This article was originally posted on our CEO and Founder's Celine Tien's LInkedIn. You can find the original article here.
Recently, Flowly won back-to-back first place in both the Employer Health Innovation Roundtable pitch competition as well as the Health Plan Innovation Roundtable. This meant that some of the top leaders in the Benefits and Health Plan worlds have selected Flowly as a vendor to present directly to Fortune 100 companies as a potential new offering.
This is an unprecedented opportunity and we were going against some top-notch companies…so we had to be very thoughtful about how we positioned ourselves.
We worked tirelessly with our amazing advisors who formerly came from Pepsico, Intel, and large national health plans to craft our pitch and solidify an approach that would resonate with both the current benefits and health plan leaders we were pitching to.
In this process, we unveiled one particular insight that became a cornerstone of both pitches. And for me, our advisors, and in the feedback from our pitch judges, it seemed this particular insight was key to our victory in both roundtable pitch competitions.
Here, I will walk you through that insight for us at Flowly, but also the process by which we came upon that insight so it can be something of a case study for other pitches you may be considering or crafting.
Go Deeper Than the Surface to Find the Problem
Most people in healthcare know intuitively that chronic pain is a huge issue. Massive. Some may even know that 1 in 5 Americans suffer from chronic pain, or that pain drives more than $630B in healthcare spend in the US each year.
There is no doubt chronic pain has a monumental impact on our healthcare system, and as a platform designed for addressing chronic pain, Flowly has the potential broad population-wide impact.
However, if you dive deeper than surface-level statistics, a deeper, ominous problem presents itself. In fact, within chronic pain, there is a highly prevalent pain segment that is often found in employee and health plan populations but massively overlooked— nonstructural pain.
Nonstructural pain is chronic pain that cannot be seen on an X-Ray or CT scan. The pain does not have, or no longer has, a structural or physical injury associated with it. The pain is largely driven by the nervous system. You may relate to this if you have friends, family, or you yourself have had continued pain for many years even past an initial injury.
You may think, how prevalent could this be? In fact, only 15% of the time can a physician diagnose a structural cause for low back pain. Therefore for most low back pain cases, there is a major nonstructural pain element.
While many of the benefits and health plan leaders we pitched to had not previously heard of the term “nonstructural pain,” once we explained who these patients were, they seemed to immediately resonate with the problem, recalling their manufacturing, retail, or first responder employees that had sustained injuries years before but still struggled with pain.
Even more significantly, here’s what our team discovered— these nonstructural pain patients spend similar, if not more, than structural pain patients because they continue to elect for repeated tests, physician visits, and even surgeries, looking for a structural cause of their pain.
And most importantly for our team, these nonstructural pain patients are largely overlooked by their employers, their health plans, and their providers because they are often considered “difficult,” “opioid-seekers,” or “histrionic.” Instead of given proper care specific to nonstructural pain, these patients are either ignored or given band-aid options like opioids, injections, etc.
If we cannot get the healthcare system to care for nonstructural pain patients on purely empathetic terms, perhaps we can draw their attention by highlighting one significant factor… even if the healthcare system overlooks nonstructural pain patients, they continue to cost our system millions of dollars each year.
So how do you treat someone without a structural cause to their pain?
Get Specific About the Solution
Our team set out to design a program, craft a positioning, and execute proof of concepts specifically for this sub-segment of the chronic pain population. We began by working with pain experts who were specifically trained in the area of nonstructural and nonspecific back pain.
Because for so many years the pain management industry has been dogged by conversations around MSK and opioid use, the actual conversation around nonstructural pain was limited (even though most pain experts knew of it and consistently had to try to deal with it with what limited resources they had designed for nonstructural pain specifically).
While it was often challenging to find providers and researchers who were specifically experienced in this sub-segment of chronic pain, we realized there was no negotiating on designing a platform that was centered on a very specific population.
If you design a product to help everyone, you help no one.
This sharp focus allowed us to interview thousands of nonstructural, nonspecific back pain patients in incredible detail, understanding the exact pains they experienced day-to-day, the solutions that were working and weren’t working for them, and what they continued to seek in their care programs. Working with specific experts gave us a clear understanding of how these patients often interacted with the broader healthcare system, how they were overlooked, and what they looked like from a broader, demographic view.
Once we had a version of our platform to test, we were able to run focused case studies, and with the NIH, conduct randomized controlled clinical trials to understand what clinical impact we could make for these patients. In running these studies, we understood that focusing on a specific sub-segment of the pain population was the right choice. We were able to specifically cater to these patients’ needs and desires, even addressing factors in their lives that were pain points but were not immediately obvious. For example, one case study patient with chronic nonstructural pain for over fifteen years was able to get his driver’s license back after using Flowly. When he started voluntarily reducing his opioid intake, he was able to start driving again, and for the first time in a decade, he was able to drive to his brother’s house and spend time with someone he loved dearly. To this day, he tears up sharing this experience with our team.
Ultimately, the Bottom Line Matters
As seemingly amazing as our results were from working with real patients, we needed to ensure they would ultimately get access to Flowly. We already knew these patients were largely overlooked by their employers and health plans. How can we get these organizations to care about these patients?
Fortunately (and unfortunately), these patients are extremely high-cost. This meant we at Flowly had the opportunity to demonstrate tremendous cost-savings for the employers and health plans we worked with.
What we discovered, is the opposite. There are massive cost savings benefits to treating non-structural pain triggers.
At face value, it may seem the number of nonstructural pain patients pales in comparison to overall chronic pain numbers. However, if you look at per dollar spent, the ability to treat and address this overlooked population could make a significant bottom-line difference for organizations.
We spent time crunching data to better understand that massive scale of healthcare spend nonstructural pain patients were costing self-insured entities, and by in large, health plans. It’s well known that MSK is one of the biggest cost drivers for employers and health plans. Despite innovative solutions on the market and new value-based care arrangements, those costs remain high.
When analyzing our core strengths and impact as a company, we narrowed in on a few ways Flowly can help reduce these costs:
- preventing unnecessary surgeries: ~60% of back surgeries are unnecessary, likely due to the nonstructural nature of most back pain. By treating pain effectively and educating patients on the nature of their pain, unnecessary surgeries can be avoided.
- reducing opioid use: chronic opioid use as well as pre and post-surgical opioid use create downstream effects that increase healthcare utilization, whether this is from increased physician visits, slow surgery recovery, increased length of hospitalization
- reducing unnecessary imaging: new nonstructural pain patients often spend extra on imaging as they look for a structural cause of their pain. As a structural cause continues to evade them, they continue to search, spending more on MRIs, CT scans, and X-Rays.
Flowly's focused approach to addressing non-structural chronic pain patients drives depth of impact, reducing healthcare costs by preventing unnecessary surgeries, curbing opioid use, and minimizing unnecessary imaging expenses.
Time will tell if this is the right approach, but for now, we are committed to serving our community of nonstructural, nonspecific pain patients. We are committed to educating the broader healthcare community, including employers, health plans, and organizations on the unmet need of these condition groups in their population as the ways to actually meet those needs.