Meet Richard (Rick) Kimball, founder and CEO of HEXL, Inc. (short for Health x Longevity.) An investment banker of 26 years, Kimball originally ran healthcare investment banking for Goldman Sachs, and provided strategic advice and capital raising to major medical device companies. The companies Kimball advised ranged from early stage businesses like Heartport (acquired by Johnson & Johnson in 2001), to some of the largest in the world, like Medtronic.

HEXL was founded in late 2014, in order to provide strategic solutions to combat the dysfunction in the U.S. healthcare system. Patients with chronic health issues, in particular, often do not receive the personalized care that they require – hospitals typically take a reactionary approach to these patients, treating them only as soon as a major health issue arises or resurfaces. HEXL is looking to implement a “flexible preventative care environment” involving a new reimbursement model, proactive use of patient data, as well as leveraging devices in the home to keep a closer eye on patients. Following this, Richard took the time to speak with me about HEXL’s strategy – and its potential to become a disruptive player in the healthcare system.

Q: What issues with patient care is HEXL responding to?
Kimball: Under the current fee-for-service reimbursement system in healthcare, doctors and hospitals are paid for more visits and procedures – not for keeping people healthy. Consequently, the system doesn’t invest in preventive care and care coordination infrastructure and services. HEXL will gain share and later, take capitated risk on populations of Medicare Advantage members. As such, we will earn more by keeping people stable in their disease state, at home and out of the hospital. These incentives will cause a re-engineering of the care process to focus on health, not just health repair. Better outcomes and reduced acute care utilization will lower system costs through this process.

Q: What is HEXL’s plan for tackling these issues?
Kimball: We will deploy a care coordination technology solution to manage these populations, ensuring proactive, consistent, and optimal management of their care. This will require both a high-touch aspect with people as well as a high-tech approach to managing all of the data, sensors, triggers, and care protocols, and serving that to the point of care.

Q: How will HEXL’s program impact medical device manufacturers?
Kimball: We will accelerate the adoption and value of devices designed to track vital signs continuously. Home monitoring equipment will be evolving rapidly, and we will want to use the best-of-breed technologies. More expensive devices used in the acute care and specialty environments (neuro, ortho, etc) may be under volume pressures as the system reduces utilization by more effective preventive care.

Q: How will the program benefit home healthcare practices?
Kimball: I think home healthcare is going to grow and institutionalize dramatically in the next five to ten years. Much more care needs to be shifted to the home. Our solution will require much more home healthcare.

Q: What benefits will HEXL’s strategy have on personalized medicine?
Kimball: By tightly integrating a patient’s health data with our in-clinic, in-home, and telehealth care coordination capability with evidence-based decision support real-time at the point of care, we are foundational to be able to execute personalized medicine across populations of members.

Q: What are some possible roadblocks in rolling out the strategy?
Kimball: The political environment around the ACA and healthcare is volatile and creates uncertainty regarding reimbursement and regulation. We will want to plan for an environment moving toward value-based reimbursement but be nimble to respond to legislative or regulatory changes along that journey.

Q: What steps will HEXL take to ensure data security?
Kimball: Security is paramount in a healthcare business. People are less comfortable sharing their health information online than they are sharing their financial information and access to assets. We must have leading edge data security and be Hi-Trust certified.

Q: What’s the next step?
Kimball: We are in discussions with several payors to run a pilot followed hopefully by a multiyear contract to deploy our capability against a defined population that we agree with the payor. At that point, we will take in some funding to finance the next stage of the company’s development and begin to build out our technology and operating infrastructure.


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