Boosting Efficiency and Improving Outcomes in Care Management with Yoni Shtein, CEO of Laguna Health

[00:00:02] Hey everybody, welcome back to the Outcomes Rocket. So thrilled that you joined us again today because I have an extraordinary guest and I've got the privilege of having Yoni Stein with us. He's the CEO of Laguna Health. He's a technology entrepreneur and investor with over 15 years of experience

[00:00:22] at that intersection of tech and finance. As a CEO and co-founder, Yoni brings his passion around data and impact to really help improve people's lives. I'm excited to have him on because look, in healthcare, we need that splice

[00:00:37] of other industries to really move the needle forward and catch up. Yoni, appreciate you being with us. Thank you for having me, Saul. My pleasure, my pleasure. So you guys are focused on care managers and really bringing in automation to the space. We're excited to cover that.

[00:00:56] But before we do, Yoni, tell us a little bit about you and why you got into healthcare. Sure. I think my path to getting into healthcare was long and arduous, which I think is typical for most healthcare entrepreneurs.

[00:01:08] They always have some compelling event, if you will, that gets people like us passionate and excited and driven enough to not give up in this important space. But so I started out actually as a soft engineer at Microsoft, this is 20 years back, which is exciting because

[00:01:25] both could have set my engineering foundation. And as importantly, this is how I met up with my co-founder of Laguna, Yael Adam. Both of us as geeky soft engineers that then had a detour in business and finance for about a decade.

[00:01:39] Had a pretty exciting startup that went public out of San Francisco and then spending some seven years at a large private equity and credit fund in the midst of which unfortunately lost my mother-in-law post-hospital discharge, which was a pretty dramatic shakeup in my life

[00:01:54] and got us to move and me leave finance and invest my time, passion and attention in healthcare, which is how we got here. Ricky Herjavec, MPH Amazing. Look, it's a winding road, but you're here. And yeah, definitely awesome work that you did at RPX,

[00:02:12] some big wins and what's followed from that. Excited to dig in here. Let's talk about Laguna. What does the company do and how are you guys adding value to the ecosystem? Yael Adam Absolutely. So Laguna is a conversational care intelligence solution for care managers,

[00:02:27] really helping them to drive efficiency and effectiveness. Sounds perhaps a bit kind of high level. I'll unpack that a bit. Care managers are essentially driven nurses, social workers, often employed by health plans, health insurance companies.

[00:02:42] As they have to balance large and growing caseloads and individual empathy and attention to every member they speak with, usually quantity takes over and given the stretching caseload, it's really difficult to be empathetic to every single individual time and time again,

[00:03:03] while they have to take notes and go through scripted workflows. That is the core problem we're helping them solve by doing several really important things using conversational intelligence or specifically natural language processing and generative AI. To first and foremost, take all the low value work away from them,

[00:03:24] automating documentation, what is known these days as ambient listening. They should not be doing that quote unquote low value work. They should be paying full attention to what and how the member is presenting, be it voice chat, text, whatnot.

[00:03:38] Above and beyond that, we also help them to drive effectiveness, to pinpoint what is being said in real time and offer some of the specific pathways that the plan and ecosystem that they work with is available to help for that member.

[00:03:53] And last but not least, we're also helping big care managers improve as we're also paying attention to what and how they are saying, which provides fertile ground for training and improvement on that front. Ricky Hernandez That's really great, Yoni. And essentially, you're customers payers.

[00:04:07] Am I hearing you right? Yoni Perreault Yes. Ricky Hernandez Okay, great. And you're helping them with their care management process, which the numbers are staggering, right? They're just like the physicians. They're just up to their eyes. Yoni Perreault They're up to the rise.

[00:04:20] And it's funny you mentioned physicians, right? Because we're living in a really exciting time of conversational intelligence, specifically ambient listening. And to your point, what I find is that majority of the attention goes to the providers,

[00:04:34] the physicians, the clinicians to drive more efficient throughput of patients, if you will. And the economics are conducive to it, et cetera. Much less attention and solution is being paid and provided to the payers that have as much, if not more, interest on the line.

[00:04:51] And are quite aligned, actually, with all of our health and well-being, economically, if nothing else, and from a mission standpoint as well. Ricky Hernandez That's fantastic. And folks, if you've been following the podcast, you've heard the interviews we've done with the folks at Abridged.

[00:05:05] You've heard the interviews we've done with the Legacy Nuance folks now at Microsoft. What I love about what Yoni and his team are doing is that there's so many aspects of healthcare that could benefit from these LLMs. And here's a sweet spot.

[00:05:20] And you guys could own this, right? You guys are owning this. And that's the beauty of it. You don't have to go to a crowded market to make a difference with the technology that is so exciting in healthcare. So talk to us, Yoni. What's making the difference?

[00:05:32] What is it that you guys do that other people don't in this particular vertical? Yoni Bernal I think that's a good opportunity to double click into the arduous journey of company building. And before we got to this, which is really where we found massive interest and traction

[00:05:47] and growth in the market, we started from the post-acute space. In looking in post-acute transitions, the first problem we're looking to tackle is what is the optimal care model? And it turns out that it's not just the clinical aspects that get people in trouble along their journeys.

[00:06:03] It's also the social and individual determinants of health, as we call it. So one of the first things we did was codify all of that, which is really exciting because once you're able to do that, several things are enabled. First and foremost, you get to speak to results.

[00:06:19] So we've done multiple randomized clinical trials with the likes like Mayo Clinic, North Shore, publishing outcomes, by the way, massively conducive to working with payers. Not as much the case with efficiency-oriented providers. Very much the case with payers who are absolutely looking at efficiency,

[00:06:36] but also looking at outcomes and cost savings. Two, it enabled us to have a tagging infrastructure and a lens, a data lens essentially, that enabled us to build a differentiated, if you will, large language model that enables us to not only take that low value documentation work away,

[00:06:57] but also elevate to help care managers practice at the top of the license as it's often called by paying attention to clinical and non-clinical factors in real time. Ricky Herjavec That's fantastic. And the differentiators, I guess, Yoni, is that dataset, right?

[00:07:13] Like the dataset you've been able to put together your own, I guess, unique language model that helps you bring forth the insights that you're bringing forth. Yoni Bernard Exactly. In that time in H11 where you have unbelievably robust platforms like Gemini, OpenAI, etc.,

[00:07:31] that subject matter expertise and data mode is really what sets you apart and creates that not just differentiation, but I would call sustainable differentiation over time. Ricky Herjavec I love that. And so for the payers listening, how can we help them understand what setbacks you're helping them overcome?

[00:07:49] What's life like before Laguna? And what's life like after Laguna? Yoni Bernard Absolutely. There's several ROI opportunities we're helping them drive, not unlike any other co-pilot, if you will, or set of technologies that help all of us become more efficient, more effective.

[00:08:09] It really depends on how we want to utilize it. So specifically, helping them cover more members with the same care team, helping them be more effective with the members they are covering. Namely, it's not just become more effective or I'm sorry, efficient administratively speaking.

[00:08:28] It's also more effective from a medical loss standpoint. And then last one, some payers that work with us are looking to optimize and rationalize the administrative spend they have on care management as well. That is another ROI lever that they get from Laguna.

[00:08:46] So to bring it back full circle, it really depends on their individual strategic goals and the tools that we have help them. Ricky Hernandez So my brain's going to Medicare Advantage, HEDIS measures, that kind of thing. Am I tracking with you or?

[00:09:00] Yoni Bernard That is a really interesting bonus that goes above and beyond everything I just said, because being able to, again, to our humble beginnings in post-acute and closing care gaps, reducing readmissions, unlocking ZCOS and risk management,

[00:09:16] all of that is being done more efficiently and more effectively on the fly. In addition to the core KPIs that I mentioned, which are again, driving higher efficiency, as much as 30% higher efficiency from the same care team.

[00:09:32] That's a lot if you think about the millions and tens of millions, depends on the size of the team they invest in that. And then better outcomes as measured by medical loss as well. Ricky Hernandez Love that.

[00:09:41] And then you compound that efficiency over time, or you're really adding major value. And one of the questions I ask next usually is key trends or technologies. We're talking about those, right? That is the essence of Laguna. You guys are.

[00:09:57] So maybe the question that I'd like to ask you Yoni is one about thinking. What's one key way you would challenge today's leaders to think differently? Yoni Bernard I love the question.

[00:10:08] I was articulating the answer in my head as you were chatting and I absolutely love the question. I was trying to recall on a line that someone once told me whereby agreeing to everything

[00:10:18] or disagreeing with everything are both the same because both absolve you from the need of thinking. And what I would caution and encourage decision makers in the industries to not to fall in that trap as it relates into the very exciting NLP and Gen AI tsunami we're in.

[00:10:37] So no, I don't think like most trends that this will solve everything, nor do I think this is all BS. Pardon my French. And as ever, God or devil, be it as if, hey, is it the details? And I think it's actually quite nuanced and fascinating, right?

[00:10:52] Be it pockets of value that are proven and exist of AI and healthcare and some of the nuanced solutions against your point about the nuance or a bridge. And yeah, I have a ton of respect for those solutions focusing on driving value for providers

[00:11:09] and appreciating the nuance and differentiated opportunity and need and proven value for payers. So again, I think some of that detail matters and that is the crux of the opportunity that we're looking at and I think of the opportunity for some of our customers set to differentiate

[00:11:27] from some of the noise, if you will, and the signal of that. That's fantastic, Yoni. Yeah, I love that tip here. And at the end of the day, it is about thinking, right? Let's think our way out of these problems.

[00:11:39] Let's think with our partners, solutions like Yoni's Laguna Health to really find a way to get consumers, and I'm saying consumers intentionally, what they want in healthcare because we're demanding it and now is the time.

[00:11:56] Yeah, as people are listening to us, Yoni, what closing thought would you leave them with and what's the best way for them to learn more about you and engage with your team? Absolutely.

[00:12:07] I think we're in a really, just for us, closing thought and on the heels of the previous question answer, really exciting time in healthcare. And I'm saying really exciting, not as much as far as when COVID, it was an exciting time,

[00:12:20] but it was an exciting time because there was this wave of tsunami and I'm sorry, of attention and funding and overall excitement probably over the top. Now, I think there's a real wave of opportunity and a confluence of factors between the technology

[00:12:39] and productization of it in proven segments or niches within it and that are paired with decision-making interests in that. So it's a really exciting time to be building, scaling, and at the end of the day, to your point about consumers, delivering tangible, improving value to our customers.

[00:13:00] Super happy to speak about that and more with folks reachable on either LinkedIn or email Yoni, Y.O. and I at LagunaHealth.com. Amazing Yoni, thank you for that great call to action. Folks, now's the time and you don't have to do it alone.

[00:13:18] That's why leaders like Yoni are building platforms that your organization can leverage and take your teams, your resources to the next level. Yoni, thanks for being with us. Really enjoyed our time today. Same here. Thank you for having me.