Many patients who are prescribed medication fail to take the full dosage as scheduled by their primary care doctor, leading to further complications that burden the U.S. healthcare system. PatchRx, founded by Andrew Aertker and Gavin Buchanan in 2018, is a remote therapeutic management technology startup that delivers “smart medication compliance” hardware and software solutions for healthcare providers.
The startup has fifteen employees. Their competitors include Pillsy, Adheretech, Hero Health, Propeller Health, Medsien, and more. PatchRx’s business model consists of billing pain management clinics on a per patient basis for use of its software and hardware solutions.
Frederick Daso: You and your cofounder’s ability to focus and make the right changes to PatchRx’s core products has led to the opportunity to revolutionize patient adherence to medication in real time. The Center for Medicare & Medicaid Service (CMS) has recently changed its reimbursement billing codes for remote therapeutic management (RTM). What necessitated these changes from CMS?
Andrew Aertker: Healthcare has been shifting towards more value-based care programs in the past five years, which is excellent. These programs essentially incentivize providers and clinicians to provide better patient care and benefit when their patients are healthier. And CMS has continued to provide ways to motivate providers in this capacity. In 2019, CMS released five codes under Remote Patient Monitoring (RPM). The new Remote Therapeutic Monitoring (RTM) codes are a way to accommodate a more expansive list of services, including therapeutic and adherence monitoring. I’d hope to see continued improvements from CMS and pickup from commercial payers around these sorts of programs, as these elements can catalyze real change in US healthcare’s fractured inefficiencies.
Daso: What is the potential impact of this change for PatchRx?
Aertker: There are two ways we think about impact: through the lens of clinical value and financial value. To make effective change in healthcare, we’ve realized that you must find a way to tie together clinical efficacy and a clear financial ROI tangibly. These new codes offer PatchRx now the opportunity to do both. From a financial perspective, we can add an additional revenue stream for providers. And from a clinical perspective, we get to offer our patient-first adherence solution to keep patients healthy and on their medication as prescribed. It’s a win-win. This new coding structure allows PatchRx to expand its offering to new verticals and larger communities of patients.
Daso: How have you positioned PatchRx from both a technology and business perspective to scale effectively to validate reimbursement on the order of tens of thousands of prescriptions per month?
Aertker: Healthcare is complicated, and as a new company in the field, it’s important to be extremely precise in our strategy to build trust effectively. So, when we’re looking at how to collect reimbursement for thousands of patients or show a clinical improvement in adherence, it can’t be done unless we validate those components in single instances first. So that’s been our approach and philosophy. This year, we kicked off with some individual patients and closely monitored each facet of our service. This approach, essentially identifying each individual component of the service and working to refine each element of the operational puzzle, has allowed us to be confident as we scale up in clinics nationally.
Daso: You two claim that PatchRx is the “first adherence company.” How will you two work to become the best-in-class patient adherence solution moving forward?
Aertker: It’s a strong claim, that’s for sure. To date, most of the “adherence” companies are just pill organizers or managers – not adherence companies in the truest sense. In reality, we’re the first true adherence data company. We’re generating granular adherence data, reporting when patients take or miss meds based on when they’re prescribed and not just whether they fill or refill. And in so doing, we’re putting the patient first and allowing providers and our nursing staff to intervene in their day-to-day adherence rather than waiting for an emergency medical event to address it. We’re a preventative adherence company, not a reactionary one.
Daso: As you move from working with your current partners to a few hundred or thousand going forward, what changes will PatchRx need to make on its end to ensure that the startup continues to operate effectively at scale?
Aertker: Scaling causes inevitable growing pains that are just part of the process. We’re focused on ensuring each client and customer receives the same high-value service every time. Some slight shifts in our approaches make scaling a bit easier as we scale. Instead of accumulating more standalone partners, we are looking to expand our services to more care networks and vertically integrated institutions. This allows us to have the greatest impact on the largest number of patients.
Daso: Given your plans to expand into adjacent markets, what do you hope to learn during this stage of your company to set up PatchRx for success in its future market expansion?
Aertker: As we’re looking at new partnerships and opportunities, much of our development surrounds how we can work within CMS’s guidelines to promote better patient outcomes for the highest-risk patient populations. From an internal perspective, we also evaluate expansion through operational consistency, i.e., extending the same product offering repeatedly and evaluating whether it provides maximal benefit to the patients at that clinic or practice. As we look to expand, a huge point of emphasis is learning how to make the most meaningful impact on patient health and adherence to prescribed medication. This is the foundation on which the company was built, but it just takes a lot of data to understand the impact of that scale.
Written by Xodas.
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