Dan Brillman and Taylor Justice, Unite Us, on bridging social and health care
In this episode of the Pulse Podcast, we interview Dan Brillman and Taylor Justice, Co-Founders of Unite Us, an outcome-focused technology company that builds coordinated care networks of health and social service providers. Based out of New York, Unite Us has raised a total of $45M after their latest Series B round in March 2019, led by prominent healthcare investors Oak HC/FT, Define Ventures and Town Hall Ventures. Unite Us today has active networks in 35 states and has tripled in employees in the last year.
We cover topics from how Unite Us is supporting their partners and communities on the frontlines of the COVID-19 public health crisis, building the foundational infrastructure and network to support Public Health 2.0, as well as the lessons they gained from attending business school.
Start — 5:00: Aspirations, instant founder chemistry and the beginnings of Unite Us
- “What did you want to be when you grew up?”: Dan wanted to be an astronaut and head to space, and still does to this day. Taylor on the other hand, having grown up in Kentucky and influenced by a love of basketball in his hometown, wanted to be an NBA basketball player. His aspirations changed when he moved to Florida and was introduced to football. Taylor ended up playing college football while he attended the United States Military Academy at West Point.
- Roles in the Military, Non-Profit and Venture before founding Unite Us: Dan has been a pilot in the Air Force reserves for almost 13 years and mostly flies KC-10s. (Editor’s Note: The McDonnell Douglas KC-10 Extender is an aerial refueling tanker aircraft operated by the United States Air Force.) He also transitioned into a role in the Defense Innovation Unit, where he invests in commercial technology for the Department of Defense. After West Point, Taylor had an active duty commitment as an infantry officer in the Army at Fort Benning, GA.
- Early beginnings for Unite Us: Unfortunately, Taylor was medically discharged, but the pain points he experienced in his transition from active duty military to the civilian sector spurred the early beginnings of Unite Us. Through both Dan and Taylor’s personal experiences, they saw how inefficient it was for returning veterans to connect with the The United States Department of Veterans Affairs (VA), and locate new jobs and new places to live for their families. Seven years ago, there wasn’t a great way for organizations providing these services to communicate with one another to address an individual’s multitude of needs. Dan and Taylor knew this was a problem that needed to be solved. Through Dan’s experiences as a Principal at Scout Ventures, he was fortunate to be able to apply a lot of his knowledge about incubating and launching ideas.
- How Dan and Taylor met: While Dan attended Columbia Business School, a veterans group connected him to Taylor, a potential applicant, who was considering the program. At the time, Dan was writing a paper about the fragmentation of health and social services and how to connect them in a coordinated system, while Taylor volunteered at a Philadelphia non-profit helping veterans make a similar transition he made. At their initial meeting, they ended up talking for several hours. Taylor attended Columbia Business School, graduating a couple years after Dan. After their first meeting, the two continued to meet and talk for many hours about actually solving this problem–in 2013, Unite Us was born.
5:00–11:00: Diving into Unite Us and Social Determinants of Health
- Defining Social Determinants of Health: Social Determinants of Health drive up to 80% of health outcomes. At the end of the day, people have multiple needs at different parts of their life, whether it’s talking about vulnerable populations or specific populations, such as veterans or targeted populations. Every human has basic elements that they need to survive. You need food in your belly, a roof over your head, and a way to make income — which make up Social Determinants of Health. Everyone has those basic needs that need to be solved for.
- The problem of broken coordination between social and health outcomes: Dan and Taylor saw a gap in how people were connecting to services in their community because human and social service providers weren’t held to the same priority level as healthcare. When you look at the healthcare landscape, there are more sophisticated clinical care coordination networks, where it’s easier to connect a hospital with a specialist or a specialist with primary care. This did not exist within human and social services. Dan and Taylor wanted to extend that clinical care coordination network out into the community. With Unite Us, they can look at people holistically and not just from a clinical lens, but also look at their non-clinical needs.
- Lack of technology platforms: Human and social service providers usually aren’t leveraging sophisticated technology platforms. For example, a lot of them use manual processes such as Excel sheets and pen and paper. Unite Us is trying to bring the social services sector into the 21st century where there are very smart people that aren’t operating at the top of their license (a term usually used for clinical services but they are looking to elevate social services to the same importance) because they have to navigate a manual process and a fragmented landscape.
- How Unite Us benefits Social Determinants of Health: Health, human and social service providers are now empowered with technology tools that can connect them to appropriate complementary services such as food security and even transportation (For example, Unite Us has partnered with Lyft in March 2020 to coordinate rides to job interviews), ultimately making people and communities healthier. Unite Us allows secure, effective and coordinated sharing of people’s information across different service industries. The Unite Us platform serves as the glue for all these stakeholders by standardizing communication and by tracking outcomes of each person after they leave the four walls of any organization.
- Challenges of building the first network: In the beginning, it was a challenging feat to build structured data and create a common standard for information sharing and reporting outcomes for all these organizations in health and social services. In New York City, organizations were still using the yellow pages, paper lists and brochures for finding services. Then they would print and hand out the information to the client. There was no way to know what happened after the client received their services. They began with a promising network of 40 organizations in New York. Today there are 100+ organizations through a city-funded infrastructure to support veterans and their families. Unite Us has scaled this model across the nation and shifted into the healthcare space such as partnering with Kaiser Permanente as well, which we break down in the next section.
11:00–18:00: Who are the stakeholders and who pays for the service?
- All stakeholders have a stake: Unite Us works with multiple stakeholders that make up our nation’s public healthcare infrastructure: healthcare providers, insurers, government (state and county), social care providers and human service agencies. All these organizations want improved health outcomes, which incentivizes them to participate in this model: the stronger and more robust the network is, the more economical it is for each stakeholder. Governments are incentivized to increase access to services for their constituents. Insurers and providers are taking on value-based care arrangements and see cost-savings down the road from the positive outcomes of their patient members. “Everyone wants the patient better off, and that that’s the beauty of the model”, Dan says.
Everyone wants the patient better off, and that that’s the beauty of the model
- Patient populations served today: Unite Us first served veterans and then shifted to Medicaid. In the last 24 months, they moved into Medicare and commercial patients. When Unite Us launched in North Carolina in 2018, Unite Us’ work was at first catalyzed by Medicaid, but now serves all populations, including commercially insured under large employers.
Editor’s note: In 2018, Unite Us and United Way of North Carolina, which manages the statewide NC 2–1–1 information and referral system partnered, with support from North Carolina Department of Health and Human Services and the Foundation for Health Leadership and Innovation, to launch a joint product offering to support public, private, and nonprofit organizations addressing the social determinants of health across North Carolina.
- As Unite Us’ business has evolved, their focus now depends on the market, the partners they work with and which populations they’re trying to serve. Dan shares the importance of focusing on one population like Medicaid, getting it right and then replicating that business model to support other types of populations. Dan then walks us through how Unite Us serves an individual through the system.
18:00–21:00: Unite Us serving on the frontlines of the COVID-19 crisis
Given the current COVID-19 crisis, we are reminded more than ever of the need for reliable public health infrastructure. The virus sheds light on the immediacy for people to be tested and screened. Predicted unemployment rates are skyrocketing in unprecedented numbers unseen even in the ’08 recession.
Unite Us’ COVID-19 Response: Over the past three weeks, Dan and Taylor have been working with state government leaders, health plan and health system leaders and that there is a growing recognition that there is a second crisis — the unprecedented stress on our human and social service system. In the coming weeks and months, the need for sufficient public health infrastructure is paramount. 40% of community-based organizations (CBOs), an official term for human and social services, either have limited services or have suspended services altogether. Thus, it’s crucial to know when clients are making service referrals whether a CBO is even open and who has capacity.
Editor’s note: Unite Us has released the following resources for COVID-19:
COVID-19 Social Needs Screening: Unite Us is adding a COVID-19 screening option to identify social needs and quickly connect clients to services. With the increased need for both health and social services, it is imperative to ensure that Unite Us enhances their ability to connect people to accurate resources, avoiding unnecessary utilization of healthcare and community services.
COVID-19 Exposure Assessment: To identify individuals who may be exposed to COVID-19, Unite Us is adding an exposure assessment form that appears in every referral workflow to determine a client’s exposure to COVID-19. Depending on a client’s responses, the assessment will provide instruction to redirect them from the hospital or connect them to the appropriate local resource if they have been exposed.
Public-facing Site for Individuals in Need: In order to better connect individuals with local resources, Unite Us is updating existing public-facing websites and assistance request forms with new COVID-19 assessment questions to support individuals.
Rapid Response Networks: Unite Us is helping new communities launch rapid-response networks for the immediate crisis and providing the infrastructure for networks to grow. If your community is in need of immediate infrastructure, please check out www.UniteUs.com/join to get started.
21:00–26:00: Long term impact of COVID-19
- Perspective on the $2 Trillion COVID-19 Stimulus bill: Dan believes that the stimulus package will be a great injection not just for the infrastructure needed to ensure health and social services are connected, but also for expanding capacity needed in communities. Though he does not believe it’s the long-term solution, he believes it’s a great start in the right direction and will help spur the change that’s needed to bring those human and social service sectors to the same priority level as healthcare.
- Silver lining on the future of healthcare and social services: A lot of regulatory change is being temporarily implemented such as waiving of copayments on COVID-19 screening. Dan’s perspective from a policy standpoint is that in all of the chaos of the clinical responses, there’s a silver lining that will shed light on some of the policies that were previously thought to be too stringent or weren’t focused on interoperability, and didn’t let patients freely move through the clinical and social service landscape. As we look forward to recovery, a lot of these near-term emergency response policies can potentially be the driving force for collaboration to build a holistic system so that people do not fall through the cracks.
26:00–29:00: Unite Us growth and future vision:
Unite Us today has active networks in 35 states and has tripled in employees in the last year.
- Exciting retail partnerships such as CVS/Aetna: Dan, Taylor and the Unite Us team are super excited about the opportunity to partner with a retail organization like CVS and other health hubs because of the presence central brick and mortar locations have. They believe there is a great opportunity to bring together a clinical and non-clinical space and better serve people consistently. Across the country, 90% of the American population live within 20 miles of a CVS location. Pharmacies provide multiple and inexpensive touch points with the individual, in comparison to how many times that person sees their primary care physician.
Editor’s Note: Beginning in 2019, CVS/Aetna and UniteUs have partnered on SDoH efforts in three states, North Carolina, New Orleans and Florida. Most recently, CVS Health and Unite Us partnered through the Guardian Angel program, designed to help individuals who suffered an opioid-related overdose. Clinical case managers can use the Unite Us network of social services to connect individuals with non-clinical support that can aid their recovery, such as community resources to help with housing, food insecurity and financial assistance. Unite Us has also partnered with CVS Health on Destination: Health, a new platform addressing SDoH and helping some of Aetna’s most vulnerable Medicaid and Dual eligible members more easily access social services within their community.
- Shifting healthcare spend from the clinical to non-clinical: Unite Us began seven years ago on building the foundational infrastructure to power connectivity. Before figuring out reimbursement, there needs to be standardized data tracking. Once the foundational structure is in place, then it’s possible to build new sources of revenue for social services that are traditionally philanthropic and grant-funded. Unite Us is focused on first establishing the infrastructure needed around the country. Then they can partner with insurers and providers who are looking for better patient economics.
As their team of 100+ public health experts build the Unite Us network, on-boarding new communities and organizations, Unite Us is looking to fundamentally change the economics of the human and social services industry, and serve as the bridge between healthcare and social services.
29:00–32:00: Culture and hiring
Unite Us’ first value is “Be A Good Human,” which is about bringing on-board really good, trusted people and encouraging autonomy for them to come up with innovative ideas. Their second value is around “Teamwork.” Dan talks about hiring smart individuals with complementary skill sets and emphasizing the empathy needed to effectively build these networks and empathetically work with these agencies.
Unite Us is hiring! Unite Us is in hyper-growth phase and is looking to hire across the board to build Public Health 2.0. They have over 80+ open career roles on their website and are hiring across customer success, network development, sales, technology, product, and more. Check out the career opportunities on www.UniteUs.com/Careers.
32:00 — End: Entrepreneurship learnings from business school
- Dan’s favorite class was business law. Dan believes an MBA is helpful to gain high-level exposure to a diversity of skill sets, whether it is working on a P&L, talking about legal matters, building out best organizational practices, or learning the art of negotiation. He believes that startups really want diverse skills and the ability to think outside the box, and he thinks MBAs can bring that type of fortitude and thought process to the table.
- Taylor’s favorite class was an entrepreneurship class. Every class his professor would bring in an entrepreneur, and they would share their battle scars and be open and transparent about what they did wrong. Taylor ends with a few inspiring pieces of advice for us:
Entrepreneurship isn’t a math equation. There isn’t a blueprint on how to build a business. It’s how you react, how you build your team, how you build your culture, and that’s going to set you up for success.
If you have the passion, the will, and the self-awareness to understand your weaknesses and you can find people that fill that out, then you give yourself the best shot to be successful.