backgrounds working on the health plans, we understand the characteristics of a provider practice that we know is going to not just drive higher quality, but lower cost. And our goal was to facilitate the connection, so those employers can understand what those practices are, and then preferentially try to direct their members and their employees and educate them to use those provider partners. In parallel, the provider partners would love to be able to work more directly with the employers, but they've kind of been shielded from that. So we're essentially facilitating that connectivity. And the beauty of this is: you don't have to change your health insurance company. You don't have to do anything massively disruptive. It's more how do you leverage the local partners in a more kind of strategic and thoughtful manner.
DM: It's sort of like a custom local package within what you already maybe have set up. Is that accurate?
AF: That's exactly right. When I was describing this to a friend of mine, and so I'll give him credit for this, basically he said, you're kind of teaching the employers how to hack their health plan. You know, it's like, how do you help them understand the best way to use the health plan that you have already purchased and help your employees use that so that you get the outcomes that you want and you can lower your costs? Oftentimes you purchase a health insurance plan or you partner with an insurance company to give you access to this big network, but you don't necessarily know the best way to utilize it, and you don't have the mechanism to partner with the people that are ultimately delivering care for your population.
DM: You announced a new partnership with Capnik Insurance. Tell me a little bit about how that fits into the matrix
AF:Yeah, so what we realized, and we've been really fortunate about the kind of ground swell from the employers, not just from the providers, but from any of the benefits agents, um, that operate in the Michigan market. Capnik is, I think, a prime example of this. So, its a benefits agency that works with employers to help them purchase insurance products, purchaseself-funded plan offerings so that they can support their populations. And basically what the partnership with Capnik is - and we're in conversations with a number of other benefits agencies – is: how can we play this role that we just talked about for them on behalf of their customers? So what this allows us to do is work alongside the Capnikc team when they're going out and speaking to their employer partners, to educate them on this provider collective that we've put together. And between the benefits agents, us, the health plan and the employer, we all think about how do we put together the right parts and pieces to make things optimal for this specific employer. And we basically are playing the role of when it comes time to say, hey, we actually think we'd like to have a more strategic relationship with one of these providers that Manifest is identifying, we're facilitating those arrangements, and we're basically providing the oversight to make sure that it works the way that all the parties kind of want to make sure.
DM: You mentioned starting in Grand Rapids, now spreading to Michigan, and I would assume more partners being added in the future. Tell me a little bit about where we see this going.
AF: Yeah, it's interesting. You know, we we announced the company a little over six months ago. And to be honest, we weren't even planning on announcing it until after the first of the year, but as we were going out anddoing fact finding and exploring things, the moment we even started talking about this, people would say, how fast can you start to bring this to market? We're very interested. So we actually were fortunate to have that momentum behind us to start moving. And we were originally very just focused on Grand Rapids. As soon as people started hearing about this, they said, how soon can you bring this to Southeast Michigan and Detroit? So, we're fortunate that we actually have some of our current provider partners that are in the southeast Michigan area. I can't tell you who, but we just signed a very large specialty practice in Southeast Michigan, actually, who we will announce shortly. Capnik is actually based in southeast Michigan, but they have now been expanding into the Grand Rapids area. So, our goal is to cover as much of the state of Michigan as possible. prove this model out. And then you know, we'll see where it goes. We think that this is something that it's probably not applicable to every market in healthcare, but many markets in the country, I think this could be a blueprint for. Right now, we're just focused on supporting the needs of these employers and provider partners in Michigan. All of them have signed up because they believe in what we're trying to do, so we want to ensure that we can realize that value for them. But we do think this is something that, if it catches on, it could be an interesting model for other geographies as well. I think both of us are very candid about this. We both built and deployed a lot of things that we thought would work and they didn't work. And a lot of the thesis for manifest was based off the lessons learned. And I think the biggest thing that you'll hear both of us mention is, we've kind of coined this idea, like “evolution, not revolution.” Lots of people will talk about wanting to blow up the system and start from scratch. And while that sounds great, and it might get you headlines here or there, in reality, we've taken a step back to say, how do you work with the parts and pieces in the system today? And just figure out how do you optimize the use of those things? And we really do think that that's going to be the way that if we do want change to happen, the way that's that's what's going to lead to change. And again, it's from a lot of battle scars and lessons learned of things not to do that we hope that we can share those insights with others so that they don't have to, you know, live through the pain that we've lived through.
DM: We do a lot of business stories, economic stories, and we often hear about the partnerships in West Michigan, the public/private and the businesses working with each other and different agencies in a way that you don't necessarily see other places, even in the state. There does seem to be the willingness to collaborate sort of across different genres of business.
AF: I currently live in Chicago, but I've been a three-time Michigan resident, between my undergraduate time in the University of Michigan. my residency and then when I was working at Blue Cross Michigan. I spent less time historically on the west side of the state. And I will tell you, it does feel different than what I'm what I've experienced previously. And that's not to put down, you know, Southeast Michigan. But I think you hit the nail on the head that this eagerness to collaborate, and also this strong desire for innovation and thinking about, well, there's a problem. What can we do to actually fix this problem and not just admire the problem that has been very refreshing? And to be honest, that's the type of stuff that has pushed us to move faster within the Manifest journey so far.
