After strong year, TailorMed looks to help more patients, hospitals with financial needs

Vince King recounted the story of a boy tossing starfish back into the ocean as the tide was going out.

An older man saw the boy and told the youth that he couldn’t save them all. The boy tossed a starfish into the water and said, “But I saved that one.”

King, the chief commercial officer of TailorMed, likened that story to the approach of hospitals and health systems in aiding patients in financial need. While hospitals have helped some individuals who have struggled to pay medical bills, King said many haven’t taken a wider look at the problem.

“That was always sort of our approach to financial aid, financial assistance, what patient, we could do one at a time. We felt really good about doing that, which was good work,” King told Chief Healthcare Executive. “The technology is now available where we can help most of them.”

TailorMed offers software solutions to hospitals and healthcare organizations to help patients find programs to assist them with their medical bills. And the company is touting its strong results in 2022.

Over the past year, TailorMed said it secured $1.75 billion in patient funding, from resources such as drug companies’ co-pay assistance to charitable funds. Since the company’s founding in 2016, TailorMed says it has secured more than $2.9 billion. TailorMed says it is now providing its solutions to more than 500 hospitals, more than 1,000 clinics, and nearly 600 pharmacies. The company’s clients include Providence Health, UnityPoint Health, Yale-New Haven Health, and Advocate Aurora Health.

“I’m incredibly proud that 2022 was such a landmark year for the company,” Srulik Dvorsky, CEO and co-founder of TailorMed, said in a news release.

(See part of our conversation with Vince King at the HLTH Conference. The story continues below.)

Looking for growth

In the near future, TailorMed aims to find ways to help more patients get the help they need, King said in an interview at the HLTH Conference in November. “We think about affordability,” he says. “In that context, how many patients can we help is our number one driver.”

“Over the next 18-36 months, we’ll continue to grow out that network,” King said. “So fundamentally, our core belief is no constituent on the value chain can do this alone. Providers need pharma, retail pharmacies need pharma, patients need all of it. Hospital administrators are thinking differently about who they partner with and how they partner.’

“We’re creating that network, that ecosystem, for folks to really lean on each other and support the patient and drive outcomes,” he said.

TailorMed also aims to do more beyond helping patients pay for prescriptions and medical bills, including nutrition assistance, he said.

Health systems need to take a broader view of patient needs and opportunities to help them. By helping patients find assistance earlier, they can avoid racking up hefty medical debt.

Some systems may do a good job in helping cancer patients find assistance, King said, but they should look at the bigger picture.

“There are so many other patients that could take advantage of medication assistance,” King said. “If we just step back and look at every prescription, where it’s written and dispensed, and narrow the funnel to find out, who’s eligible, who’s appropriate, what is the timing of that, and how do we engage with them today.

“You can take a holistic view of the organization,” King said. “And that is really the conversation with health providers. You’re asking them to think about it a little differently.”

Hospitals and healthcare organizations haven’t had a lack of will to help those with financial needs, King said, but he pointed to the growing workloads as an obstacle. He noted pharmacists are now administering vaccinations.

“So in doing that, we reduce the time they have to look at other opportunities, for financial assistance or nutrition assistance or other things,” King said.

Clinical and financial benefits

It’s time for health systems to look more broadly, and use technology to engage all of their patients and help them see what help is available, he said.

The goal is to “prioritize patients that are in a higher risk situation financially or clinically, and put them at the front of the line to make sure that we're helping them at the right time, under the right circumstances,” King said.

By taking that approach, health systems can also improve their own finances, he adds. From a business perspective, King said TailorMed can hit on a host of key performance indicators.

“The clear ones are revenue increase,” he said. “For the system, we directly increase revenue. We increase cost avoidance. They’re managing some of these things and we can do it cheaper and better. Those are hard, tangible dollars that they’ll receive.”

Beyond the financial benefits, health systems can see better clinical results by helping patients with their financial needs.

“If I remove the cost for medication,” he said, “can I get that patient on therapy more quickly? Can I get them to adhere to their therapy throughout the treatment protocol?

“Do I increase outcomes? Do I reduce readmission rates?”

When patients struggle financially, they aren’t the only ones who are affected, he said.

“When that patient chooses rent over medication, that has a downstream impact to your physician, who now cannot get that patient on treatment,” King said. “That patient doesn’t adhere to treatment. They’re missing cycles of medication, so I’m not driving the value-based outcome I want to drive. The patient’s having a poorer experience, clinically and financially.”

Many Americans have deferred treatment due to cost. About four in 10 Americans (38%) deferred care due to cost concerns in 2022, the highest since Gallup began polling on that question in 2001.

As many health systems and patients are struggling financially, TailorMed sees a greater role for the company’s services.

“There are more patients to help certainly,” King said. “We can broaden our reach and we can engage with more patients. Providers are going to struggle, and that’s a bad thing. And if we can help connect the dots there to get some assistance, it’ll be good for our business and good for their business as well.

“We very much think about ourselves as sort of that connective tissue,” King said. “There will be more opportunity for people searching for assistance.”