HIStalk Interviews Jeff Smith, CEO, Bamboo Health

Jeff Smith, MBA, MIB is CEO of Bamboo Health of Louisville, KY.

Tell me about yourself and the company.

I have successfully led multiple startups to market-leading companies that have served payers, pharmacists, and providers. I have found that with a relentless focus on the customer and their needs, you can exceed expectations. While at Lumeris, I led the value-based care enablement business. We worked with health systems and independent physicians to transform their financial and clinical model towards value-based care. That required strategies and tactics that were data-driven, team alignment, and clinical innovation to get to better outcomes in the communities we serve coast to coast. At CVS Health, I led enterprise strategy acquisition, physician connectivity, and population health. I was responsible for working with leaders across the business to develop innovative strategies and translate those into technology-enabled services at the point of care decision-making with the physician office and the pharmacy. That was focused on a scaled, innovative approach across the US for a Fortune 50 business.

Bamboo Health works across the healthcare ecosystem. We have the ability to share what we call critical information through our Smart Signals network. We do that by connecting with more than a billion patient encounters across the United States annually through 2,500 hospitals, 8,000 post-acute facilities, 25,000 pharmacies, 32 health plans, and 50 state governments. It’s a broad reach of the ecosystem, enabling admit-discharge-transfer alerts, bed capacity and availability, insights around where patients can receive care, and valuable prescription drug information down to the point of care as well as at the pharmacy. We do that across more than a million acute and ambulatory providers as well. It’s a broad reach on which we will build our strategy to help individuals across the country.

What has changed since the early days of the pandemic when it quickly became obvious, particularly from a public health standpoint, that our lack of real-time capacity and patient information hampered decision-making?

That’s part of the reason that I joined Bamboo Health. I saw that they had these hundreds of millions of critical moments that were occurring every year at the physician level, point of care, at the hospital admit or discharge, or in the pharmacy. Bamboo’s network has the capacity to be real time. It presents an opportunity for us to branch out from being just a technology company into a technology-enabled services company to connect those individuals, when those critical moments are occurring, to the care they need.

How will drug chains and other retailers fit into a system that has been based around health systems and physician practices?

The value-based care movement is creating companies, or is challenging companies to rethink their strategies as well, as what the end-to-end delivery of care looks like for these individuals. The CVS organization has created  strong vertical integration of everything from insurance all the way to pharmaceutical dispensing and engagement at the filling of those prescriptions. That will present an opportunity and a challenge for many of the existing players to rethink the overall value chain and how they can participate and drive value going forward. 

What’s most critical here is that we keep the patient and what’s best for them in mind and determine how everybody can contribute to the end result of what value-based care is trying to achieve, which is a better experience, a better financial outcome, and overall quality for that patient.

With all these new players requiring clinicians even as more of them quit their professions, how will we shift the design of the system to address clinician scarcity?

The solution is ensuring that people are operating at top of license and that we are efficiently connecting individuals to the care that they need at the right location for the right value for the patient in the system. That will be central to the Bamboo strategy and is seminal for us going forward to be successful as a country and fighting these high cost trends and quality challenges we have.

How will AI contribute?

It will be about information assist versus artificial intelligence actually taking the action. We have started to see here at Bamboo, and I’ve experienced this in other companies, a leapfrog moment for the healthcare delivery system in the United States. The ability to leverage vast amounts of information and be able to create an information assist environment — whether it be for physicians, pharmacists, or even the patient — presents an incredible opportunity for us all to drive greater quality of information that will be presented to all of those different stakeholders, along with an opportunity to create greater efficiency among the system itself and get to the highest value outcomes more quickly.

How do you set a company direction that involves AI when it changes significantly literally every day?

That’s why information assist is the correct framing for the healthcare community versus artificial intelligence that actually takes the action. As we see the future unfolding over the next several years at Bamboo Health, we have these millions of critical health moments occurring. We need to take all of the information that we have through our network and have those manifest themselves in the best next action for the patient. We can turn these seminal moments into an information assist moment for the healthcare providers to help them take that next best action.

We are focused on whole-person care at Bamboo Health. That means prioritizing the entire patient, including behavioral health, in the hundreds of millions of critical moments that occur each year. For example, an elderly woman is brought to the ED by her family after she has ingested a large number of pills. The ED physician will have certain suspicions around what she’s suffering from, such as depression, lack of sleep, or other life pressures. These individuals with severe to moderate mental health or maybe drug addiction issues show up into these points of care, and unfortunately, hospitals don’t have the infrastructure to help them.

The doctor at that moment could create direct access for that patient through what I would call the Bamboo Bridge or maybe some type of easy button, where they would be able to connect that patient to a caregiver in that moment who can serve up information to help them assess that patient. Then imagine that a Bamboo Health care navigator springs into action based on that easy button from the physician, where they can directly assess the patient with the information that we have and that’s provided to us. They can help determine the level of care that is required and then schedule, for example, this woman into a mental health care moment as a follow-up.

We have now been able to efficiently capture a critical moment and connect that physician so they can make a decision based on the information that we either serve up to them or to a Bamboo care navigator who will be more informed because of the information assist that occurs. Now that patient gets connected to the right next step, right next moment of care, and then the physician can feel like the next best action has occurred and that patient is better teed up for their next step with care that’s going to occur. We are getting to a state where we are able to help that patient navigate the system and providing the level of care at each step that is more complete, more informed, and helps that caregiver in the limited time that they have be able to make better decisions on the next best step for that patient.

Many people, especially younger ones, prefer episodic interventions over having an ongoing relationship with a primary care provider who quarterbacks their health needs. Could that next best action concept serve as a technology substitute for an ongoing provider relationship?

Our healthcare system needs to meet the patient where they are. What I’ve seen is that at least around value-based care, you need a quarterback of that care that the patient is attributed to. What’s critical here is that we think about some of these patients in behavioral health, where there’s not enough infrastructure around that primary care provider who has this patient attributed to them. This is something that I think the government is recognizing, that there hasn’t been sufficient reimbursement for physicians who are treating those with depression. They have made some changes to the reimbursement model and ensuring that there are enough dollars to those who are providing care for some of these complex patients that have comorbidities.

To your question, the technology should be part of that infrastructure and providing that information assist for these patients, so that not only are we identifying and engaging, but also helping nudge the patient towards the right actions as they move through their life and through the care delivery system going forward. I see it as complementary, and it likely will be different based on the type of patient and individual that we’re treating.

A healthy individual will have different needs than somebody with behavioral health and the complexities associated with that. The top 5% of patients drive about 50% of healthcare costs. Those patients in that 5%, as we see based on primary and secondary data, have behavioral health issues. These individuals will require more infrastructure and more care, particularly given the comorbidities they have. A patient that has substance use abuse may also have chronic kidney disease. Of those that have chronic kidney disease, one study found that almost 50% have symptoms of depression and anxiety. They also likely have heightened hypertension and diabetes. How are we creating an infrastructure and a care around that patient to engage them based on the different points that they engage in the healthcare community?

Part of our mission at Bamboo is that we want to work with these individuals who have these needs and then take advantage of all these seminal moments, working with our care partners — physicians, pharmacists, the care teams — to best engage that patient along each step of the way. I hope that if we can do that, that technology can nudge them into that next best action. Where I’m particularly excited about is that given the opportunity to engage some of these patients earlier in their disease or as we start to see certain habits emerge, we can more rapidly connect them upstream to these care providers to get them the care that they need. That will help the patient and the families that are trying to get them to a better state down the road.

As a company with private equity backing and an acquisitive history, what are the challenges for younger companies that might be running out of financial runway and opportunities for companies like Bamboo? 

Bamboo is very strong in terms of the current state of the company and our future growth prospects. I feel confident with the involvement of our backers Clearlake Capital and Insight Partners, with $100 billion of capital. Healthcare providers are looking for a turnkey solution to their problems. Bamboo is well positioned, given our customer base and the solution we already have in place, to find partners to supplement what we’re able to do today to create a better turnkey solution for our customers and the patients that we look to serve and exceed their expectations every day.

I came here because of the personal calling that I saw observing the healthcare system and where it is today. We have an opportunity to reduce the suffering that people are experiencing today, like many of us who have had family members and close friends who have struggled with behavioral health. We can make a real difference with the platform we have.