Firefly Health wants to transform healthcare for small businesses

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  • Digital health startup Firefly Health is launching health plan for small businesses.
  • The plan is built around its virtual approach to providing primary, mental and specialist care.
  • Firefly is betting its roots in caregiving will help it compete in the crowded health plan market.

Firefly Health is betting it can revolutionize healthcare for small businesses and their workers.

The company started in 2019 providing primary care, mental health care, and specialist patient care online. Now he’s gearing up to sell a small business health plan that revolves around his virtual approach to care.

National and regional health insurers, from UnitedHealthcare to Humana to New England insurer Harvard Pilgrim Health Care, have launched virtual primary care services and plans over the past year, as people felt comfortable seeing a doctor online amid the COVID-19 pandemic.

Head of Fay Rotenberg, CEO of Firefly Health

Fay Rotenberg, CEO of Firefly Health

Firefly health


Firefly, which has raised more than $ 52 million in funding to date from investors like Andreessen Horowitz, is betting its caregiving roots and focus on helping small businesses save money will help it. to compete in the crowded health plan space.

“You don’t see people who start with this technological care and then add coverage. You see a lot of plans that focus on administration that then attach to care. Firefly CEO Fay Rotenberg told Insider.

Firefly Says Virtual Care Model and Network Help Cut Costs

Firefly patients receive care through the Firefly mobile app from teams of primary care physicians, nurse practitioners, behavioral health specialists and health guides employed by the company.

The startup is partnering with medical centers such as the Dana-Farber Cancer Institute, and specialists in cardiology, dermatology, urology,


Diabetes

, and other areas her patients can view online or visit in person. Firefly also has partnerships with emergency care centers and home care providers.

The company collects fixed amounts from health insurers to provide a patient’s primary care. Such “value-based” arrangements encourage physicians to keep patients healthy and out of hospital so they don’t waste money. Traditionally, doctors are paid based on the number of patients they see and the services they provide.

Rotenberg said patients interact with the healthcare team an average of 41 times per year through visits, messaging, and completing aspects of their care plans. This frequent contact helped encourage healthier behaviors and outcomes, she said.

For example, Firefly has reduced its patients’ emergency room visits by 53%, according to the company. The company claims to reduce patient healthcare costs by 25-30% compared to the commercial average through fewer emergency room visits, less unnecessary care, and referring patients to high-quality, lower-cost specialists.

These savings are currently benefiting health insurers, but Firefly wants to offer them to small businesses through a new health plan.

The startup launches a health plan to cover employees of small businesses

Head of Jonathan Bush, Executive Chairman of Firefly Health

Jonathan Bush, Executive Chairman of Firefly Health

Firefly health


Firefly’s long-term goal is to become the next Kaiser Permanente, but “without the bloated buildings, union contracts and the geographic trap,” said Jonathan Bush, executive chairman of Firefly.

Bush is the former CEO of electronic health records company Athenahealth and is also married to Rotenberg.

Kaiser Permanente is well known for combining caregiving with health insurance, which many healthcare providers have tried and failed.

Firefly has a long way to go. It currently serves fewer than 7,500 patients, primarily in Massachusetts.

Its new health plan, scheduled to launch on January 1, 2022, is designed for self-insured businesses with up to 2,500 employees. Self-insured businesses pay for the health care of their employees, rather than a health insurer paying them. Firefly focuses on employers in Maine, Massachusetts, and Ohio, but it can serve remote employees in other parts of the country.

These companies would pay Firefly a fixed fee per member per month. In some cases, if Firefly’s medical group cuts a company’s healthcare costs, Firefly will share those savings.

With the plan, workers don’t have to pay a share of the cost, such as a copayment, or pay a deductible when they get the care recommended by Firefly.

This is a feature that stands out in the market, as 83% of people who receive care on the job have a deductible, or an amount they have to pay out of pocket before care is covered, according to an annual survey by the Kaiser Family Foundation. These franchises have also skyrocketed over the past decade, according to the report.

Julie Yoo, general partner at Andreessen Horowitz, who invested in Firefly during its Series B cycle, told Insider that much of the innovation in digital health to reduce healthcare spending has targeted the big and the big. large employers with large human resources teams, leverage and the means to invest in health. Millions of small employers have been left behind.

Firefly is getting into the health benefits game after already showing its first virtual primary care model improves outcomes and cuts costs, Yoo said, and she’s betting it can scale nationwide .

“These guys have the ability to go beyond state lines with very little friction,” Yoo said.


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