The following interview is a conversation we had with Kyle Kiser, CEO of Arrive Health, on our podcast Category Visionaries. You can view the full episode here: Over $40 Million Raised to Improve the Value of Healthcare Through Informed Decision-Making

Kyle Kiser
Glad to be here, Brett. 

Brett
Let’s kick off with a quick summary of who you are and a bit more about your background. 

Kyle Kiser
Sure. So I’m a dad, father of two. I grew up in North Carolina, came up in the healthcare world generally. So my family’s business was primarily in employee benefits. So working with employers to provide those benefits and manage cost. Early employee, a couple of startups. So I started off in health insurance world, sort of transitioned over into the startup land after just having that experience of seeing what employers are facing and the costs that continue to mount and not seeing a ton of great answers. Right. That seems like an insurmountable problem at times. So just wanted to be a part of trying to help manage that cost and manage that risk rather than just being a part of the existing system, looking for ways to make it better and sort of led me down the startup path. 

Kyle Kiser
So I was an early employee at a couple of companies, one well talk, which is consumer engagement in healthcare. So sort of helping those who are consumers of the system more consistently engaged with the content and the pricing and the choices. And then early employed a company called Catapult Health that was doing primary care at the work site. So like bringing the doctor into the employer to do preventive checkup type things, got introduced to the sort of forming original team at what was RX review at the time and is now Arrive Health. We rebranded about a year and a half ago and been at it ever since. 

Brett
What was the company like when you first joined? And I understand you joined in 2015. 

Kyle Kiser
Yeah, there’s just a handful of us. We were all working out of a cowork space in Denver at the time. Company was founded in Denver. I was living there and one of the key co-founders is a guy named Kevin O’Brien. He is still a doctor in Denver. And what inspired all of this is his mom came to him asking for help on her out of pocket spend. And like any son with the skills to deal with such things as a doctor, he looked at her meds and has got this is a branded med with generic parts. Those two would be less expensive. Here’s one with therapeutic alternatives. Here’s one you could pill split and just sort of found these ways for her to lower her out of pocket spend. And in doing so, inspired him to start doing that at his clinic. 

Kyle Kiser
So Kevin just started doing this type of thing at his clinic with the patients he was seeing on a day to day basis, and started to manage that inside of a massive and ever growing spreadsheet and was going to turn that into a, you know, Matt, the rest of the founding crew, along the way, they convinced him that it was an API opportunity, not a book opportunity. That book, because of a bunch of things in healthcare, would have been obsolete the very first day because things changed so dynamically in healthcare. So that was sort of the outset of everything. We still to this day, have a mantra inside the company called Lucy up. And it’s our reminder to each other and to ourselves that we’re working on behalf of a problem that’s big and important and that has a real personal impact. 

Kyle Kiser
And it’s because Kevin’s mom’s name is, you know, every month we still give a Lucy up award, someone, we’ve got a belt that we pass around for the Lucy up award each month. And we’ve made the Obama hope poster out of a picture of Lucy. So it’s still really a really important part of our culture and our identity and why we get up and do this every day. And ultimately, it’s because everybody knows a lucy has a Lucy in their life. Or frankly, was the Lucy in this case that just had an experience with the healthcare system that didn’t make a lot of sense or couldn’t afford or couldn’t understand or couldn’t access. And that’s what we’re up against. That’s the problem we’re trying to solve. 

Brett
When it comes to the business model and the actual product suite that you have. Can you tell us a bit more about that? 

Kyle Kiser
Yeah. So what we do at its core is we’re providing point of care, price, transparency, insight. So in simple terms, we tell doctors how much medications cost at the point of order. Now, as technologists outside of healthcare, you may ask, well, why doesn’t that happen already? Every other point of the economy that happens. So, yeah, this is the only place in our economy where somebody else is making a purchasing decision on your behalf, and neither of you know what it costs until you’re asked to pay for it at the point of sale. And so what we’re doing is bringing that information upstream into the decision making processes, where doctors are initially selecting that medications so that they can make lower cost choices, where possible, help choose the right pharmacy. 

Kyle Kiser
There’s a lot of restrictions around pharmacy selection and which pharmacies you can and can’t go to based on payer or several other types of restrictions. So we’re bringing all of that upstream into workflow. That’s kind of core level what we do. It kind of plays out not too dissimilarly than an ad exchange. Right? Like there’s supply and demand dynamics. There’s a supply side of our network, which is the connectivity that we have established with health insurance companies and pbms and those who sort of control the prices. And then there’s demand side utilization. These are doctors making prescribing decisions, care teams sort of assisting in those prescribing decisions, and ultimately, consumers try to understand how much those things cost. So we are the network that manages that supply and demand dynamic and helps inform one side. 

Kyle Kiser
Try to make a decision with the other side’s information, which is not necessarily visible to them, depending on the use case. 

Brett
Can you give us an idea of the growth and adoption that you’re seeing right now? 

Kyle Kiser
Yeah, went from a few thousand transactions a month towards the end of 2019 to now a little over 10 million transactions a month. So we’ve been on a pretty good run. I think there’s a few things that are feeding that. One is, frankly, a big problem. And the way we pay for medications has changed a lot. Patients are asked to pay for a lot more that share that total cost. The complexity of the benefit design and the formularies associated with that has gone through the roof, but it’s really hard to understand, and it’s really expensive. And so there’s just this massive need now that making the right clinical choice also requires that you make the right cost choice. 

Kyle Kiser
Those things are just inextricably linked because of the dynamics of how we price medication, and ultimately, because the only medication that works is the one the patient can afford. So one, there’s this big problem. Patients are demanding that their providers help guide them in these ways. So that’s been a big part of our growth. The other is the CMS center for Medicare and Medicaid have now required this type of capability if you’re a part d plan. So if you’re a health plan that provides Medicare coverage for pharmacy benefits. You now are required to have what’s called a real time benefit tool, and we provide a real time benefit tool. So there’s been some helpful regulatory tailwinds on that front as well. 

Brett
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Brett
From a marketing perspective, what are you doing to really rise above all the. 

Kyle Kiser
Noise that’s out there today? B2B marketing in healthcare is tricky. It’s a really complex buyer environment. And even inside of an organization, there’s a bunch of different stakeholders that are required to buy in, and in some cases, all have veto power. So there’s this role called a chief medical informatics officer. Inside of a lot of health systems, that person is there to only represent the voice of the user, right, the doctor that might use the electronic health record software. And then there’s the chief information officer, who’s actually the one that likely is saying yay or nay on what goes into that electronic health record system. And then there are a bunch of other sort of business stakeholders depending on your use case, and we’ve got to get all of those aligned to get to a yes. 

Kyle Kiser
So the marketing voice is different for each one of those roles. Like in the user case, there’s a really important quality and objectivity argument to be made for our tools. For the chief information officers, it’s all about the ease of implementation and use and the support that we can provide so we make their lives easier, not harder. And so the marketing message is mixed, really. It has to be very specific and targeted really specifically, because otherwise it’s just too complex a sales environment to just have one big blast marketing message. 

Brett
What’s the competitive landscape look like? 

Kyle Kiser
We’ve got a couple of big incumbent types that we compete with. There’s a company called Cisrip that’s like the historical eprescribing network that we compete with, and they do have a competitive product. And then there’s the big wholesalers, like big companies that do wholesale type work or drug and hospital supplies have some competitive tools. So yeah, we’re a company of 40 competing against companies with tens of thousands of employees, but I think that’s actually been an advantage. We’ve just been able to be really user centric. In our case, that’s providers. So provider centric of solving the problems that those providers need solved, to rely on the tools, to trust the tool, to use it consistently. And that’s gone a long way. Help us win business. 

Brett
As I mentioned in the intro, you’ve raised over 40 million to date. What have you learned about fundraising throughout this journey? 

Kyle Kiser
I learned it changed a whole lot in the last six to eight months. The most important lesson for me is just to make sure we’re dealing with investors that add value beyond the capital. We’ve made a really concerted effort to work with strategic investors. Some of those have been health systems for us or their associated funds, and it’s made a huge difference. Right. It’s like a couple of things there. One is that B2B sales environment that’s complicated and hard. It’s just much easier when you’re dealing business with trusted other organizations. And so strategic partnerships were important there. Two is a few of these University of Colorado health system in Denver, UPMC and Providence. Those are folks we work with to develop product. 

Kyle Kiser
The hard part about what we do is if you’re not accessing that electronic health record and actually having hands on keyboard in some cases, it’s really difficult to build products because you don’t exactly understand the user experience or how you integrate or any of those things. So we’ve worked really closely with those health systems to gain access to systems in a way that allow us to innovate. And then the third was your face. Multi sided networks are faced with this chicken or the egg problem and you have to aggregate enough utilization to command the interest of the supply side in most cases or vice versa. 

Kyle Kiser
We really used strategic investors as a way to gain scale on the demand side so that we could then start to work really closely with the supply side to say what to work in today, what’s not, and how do we make it better. And without that type of strategic investor at the table, I don’t know that we would have overcome that first chicken or the egg moment. 

Brett
Let’s imagine that you were going out and starting a company again today from scratch. Based on everything you’ve learned so far. What would be the number one piece of advice you’d give your on? 

Kyle Kiser
Do something that you care so much about that it’s all you can think about, right? That everything is harder and slower than you think at the outset, and resilience is consistently required. And the form that resilience takes is wildly variable, dependent on stage. But the one consistent thing across the board is you got to be willing to just dig in your heels and overcome whatever’s in front of you. So you got to be working on something that really matters to you, that you care deeply about. That’s like a problem you obsess over, that you think about at the dinner table when you should be thinking about other things, which has been a gift in this business. It’s a really important problem, has a huge impact on humans, and that makes a big difference. Love that. 

Brett
Final question for you. Let’s zoom out into the future. So let’s go maybe three to five years from today. What’s the big picture vision that you’re building? 

Kyle Kiser
I mean, this sounds simple when you’re trying to describe it to a non healthcare audience, but consumer choice doesn’t exist in healthcare. Is that when eprescribing, when went from paper prescriptions to electronic prescriptions, the only time in the history of our economy that I know of where we restricted consumer choice, in every other case, it got more competitive choices, got more transparent and more numerous. And when we adopted depreciing in the first version, in this environment, it went from you being able to take your paper script walk to any pharmacy you want and get a price to that same prescription going from your point of care system to the point of sale at the pharmacy without any knowledge of what your options are. 

Kyle Kiser
So my vision is we’re going to restore consumer choice and at least prescription drugs, probably beyond that, and that it requires this new type of network to do that. So even in the eprescribing context, it’s not one node to another node anymore. It used to be from point of care to point of sale. Because of the growing complexity of the pharma supply chain, there are dozens of nodes along the way where you’ve got to get the decision right from a cost perspective and a clinical perspective on the front end, then route it. Then you’ve got to solve prior authorization, then you have to pick the right pharmacy, and may have to deal with enrollments in certain specialty enrollment type context. You may have to solve an affordability program and work with foundations or other sources of funding to help people pay for their meds. 

Kyle Kiser
It’s just this amazingly complex system that’s been created around just making the right medication decision and a network that isn’t adaptable enough and broad enough in scope to handle all of that is now required and is yet to exist. And we have an opportunity to build that network where we’re going to help influence. We’re already influencing nearly 150,000,000 of these transactions a year from a run rate perspective, and that’s only going to grow. And our ability to impact those is going to expand to include a lot of things, all the things that matter to an individual that’s faced with a high cost prescription and doesn’t know how to afford it or doesn’t know how to access it. That’s the network we’re going to build. Empowering consumers with choice again, amazing. 

Brett
I love the vision. Kyle. We are up on time, so we’re going to have to wrap here before we do. If there’s any founders that are listening in and they just want to follow along with your journey, where should they go? 

Kyle Kiser
Probably LinkedIn is probably our best buy. We’re pretty active there from a company perspective and then relatively well active there with them. Awesome. 

Brett
Kyle, thanks so much for taking the time. Really appreciate it. 

Kyle Kiser
Thank you, Brett. 

Brett
Guy, keep in touch. 

Brett
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