Employee healthcare navigation company Transcarent is teaming up with The Clinic by Cleveland Clinic, the hospital's joint venture with telehealth company Amwell, to expand access to medical specialists.
Through the partnership, Transcarent members will gain access to 3,500 specialists in more than 550 advanced subspecialties for expert second opinions on diagnoses and to confirm treatment plans, according to a press release. The service will be offered as a Transcarent benefit and, in many cases, with no out-of-pocket costs.
It marks Transcarent's second major hospital partnership to expand access to specialist care. The company also collaborates with Hospital for Special Surgery (HSS) to enable employees of self-insured employers and their families to have access to HSS’ orthopedic and musculoskeletal specialists. As part of the program with HSS, Transcarent said it would handle all member referrals and help cover the cost of certain orthopedic surgeries along with travel coordination and associated costs when necessary.
Livongo founder Glen Tullman launched Transcarent in March 2021 to tackle the employer-sponsored benefits space. The startup uses a combination of software, technology and data science to provide members with health navigation, virtual care and bundled providers. The company connects members via chat, phone or video to a personal health guide or a physician, expert second opinions, medication review and management, virtual physical therapy or full surgery management.
The Clinic by Cleveland Clinic launched two years ago to offer virtual medical second opinions as part of Cleveland Clinic and Amwell's telehealth joint venture. The Clinic offers video consultations, digital record collection and concierge-level service, according to the organizations.
"When surgery or complex care is being delivered and it’s serious, everyone should get a second opinion, both on their diagnosis and their treatment plan,” said Jeff Dobro, M.D., Transcarent chief innovation officer, in a statement.
Through The Clinic’s virtual medical second opinions program, a physician reviews a member’s diagnosis and treatment plan and provides a personalized second opinion. Seventy-two percent of expert opinions uncover potential diagnosis changes or treatment plan modifications, according to Transcarent.
Virtual access to specialists provides members with high-value care regardless of income, ZIP code or shift schedule, Tullman said in a statement.
Misdiagnoses harm consumers and drive-up costs for employers. An integrated expert second opinion program, paired with access to treatment at centers of excellence, can result in better outcomes for consumers, a faster timeline for returning to work and a reduction in employers' expenses, Transcarent executives said.
Initiatives linking employees to trusted guidance from industry leaders have demonstrated an avoidance of unnecessary surgeries in favor of more conservative treatments such as physical therapy or more appropriate treatment. In the case of one large employer, Walmart, 54% of patients seeking spine surgery and 20% of joint replacement patients were guided into other forms of treatment, according to a case study in Harvard Business Review.
In the past 18 months, Transcarent has notched notable acquisitions and partnerships along with rolling out new services. It acquired surgical care provider BridgeHealth last year and inked a partnership with Walmart to provide low-cost prescription drugs and other services to employers that are self-insured.
The startup launched an oncology care program that aims to offer an end-to-end solution to better manage outcomes and costs for patients who are diagnosed with common cancers. Transcarent also rolled out a behavioral health offering that aims to boost access to care.
More recently, the company developed a pharmacy program for self-funded employers and health systems and tapped healthcare technology company Prescryptive Health to power its new pharmacy benefit offering.
The company has raised $298 million and hit "unicorn" status last year with a reported valuation of $1.6 billion.