The U.S. faces a growing shortage of neurologists, creating care "deserts" around the country, forcing patients to wait longer and drive further to receive care.
More than 20 states in the U.S. are classified as a "dementia neurology desert" by the Society of Actuaries. Based on scientific modeling in 2012, the National Center Health Workforce Analysis projected a 73% increase in the national shortfall in neurologists needed to meet the national demand by 2025. In 2025, the need for neurologists is projected to exceed the supply by 19%.
At the same time, an estimated 41 million cases of dementia across the globe are undiagnosed and new treatment breakthroughs could result in an oncoming "tsunami of demand" for diagnosis, which could overwhelm unprepared healthcare systems worldwide, according to a 2021 report from Alzheimer’s Disease International (ADI).
This opens up opportunities to leverage technology to make more brain health more accessible to patients.
Digital health company Isaac Health launched in 2022 to provide a virtual brain health and memory clinic platform with the goal of improving access to constrained brain health services.
Isaac Health partners with health systems and health plans to screen, diagnose, treat, and manage their populations who have brain health conditions, starting with dementia. The startup is also available to patients or their caregivers directly as a memory clinic service.
Isaac Health completed an oversubscribed $5.7 million seed round to fuel its growth. The round was led by Meridian Street Capital and B Capital with participation from Primetime Partners, Co-Found Partners, VU Venture Partners and AirAngels.
"Dementia has always been a problem near and dear to my heart because my grandmother had dementia. I always wanted to do something to help patients and their families with dementia care management," Issac Health CEO and co-founder Julius Bruch said in an exclusive interview.
A former physician and medical researcher in the fields of neurodegenerative disease and dementia, Bruch teamed up with Joel Salinas, M.D., a neurologist with expertise in behavioral neurology and neuropsychiatric, to launch Isaac Health with the mission of bringing an innovative approach to brain health. The company offers virtual and in-home care services to patients, with a focus on treatment and early detection.
For patients without internet access, Isaac Health will dispatch home care aides to facilitate the medical visit with specialists, Bruch said. "We work with populations facing big health equity gaps such as dual eligible Medicare-Medicaid populations," he added.
"The time for a solution like this was right as the specific problem that we're addressing is the lack of access to specialist services for dementia care," Bruch said. "Most behavioral neurologists are in academic medical centers and that clinical hospital environment is not the best place to look after our patients with dementia. What Isaac Health does is bring this center of excellence model out into the community where patients can access it from the comfort of their homes and make it much more accessible for the population, especially rural populations and patients who struggle with barriers to access."
He added, "Our mission is to make great health accessible to everyone. We want Isaac Health to be the go-to solution for everyone in the country who thinks about their cognitive health or their wider brain health."
Isaac Health uses cutting-edge technology and predictive machine learning to identify patients with different cognitive and brain health conditions and enable center-of-excellence-level care to be scaled across communities, executives said.
"Over 60% of people with dementia are not diagnosed yet. There's a huge under-diagnosis issue. Even if you go to a primary care doctor, the diagnosis is just as good as the flip of a coin," Bruch said. "Typically, when we partner with a health system or a payer, the first thing that we do is really to do is an analytics-based screening campaign. We run our algorithms on their data, identify the members that most likely have undiagnosed dementia and then reach out to them proactively for a brain health screening and then do the complete diagnosis.
"We've got the complete diagnosis pathway filled out, including all the assessments and then the medical assessment. We use nearby imaging centers so that what you can access in academic medical centers is available to everyone. If a patient already has a diagnosis, then we will also provide treatment and care," he said.
The company's care management services include a 24/7 hotline that patients can access as well as caregiver support and training.
Patients can also access Isaac Health's service directly through the website to book an appointment with a specialist.
"The bulk of our patients come from those partnerships with health systems and payers. Health systems and payers have a strong incentive to manage these populations better and they are increasingly learning the value of better dementia management," Bruch said.
He added, "This helps to address this huge issue that we have with diagnosis usually occurring too late. With earlier diagnosis and detection, providers can prevent unnecessary hospital admissions and emergency department visits, he noted.
"Brain health should mean more than just supporting the late stages of disease. It should mean early detection and proactive care, in and beyond the four walls of a clinic,” George Ribaroff, partner at Meridian Street Capital. “Isaac Health, through their novel model and technology, has the potential to scale the gold standard of care."
The seed funding will help the startup further develop and expand its brain health provider platform, driving advancements in the screening, diagnosis, treatment and management of brain health and dementia.
Isaac Health currently has several payer partnerships with Medicare Advantage plans and accountable care organizations and works with about 1,000 patients. Bigger partnerships are in the works with payers that cover hundreds of thousands of patients, Bruch noted.
The funding is instrumental in scaling operations and driving these strategic partnerships to position Isaac Health as a leader in the rapidly evolving brain health landscape, executives said.
"We've got three to four new health insurance contracts that we will be implementing, so we're using the funds to build new partnerships and to develop those as well as to build out our technology and scale operations. Our goal is to scale 10x this year," Bruch said.
Isaac Health's services are currently available in five states: New York, North Carolina, Florida, Georgia and Colorado. The startup plans to expand to five additional states this year.
The U.S. is grappling with an unseen challenge from patients and families impacted by Alzheimer's, dementia and Parkinson's, with the Centers for Medicare & Medicaid Services (CMS) emphasizing dementia care as a major priority.
Currently, Alzheimer’s and other dementias affect over 6.7 million Americans, costing $655 billion annually.
Last summer, CMS introduced the Guiding an Improved Dementia Experience (GUIDE) Model, a voluntary national Medicare payment model beginning next July that aims to help dementia patients remain at home and improve quality of life for them and their caregivers.
Innovation in developing new treatments for neurological conditions is driving regulatory change, which, in turn, fuels opportunities for entrepreneurs focused on aging seniors, according to Abby Miller Levy, managing partner at Primetime Partners, an investment firm focused on longevity tech and one of Isaac Health's backers.
"Outside of pediatrics, maternity and oncology, every healthcare issue is an older adult issue," Miller Levy said during a Bloomberg Tech event in New York City. "We are investing in everything from the social determinants of health to fitness, nutrition, mental health and social connectivity, all of those pieces of aging well, as well as some pretty direct healthcare IT around telemedicine, cardiac rehab and remote patient monitoring."
Several other startups have launched in this space such as Harmonic Health, which provides a variety of tech-enabled patient care and coordination services to help providers deliver comprehensive dementia care to their Alzheimer’s, dementia and Parkinson’s patients. Rippl launched in 2022 aiming to pioneer a new care model by expanding access to wraparound mental health care for seniors. And Los Angeles-based Bold recently nabbed $17 million in a series A funding round to build up its virtual exercise programs for aging adults.
Brain health and dementia care have become top priorities for many health systems as new treatments are developed, Bruch said. "We are where oncology was 30 years ago," he noted. And that is fueling interest from investors in startups in the neurology care space.
“We are currently at a historic inflection point for brain health with the first full FDA-approved disease-modifying treatment for early-stage Alzheimer’s disease, and the company's commitment to innovation, coupled with the vast potential size of the brain health market, strongly aligns with our vision for the future of healthcare,” said Karen Page, general partner at B Capital, in a statement.