Todd Park, Devoted Health, on building the “American healthcare system as a service”

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Todd Park

Our guest on this episode is Todd Park. Todd is the co-founder and Executive Chairman of Devoted Health, a Medicare Advantage “payvider” providing virtual and in-home medical care for older Americans and leveraging their technology platform to drive clinical results. Founded in 2017, Devoted’s team of over 2,000 cares for nearly 124,000 members across 14 states. Todd previously served as the White House Technology Advisor and the HHS Chief Technology Officer in the Obama Administration, and was the co-founder of athenahealth and Castlight.

In this episode, I spoke with Todd about

• His entrepreneurial journey
• His time in the White House
• Why Devoted is situated to transform the healthcare experience for older Americans

Beginning to 9:36: Starting athenahealth, pivoting to a tech platform, starting Castlight and public service

Athenahealth’s mission was to help make healthcare work the way it should, by helping doctors and midwives and clinicians be their best selves

• Todd, his brother Ed Park and their friend Jonathan Bush started athenahealth when Todd was 24 years old. Athena started as a OB/GYN practice, improving maternity outcomes and reducing costs by implementing team-based care and new tech-based workflows.
• In their effort to scale this strategy, they built the first web-based practice management and physician billing software. After struggling to grow the maternity business, they pivoted athenahealth to focus on using that software to support physicians in running their businesses.

In order to actually enable the practice to survive, we built the world’s first web based practice management/billing system, and integrated with that a tech-enabled billing service that got practices paid a lot faster, for a lot less cost.

• Todd left athenahealth about a year after the company went public after determining that the culture he had helped instill would remain intact. He joined Giovanni Colella to start Castlight Health, a healthcare navigation platform that has since merged with Vera Whole Health to form apree health. However, shortly after starting Castlight, he spent over 7 years in public service, first as the Chief Technology Officer of the Department of Health and Human Services, then as the U.S. Chief Technology Officer and Assistant to the President, and finally as a Technology Advisor to the White House. Finally, in 2017, he decided to start Devoted Health with his brother Ed.

9:43–37:34: Building the many parts of Devoted, the company’s strategy, and treating every member like family

Devoted’s mission is a very, very simple and powerful one, which is to dramatically improve the health and well being of older Americans…by caring for every single person like they’re literally our own family.

• The “prime directive”, a standing order to treat every member like family, enables team members to take action without permission to support members.

What you had to build in order to guarantee the ability to deliver on that mission is an alternate universe, full-stack, American healthcare system as a service, and anything short of that was going to fail at hyper scaling, to everyone, the kind of care you want for your family.

• The goal in building Devoted was to combine the “a stitch in time saves nine” proverb with the power of modern technology. To do this Todd and the other Devoted founders found that the smallest possible product to achieve this was actually a massive undertaking.
• There are five key components of the Devoted Health platform:

1. In-house Medicare Advantage health insurance plan, optimized to deliver the best service and coverage to members
2. Devoted Health Guide, a tech-enabled “guardian angel” that navigates members through their healthcare journey
3. Contracted provider network in every community they serve
4. Prevention-focused in-house, virtual-first medical group called Devoted Medical to complement existing primary care network
5. Orinoco, their proprietary software platform that serves as the electronic medical record, the billing and claims system, and the technology driving the other four components of the Devoted ecosystem.

All of these components are designed to yield three results:

1. A member experience that features net promoter scores that compare to loved brands such as Apple, Amazon Netflix and USAA
2. 5 stars on clinical quality measures by the MA Stars program
3. Better clinical care that drives lower medical costs

They describe the experience of Devoted as the feeling of being loved, and they say it in different ways, like ‘the experience of Devoted is like getting a giant hug through the phone!’

• Part of the experience of Devoted’s intense care for members is a responsive engagement by members in their own health outcomes. Members recount stories of continuous outreach from Devoted (prompted by their risk surveillance) and how those interactions changed their health behaviors.
• This process also includes goal-setting called Patient Priorities Care, focused on activities of living rather than clinical outcomes.

We learned from Athena that if you don’t control how healthcare is paid for, it’s really hard to change its delivery.

• Devoted built all of these components at the same time to eliminate the dependencies on legacy systems. The lesson of athenahealth was that controlling how healthcare is paid for directly impacts a company’s ability to direct care.

I would characterize this as 100 times more ambition than athena, and athena was plenty ambitious.

• Todd credits the ability to build all of these complex components as once to being a middle-aged entrepreneur who has the experience, network and capital to manage these moving parts.
• Building in-house is also credited for the rapid success of Devoted MA plans. Devoted plans have reached 4, 4.5 and 5 star ratings, including plans in Ohio that achieved 5 stars in their first year of eligibility. For reference fewer than 10 percent of new MA plans receive 4 stars or higher in their first year of eligibility.

Devoted did not proceed by building each layer of the 5-layer stack sequentially…that makes it an incredibly ambitious play…that requires a level of capital investment that is different from, say, a SaaS company.

• The multifaceted bottoms-up product build that Todd described earlier is also the driver of the major capital raises Devoted raised in their first few years. Over three funding rounds from October 2018 to October 2021, Devoted raised nearly $2 billion, most recently in a $1.15B series D round led by Uprising and the Softbank Vision Fund 2.

37:35 to end: Public service, working alongside his brother Ed, and advice for young professionals

[After public service]…Devoted was the only mission that didn’t feel like a letdown

• Todd spent 7 years in the U.S. government between HHS and the White House. The only “downside” of public service he notes is that nothing in the private sector can match scale of impact one can have
• Devoted Health, both the solution and its scale, is in many ways a continuation of Todd’s public service mission.

[Ed is] just the most extraordinary human being and he would be my #1 draft pick to build anything. The fact that he’s also my brother is a gift…I get to work with the dream partner.

• Devoted is Todd’s 3rd endeavor working with his brother Ed (after athenahealth and Castlight). He describes it as “the best thing ever”.
• Todd serves as Devoted Health’s Executive Chairman, which he describes as a “beyond full time” job, unlike the typical board member. He didn’t believe a co-CEO role would be more effective.
• In addition Ed’s deep experience in the healthcare industry made him extremely well-prepared to step into the CEO role at Devoted.
• Todd asks young professionals to not settle for the right role and to not wait for the to have the impact they’re focused on. Fall in love with the thing you do, and don’t settle for anything less.

To see all of the roles Devoted Health is hiring for, check out their careers site.

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