This week, a startup joined forces with one of the nation’s most prestigious health systems to improve care for patients with chronic gastrointestinal conditions. More than 70 million Americans — 25% of the commercially insured population — live with GI conditions like irritable bowel syndrome or inflammatory bowel disease, which cause uncomfortable and persistent symptoms like stomach pain, constipation, diarrhea and fatigue.
Boston-based digital health platform Ayble Health is partnering with Mayo Clinic to offer patients a hybrid care model for digestive health that matches them with the appropriate virtual and in-person services based on the acuity of their symptoms and needs. The hybrid care model is available for large employers and health plans.
At ViVE 2024, Panelists Share Prior Authorization Progress and Frustration in Payer Insights Program
At the Payer Insights sessions on Day 1 of ViVE 2024, a panel on prior authorization offered compelling insights from speakers who shared the positive developments in this area after years of mounting frustration. Speakers also shared challenges as they work with providers to figure out how policy developments and technology will work in practice.
Ayble, founded in 2020, focuses exclusively on treating GI conditions. The country’s direct healthcare spend in gastroenterology tops $140 billion per year, which is more than its annual spend on heart disease, mental health and trauma, declared Ayble CEO Sam Jactel.
“One in four Americans has a GI disorder, average wait times for a gastroenterologist are over 6 months, and even when patients work with a GI provider, drugs aren’t a silver bullet solution to find digestive relief,” he explained.
Jactel added that many chronic GI conditions have a severely negative impact on patients’ quality of life. Many GI patients have said they would be willing to sacrifice 15 years of their remaining life expectancy for a cure that doesn’t exist today, he remarked.
Medical literature shows that lifestyle modifications, such as diet choices and going to psychology appointments, can improve outcomes for most patients with digestive disorders, Jactel pointed out. Unfortunately, these modifications are difficult to implement in practice because most approaches are based on trial and error.
When Investment Rhymes with Canada
Canada has a proud history of achievement in the areas of science and technology, and the field of biomanufacturing and life sciences is no exception.
Ayble seeks to address this problem through its nutrition and behavioral health platform, which guides patients to identify and remove their trigger foods while “retraining how their mind and gut communicate,” Jactel said.
Once a user joins Ayble’s platform, they are paired with a board-certified digestive health coach. This coach learns about the user’s needs and guides them through a personalized nutrition plan, behavioral therapy and a range of wellness tools, including a food tracker and groceries database. The platform gives users options for both in-person and virtual care.
“Each user’s journey with the Ayble program is personalized through AI and expert health coach guidance. Ayble’s clinically rigorous approach takes into account expansive patient biographical, diet, allergy, lifestyle and symptom information, then marries it with its massive GI behavioral health data set to personalize treatment plans,” Jactel added.
Ayble’s new partnership with Mayo enables employers to provide the right care to the right patient at the right time, he noted.
The startup and the health system will partner with large employers and health plans to analyze claims and better understand their digestive health population. This analysis is meant to determine where costs are coming from, how patients behave and identify any patterns in that data.
“For the vast majority of digestive health patients, Ayble as a standalone platform is all they require to find digestive relief. However, if an Ayble patient meets clinical criteria to require escalation of care, Ayble refers that individual to Mayo seamlessly, ensuring they get the highest quality support,” Jactel explained.
In this scenario, the patient will travel to a Mayo facility to receive care from one of the health system’s expert gastroenterologists. The partnership is designed to break down barriers to high-quality GI care, so the patient’s employer or health plan will offer travel and lodging benefits. After receiving care at Mayo, the patient will be referred to Ayble for continuous nutritional and behavioral care in their local community.
“The collaboration with Mayo Clinic is a first-of-its-kind model that Ayble is hoping to scale to health systems and provider groups nationwide,” Jactel declared.
Ayble sells its platform as a digestive health benefit to self-insured employers and health plans. The startup typically charges on an enrolled-member basis, with a significant proportion of its fees being at-risk, based on clinical and cost outcomes.
By participating in Ayble and Mayo’s patient-matching collaboration for GI care, employers could see reduced absenteeism and enhanced productivity from their staff, as well as be assured that their workforce is receiving care tailored to their unique needs, he noted.
A collaboration like this is necessary because digestive diseases present heterogeneously, meaning that healthcare costs vary based on the type and severity of the condition, and severity often fluctuates based on where a patient is in his or her journey, Jactel pointed out. A one-size-fits-all solution like a virtual clinic model cannot meet the needs of patients across all levels of acuity — he said this type of model usually only cost-effectively addresses 30-40% of the population.
Virtual clinics for digestive health, such as Oshi Health and Vivante Health, are Ayble’s main competitors. In Jactel’s view, his company stands out for a couple main reasons.
The first is Ayble’s breadth of published clinical outcomes in the GI space, which includes 14 studies, most of which involved more than 10,000 patients. The startup’s hybrid care model is another key differentiator, Jactel contended.
“Our coach-first model means we are lower-cost and complementary, rather than competitive, to gastroenterologists and primary care providers. Collaborating with [Mayo] is a perfect example of how Ayble can enable clinicians to deliver one-to-many care, enhance the care a provider can offer to a patient, and match acuity with level of intervention cost-effectively for an employer or health plan client,” Jactel explained.
Photo: metamorworks, Getty Images
