Colin Quinn, President of Included Health Communities & Co-Founder of Included Health, on building patient-centric healthcare experiences

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Colin Quinn, President of Included Health Communities and Co-Founder of Included Health

In this episode, I sat down with Colin Quinn, President of Included Health Communities & Co-Founder of Included Health. Colin started Included Health in 2019 to improve care equity for underserved populations, starting with LGBTQ+ individuals. In May 2021, the recently merged Grand Rounds, a care navigation company, and Doctor On Demand, a virtual care company, acquired Included Health. In October 2021, the new entity rebranded as Included Health, which provides integrated navigation and virtual care across everyday and urgent care, primary care, behavioral health, and specialty care.

As President of Included Health Communities, Colin leads the organization’s work on health equity and raising the standard of care for underserved populations. The company’s first offering, which we discuss in-depth in the episode, is tailored to the LGBTQ+ population. Colin and his team are also working on a solution designed to serve the black community’s needs.

Colin and I discuss:

• His path to founding Included Health and how his prior experiences at a Fortune 500 company and a startup prepared him to start his own company
• His decision to sell to employers as well as how employer healthcare purchasers’ priorities have evolved in recent years
• What Colin and his team learned from the research study they conducted and how its findings influenced the company’s trajectory and product strategy
• Why partnering with Grand Rounds and Doctor On Demand made sense for Included Health and why the new entity took on his original company’s name
• What it will take to rebuild trust in healthcare amongst populations for which that trust has been broken

Beginning to 10:57: Colin’s early career

• Entry into healthcare: Colin and I began our conversation looking back to his graduation from Indianapolis’ Butler University. He graduated during the 2008 financial crisis and recalls the stress surrounding his and his peers’ job searches. Although Colin didn’t know much about healthcare, he sensed the industry was relatively stable and not going anywhere considering the rapidly aging US population. These observations led him to join Eli Lilly, a Fortune 500 pharmaceutical company headquartered in Indianapolis, where the company is a household name. Colin felt proud and honored (and relieved!) to have landed a job at such a widely respected company.
• Early career experiences: Colin shared how his career experiences prior to founding Included Health were foundational to becoming an entrepreneur. His ten years at Lilly taught him critical skills including how to be a good professional and run a successful business. More specifically, he learned about business problems, process and procedure, and the sorts of infrastructure organizations need to thrive.
• Reflecting in business school: After spending a number of years at Lilly, Colin got his MBA at Stanford GSB. He took this opportunity to reflect on his career and think about what he really wanted to be when he grew up. For example, he found that while he enjoyed finance, it wasn’t the right long-term career path for him. He found himself interested in working more closely with patients. Aspects of entrepreneurship also kept surfacing, so he spent time in school opening his eyes up to what entrepreneurship really meant.
• Transitioning to a startup: After school, Colin returned to Lilly where he worked in sales, marketing, and general management roles. He got firsthand experience as a sales rep, engaged with providers and their offices, and supported patient populations. After ten years at Lilly, Colin left the 40,000-person global organization for Hometeam, an ~65-person startup that was reimagining how older adults get healthcare. It was a completely new and different environment, but that’s what he wanted — “a different slice and flavor of healthcare.” He also began thinking about starting his own company and saw gaining startup experience as an important prerequisite. In classic startup fashion, Colin led many different parts of the organization and witnessed multiple business model pivots. Together, his experiences at Lilly and Hometeam prepared him to start Included Health in 2019.

“I think each of the experiences lended something different to my overall preparedness to become a founder and CEO. I gained something different from each of those experiences.”

10:57 to 21:54: Included Health’s early days

• Included Health’s mission: Included Health sought to create a better healthcare experience for underserved populations, a mission rooted in Colin’s experience navigating the healthcare system as a gay man. At the time, due to the rollback of the ACA, there were a lot of threats facing the LGBTQ+ population’s access to healthcare including denials of care and discrimination. Colin believes that healthcare should be a safe space for everyone regardless of their health needs or background, and he was confident that a better experience could be had.
• Figuring out the business model: To determine how Included Health could best serve the market, Colin conducted a research study with LGBTQ+ employees at Fortune 100 companies. He wanted the company’s value prop to be rooted in data rather than his hypotheses about what he thought the population needed. He set out to identify the main health disparities this population faced and how their ideal healthcare experience differed from the one offered today.
• Key research findings: The data from the study revealed that LGBTQ+ individuals cannot find providers who meet their needs. They experience discrimination when seeking care, leading them to avoid getting care and feel a loss of trust. As expected, this pattern leads to worse health outcomes and more expensive care. For example, someone who doesn’t have a PCP because they haven’t found one who meets their needs is more likely to go to the ER, an expensive site of care compared to a clinic, when they need medical attention. Using this insight, Colin decided that building a tailored, wraparound navigation and advocacy offering powered by a dedicated care team was the best way to serve the LGBTQ+ population. The care team would be composed of LGBTQ+ individuals, plus allies, to create a safe and welcoming environment. Services focused on three core areas:

1. Connecting members to in-network providers who deliver affirming and clinically competent care
2. Understanding health needs of the LGBTQ+ population
3. Providing benefits routing and navigation

• Holistic care: Colin had also learned that for the LGBTQ+ population, healthcare often extends beyond traditional means into lifestyle and wellness issues. This could include supporting an employee who is coming out in the workplace or connecting the parent of an LGBTQ+ person to a local PFLAG chapter. Included Health can also support these sorts of situations, which sets it up to be an end-to-end support system for the LGBTQ+ community and family members.
• Selling to employers: I asked Colin why he decided to sell to employers. He explained that although many digital health companies start B2C in order to build out a use case and find product-market fit, he and his team completed the research and learning before launching that many companies do after launching. So, they had already built a strong business case, making them equipped to bypass the B2C step. Also, Colin found that employers were really looking for a solution like Included Health’s offering at the time, and he wanted to roll out the solution nationwide due to the population’s high level of need.

“Looking back over the past couple years, it’s really been a cultural awakening for many. Whether that was the pandemic where we saw an increase in social isolation…rising behavioral health and mental health needs…not engaging with health care because [it might not be] safe for us even [to] go into the doctor’s office at the time…to the murder of George Floyd and the continued racial bias that we see in the health care system and across the country…it’s really given HR benefits buyers an opportunity to rethink their benefits strategy.”

• Evolving employer priorities: Colin shared that he’s seen many employers undergo a cultural awakening over the last few years. The pandemic, rising awareness of behavioral health needs, and growing recognition of the racial biases that exist in our healthcare system and beyond have led organizational leaders to rethink benefits strategies. They’ve started conducting equity studies and assessments to determine if all employees can access benefits. Findings show that access is not equal and that experiences with available benefits vary widely, leading employers to accept that a one-size-fits-all approach doesn’t work.

21:54–34:46: Included Health Today

• Expansion beyond commercially-insured populations: I asked Colin if Included Health plans to expand beyond partnering with commercially-insured populations since those with government-sponsored insurance — Medicare and Medicaid — are often the highest need populations. He shared that this expansion strategy aligns well with the company’s long-term strategy. Its approach has been to start by demonstrating product-market fit in the employer market and then expand to health plans. Colin noted that educating employers on issues of health equity and access was an important initial step. We should expect some exciting news on the payor front in the coming months!
• Importance of shared values: In response to my question about how Colin knew that partnering with Grand Rounds and Doctor On Demand was the right move, he described that it came down to alignment of values. Moreover, the magnitude of mission and values overlap between the three companies was “a little bit scary.” Doctor On Demand’s best-in-class virtual care offering, Grand Rounds’ leading navigation and expert medical advice platform, and Included Health’s focus on underserved populations made the leaders confident that together they could deliver a seamless experience.

“From a naming perspective, [I’m] really excited and honored that the organization chose to pick our name. It has much greater meaning and is able to live on longer and have larger impacts than I had originally envisioned…It does fit in really nicely [in]to our overall mission of raising the standard of healthcare for everyone, where we envision and believe in a world where all healthcare services are included for individuals, for all people, regardless of who you are, regardless of where you live, regardless of what your healthcare need is.”

• Naming the new organization: Colin felt honored that this new entity went with his company’s name. The decision is a testament to the organization’s mission to raise the standard of healthcare for everyone, where all healthcare services are available to all people regardless of who they are, where they live, and the types of healthcare they need.
• Included Health Community and Colin’s role: Colin leads Included Health Communities, the division of the organization focused on underserved populations. Its first product is for the LGBTQ+ community, and the second one, launching soon, is for the black community. The company will continue to develop products and tailor navigation advocacy offerings for other underserved populations with unmet needs. Colin focuses on the organization’s go-to-market and member experience strategies and ensuring that it delivers high-touch experiences to its diverse set of clients.
• Product evolution: While Included Health Communities’ core product remains similar to what Colin’s team had initially built (e.g., value prop, buyer), they have continued to upgrade the product’s technology capabilities. Today, there’s a member-facing app and experience paired with a care team. Post-merger, the team can also offer expert medical opinion thanks to Grand Rounds’ and Doctor On Demand’s offerings.
• Building a provider directory: Colin did a lot of research into how to build the most useful provider directory, a tool that underpins the company’s navigation capabilities, for the LGBTQ+ population. He found that members of the community typically rely on referrals from friends to find doctors. Other directories have been created through self-attestation from providers, but there’s no way to verify if the providers are being truthful or fully understand what affirming care entails. Today, to fill the top of the funnel, Included Health takes a crowdsourced approach, going to the LGBTQ+ community to find which providers they’ve seen and who has met their needs. Then, they go a step further to figure out why someone recommends a particular provider.
• Eye towards clinical competence: In addition to looking for providers who create safe and welcoming environments for members, the team also screens providers for clinical competence. Providers who pass Included Health’s proprietary scoring index are added to the directory.

34:46 — End: Future of healthcare

• Breakdown of trust: I asked Colin about what’s required to restore trust with populations who have had their trust in the healthcare system broken. He shared that his company’s survey found that 40% of LGBTQ+ individuals have faced discrimination when seeking healthcare, leading 35% of them to not use the system. Simply, they decide to give up on healthcare because they don’t know who to trust. A similar pattern is observed in the black community. Included Health has found that 50% of black employees have experienced a negative healthcare interaction and are postponing or avoiding care.
• How Included Health rebuilds trust: To solve this problem of broken trust, Included Health focuses on improving every aspect of the member experience. They have member representatives from the communities they serve, who help members feel safe picking up the phone and calling because they’ll be welcomed by someone with a shared experience. Then, they make sure that team members can speak the same language as members, respect members’ pronouns, and understand cultural differences or norms. Finally, they connect members with culturally affirming, high-quality, in-network providers. By showing up at each stage in the healthcare journey, Included Health is slowly but surely rebuilding that trust.

“It’s really going to take all of us, forcing big healthcare to really move in this direction…smaller startups and innovative companies can really influence the direction and speed at which [the industry moves]. But we need everybody in the ecosystem to participate and join in.”

• Three recommendations for the healthcare industry: Colin closed with three recommendations for building a more equitable healthcare system:

1. Collect and report health equity data, which has historically been a blind spot in healthcare
2. Provide member-centric experiences that reflect the needs of a population
3. Make virtual care available to alleviate provider shortages in certain geographies or fears about going into an office for certain types of care

We are so appreciative to Colin for joining us on this episode of The Pulse Podcast! Subscribe to our new releases on Twitter, Spotify or Apple podcasts.