Transcript
David Ezeobinwa (00:00) hey, Chris, how are you doing? You are on mute by the way, if you are speaking?
Chris Stokowski (00:06) Sorry about that. Sorry, I was a little late. I was out for a walk and then lost track of time, so.
David Ezeobinwa (00:13) Actually, no worries. No worries. I was like, let me just, I sent you an email. I don’t know if you saw that. Yeah, I.
Chris Stokowski (00:17) Did I sent you back? I was like, I’m joining. I promise.
David Ezeobinwa (00:21) Actually, no worries. No worries. I appreciate it. How was the walk?
Chris Stokowski (00:25) It was nice. It’s really been nice in Denver this year. So, okay, nice. Actually like not winter at all. Good. It’s been a little not wintery which is different. So.
David Ezeobinwa (00:39) Yeah, no, it’s good. Yeah, at least you, at least you have the seasons. I’m in Austin. I’m in Texas. I feel like it’s just hot and then less hot. Yeah.
Chris Stokowski (00:48) I have family and family down there. So we come down every couple years and it’s always good. Hot or, hot or hot, her, I guess is the word, right?
David Ezeobinwa (00:58) Yeah, exactly. Exactly.
Chris Stokowski (00:59) What you said, it’s like never like cold that’s for sure.
David Ezeobinwa (01:04) Gotcha. Yep. But yeah, no, I appreciate, you making out some time. I saw, the request come through this morning. So I figured I’d book something. I saw you had time today. So I figured I’d book something and just like kind of just level set for the call like essentially just as like I said in needs assessments kind of just kind of get an understanding of the organization and what you’re looking for. And if medallion, would be a good fit potentially, you know, we can kind of move forward with next steps, get you to schedule with the, one of our account executives. But yeah, my name’s of course, David by the way. But I would love, to learn a little bit more about yourself introduce yourself and we can kind of dive in from there.
Chris Stokowski (01:42) Sure. My name is Chris takowski, I’m a senior product manager for plume. I’m the only product manager for plume right now. So we’re kind of in the process of kind of thinking a little bit outside the box of what we’ve been currently doing. So we’re… a gender affirming hormone therapy clinic essentially. So we help the transgender community connect with care kind of all over the country. And so part of that looks like mostly there’s like the gender affirming clinical side, which is what we’re kind of doing today, which is mostly a direct consumer scenario. We were doing insurance for a while but we didn’t do a really good job rolling the product out and then we had to roll it back because our… contracts, all of our insurance contracts are really bad and like there’s a lot of stuff in the space that just wasn’t really working for us. And so we’re pretty committed to the just being a cash pay option for those in the community. The thing that I’ve been thinking about deeply is in the mental health space and trying to find ways that we can bring mental health care to our community. It’s just another way of making our products a little bit more sticky. And so like I have this idea of doing a beta or like some sort of test where we can get a couple of providers into our platform and then figure out how it could scale, what the costs are, what the effort is on our side. And so the most important parts of that are us not having to manage billing, RCM, all that kind of stuff we can do scheduling, we can do all the other stuff, right? Like we can find providers. It’s just really more of the licensure… credentialing and RCM that we really want to have somebody else kind of deal with. And so kind of what I’m looking to understand is one if your group can handle that or depending on scale. And I understand that was kind of one of the questions that I answered when I started the… conversation… that’s kind of where we’re at. So I’m trying to figure out like how is this really possible?
Chris Stokowski (03:47) And like, because I want to keep it light on our end from a level of effort perspective and be able to scale, we currently have 40 clinical providers. Okay. We have about 15,000 members. Each of those members participates in clinical care probably once every three to three and a half months Ish.
David Ezeobinwa (04:07) Okay. But.
Chris Stokowski (04:09) I imagine that the load would be pretty substantially different on the mental health side. Even if we had a take rate, that was, I mean a third of what that population is. They would probably see a provider once every couple of weeks on the kind of midpoint. And so if those things are all true, then the scale is going to be probably larger from an appointment and an RCM perspective than it would be. Yeah, and probably total providers potentially depending on how that would all work out if we ended up serving our whole population. So those are kind of like that’s kind of my initial foray into kind of thinking about this as a product. And the most important thing that I need to take back to my leadership team is figuring out the unit economics of like, can I make this work or not? And so that’s kind of where I was kind of reaching out to potential organizations that kind of sit in the space that can kind of help us with that. Yeah.
David Ezeobinwa (05:01) Yeah, no, definitely, Chris. I appreciate the insight into all that. Yeah, definitely off the top of my head. A few questions there. I know you mentioned the four D clinical providers. So those providers, are they currently already like in the platform in a sense like licensed in our?
Chris Stokowski (05:17) Platform? Yeah. But they wouldn’t be like for this new product, I’m talking about. They are like physical clinic, clinical care. And so we’d be looking at a new product of potentially doing mental health within the confines of our same platform. Okay. Yeah. So all the other things kind of stay the same, our clinical documentation and sources, all that stuff stays the same but we just need to figure out the licensure and RCM components for the mental health side.
David Ezeobinwa (05:44) Yeah, definitely. Okay. So for the new product, then there’s no providers under the new product yet, right?
Chris Stokowski (05:50) Currently, no, yeah. It’s, like, I kind of want to do a beta to kind of get a feel for like what the uptake would be. But if it’s I mean, even if it’s a small subset of our population, it could still be pretty substantial from like a revenue perspective. And also like a provider perspective because they’re you know, like it pretty easily get to 20 providers even if the small percentage of our total population took mental health, so.
David Ezeobinwa (06:21) Gotcha. Yeah. No, no, definitely. I could see it scaling to that 20 provider mark. And I guess from your perspective, would you, if that beta test kind of goes well, did you, do you foresee that scaling even past 20 like, you know, 50 60 so on and so forth?
Chris Stokowski (06:35) It could and I think that’s what’s really interesting about it is, I think when I think about it, I, you know, like just my own mental health journey. And like all that like that’s, probably like the most underserved part of anybody’s… health like in general, like we don’t know when to engage with it or how to engage with it. And then for those that are kind of on the fringes in different populations like the trans community or the LGBTQ community, in general, at large… they tend to have more stuff, right? They’ve had a different journey than like I have as a cisgender white Guy like, you know, there’s just like a large spectrum that could fall under that care. And so being able to provide that with people that specialize in it in particular, that fall under our clinical care model, I think of it as whole person health, right? Like we have this clinical, we have this clinical dimension today in a community. So a community platform where people can join and, you know, meet and hang out and talk with others that are like them. And the clinical part which is the physical side. And then just the mental health care is the piece that I feel that’s really kind of missing gotcha.
David Ezeobinwa (07:46) Gotcha. No, that definitely makes sense. And I will say, are you looking for a system as well that’s kind of doing it all? Because I would say for Medellin, we’re end to end for provider operations that’s all the licensing, credentialing enrollment with the payers so on and so forth. But we don’t we’re not billing, you know, we can connect our, we have an open API that can connect to billing platforms, but we’re not, we don’t handle billing. So I’ll say that as well. Yeah. And.
Chris Stokowski (08:09) that’s like that’s. Okay, like we can connect with a billing provider. You know, I think there’s kind of always the two dimensions to RCM right? Where it’s like first, you have to figure out how you can get the contracts in place and do all that work first before you can actually connect. And that’s probably the most important part from my perspective. Even if we had to use a second, a secondary vendor, for billing.
David Ezeobinwa (08:34) Okay. That’s fair. Yeah. And then I’m just looking at also just like who else? I know you’re kind of like looking at this from your perspective. You said you take it back to leadership. Are they going to have a weigh in on this? Like, hey, like we want to see a platform we want to see, you know, not.
Chris Stokowski (08:50) So much that I think it’s really more like from my perspective, it’s showing that the unit economics can work. So, like if we hired one or two providers, this is what it would cost for us to hire those providers, turn them up on our process, you know, and then get them licensed and credentialed and insurance contracts. And then, you know, active within the available to the community and we see what all that, how that all worked.
Chris Stokowski (09:20) And then like the billing side would be a little bit separate from that, but it’s just kind of understanding like basically both the revenue side, so what we could charge and what we would give for insurance and then kind of bounce that up against all the costs of like your platform and the billing platform kind of smashed together to see like if we can make the unit economics work at, you know, both a small scale and a large scale. You know, so like because I think it can scale relatively quickly. It just depends on how quickly we could hire providers that specialize in that kind of care. So, yeah.
David Ezeobinwa (09:55) Yeah, no, definitely. That makes sense. And this, I know these are kind of like beginner beginning of conversations. Is this like a timeline you have in place? Like, you know, certain time?
Chris Stokowski (10:05) No, there’s nothing that I have in place that would say like we have to do anything at any given set of time. I’m, really in like discovery mode right now, just trying to figure out like what the realm of possibility is, what the right partners are, that exist in the space, if we’re a good fit. Great. If we’re not that’s cool too. Like we can be honest about it like that’s just kind of how I operate, because not everybody’s going to be a perfect fit for like our population of members or like the services that we provide necessarily or, you know, just the scale on which we’re looking to operate. And so, like all those things are okay. And I think to me like my core values are like clarity, honesty and integrity. So, like, you know, I’m going to be that way for you and your teams. And I just kind of accept the same in return.
David Ezeobinwa (10:49) Because.
Chris Stokowski (10:49) I think that you just end up in a really good spot and you can agree that like, yep, this is a good fit or no, this actually is a terrible idea, right?
David Ezeobinwa (10:58) So, yeah, no, 100 percent. That definitely makes sense. And just looking at it, last question, I was just curious, just looking at it. Is there any, is there any system in place today for that piece of, are you just, you know, straight up looking for someone to kind of like take that over? Is that kind of like?
Chris Stokowski (11:17) Well, we did it for a while like we had a product, an insurance product for almost two years. Okay? And so we had like a credentialing team and a licensing team. They have all since been like, because we don’t do that product anymore. We didn’t do it really well. And so my underlying assumption is it’s like in this scenario, it’s like it’s something that we can trust experts on until we got to a particular scale, where then it might make sense to say like, well, maybe we should bring this in house at that point as opposed to trying to build your in house thing and also build a product.
David Ezeobinwa (11:52) Gotcha. That definitely makes sense. And Chris, also one thing I did want to call it. It’s kind of just budget. Like the reason we kind of have that, you, know, I forget who was on the other email. I think Anika, I just kind of mentioned that provider account is when it comes to the budget because typically, I will say medallion starts around the 50 K mark like that’s kind of like the floor and then from up from there per annual. So like, you know, it’s typically 50 K per annual, you know, build, you know, yearly or quarterly, whatever it may be. And that’s just due to volumes because like that’s typically around the point we see like, hey, the organization is needing around bringing on about 20 like 25 to 30 providers. They can’t handle that work anymore. And that’s usually about the cost of like an fte or so maybe a little less of someone handling it. They’re kind of like, hey, like let’s just get a system in place as we scale versus like trying to figure it out later so that’s kind of where that price point comes around.
David Ezeobinwa (12:48) So I don’t know if that’s something like you guys have or I’ll say for you kind of like thought about or budgeted for because it cannot make it could get a little like, okay, does this really make sense for us right now if we don’t even have two provider or, you know, a provider on board and we’re going to scale?
Chris Stokowski (13:03) Yeah. And I think that’s a bit of the challenge is like looking for somebody that’s going to scale with us is kind of my like desire. And if like your minimum is 20, that’s cool. Like it’s not a fit and that’s all right. I can work with finding somebody else that can help us kind of build from the ground up. Yeah. And that’s okay. So it’s the first few conversations that I’ve had. So… and everybody’s products are structured differently, so.
David Ezeobinwa (13:29) Yeah. No, definitely. We’re always willing to scale with organizations. It’s just, yeah, it can be tough from your perspective of like, yeah, why are we spending 50 K already? You know, and we haven’t even.
Chris Stokowski (13:39) Well, yeah, I think that would be a hard conversation unless like I could say like if there was some sort of ramp, right? Like if there was an onboarding ramp for us that said like, you know, like you help us facilitate this beta test for a fee, of course, you know, whatever made sense. And then after we got past the beta, we would have an out. If we said this actually just isn’t going to functionally work for us. We all made some money, we reduced our risk. And then after that, it would be like, okay, if we’re going to commit to doing this product, then we would commit to some sort of minimums with you after that point like that’s how I see like a mutually beneficial scenario where like.
David Ezeobinwa (14:20) We.
Chris Stokowski (14:20) mitigate both of our risks, right? And saying like, you know, we have this ability to do some sort of startup plan or something where we can, you know, bring on a couple of providers, test our market before we actually roll out at scale. And then once we understood like how we believe the product was going to work, then we could actually start to, I mean, we operate in four states. So like I’m highly confident that, you know… just between the scale and the number of members that are likely going to want to engage in this kind of therapy. Like there’s not a problem of like need. It’s probably going to be more of a problem finding providers in… the space. And so like those are things that I just need to understand better. But I think ideally a partner that can help us scale. So like help us do the beta test. And then if you know, if it was necessary to like guard against y’all’s time, then we could create some minimums and say, okay, well, we’ll be to that 20 count of providers in six months after we do the beta, if we agree to move forward and we believe that the partnership’s going to work.
David Ezeobinwa (15:30) I.
Chris Stokowski (15:30) mean, that’s kind of how I think outside the box in a lot of ways. It’s just trying to figure out how things can work. But again, it’s not up to me a.
David Ezeobinwa (15:38) Lot of times like.
Chris Stokowski (15:39) Your organization as to whether or not that’s like a palatable opportunity for them. If you’re doing, you know, 152 150,000 dollar contracts every year… know, working with somebody I guess is a harder ask.
David Ezeobinwa (15:56) Yeah, yeah, no, definitely fair points. Fair points, Chris, and, yeah, and to be fair, and to be honest as well, we don’t typically do trials. We don’t even do trials at all. I will say like this is not something our organization has tested or seen or maybe they have in the past, but I don’t think they’ve maybe seen it valuable. So they don’t do it anymore. But so that’s kind of where, yeah, kind of like referring back to my original points kind of like we come in where organizations are like, hey, we do truly kind of just need this and like they’re like just kind of ready to go. They’re not really trying to like ideate too much because they’re just seeing the value immediately versus like, hey, we need to build up to it. So, yeah, but it’s obviously down the road like, you know, as you scale or you’re seeing like, hey, like maybe there’s something that would make more sense as we scale, medallion is always open to conversations, always looking to bring up. We work with a range of organizations like some have 30 40, some have thousands, you know. So we do work with anything anywhere in between. So.
Chris Stokowski (16:58) Cool. Well, I appreciate it. I appreciate the clarity and yeah, if we end up getting to that point, I’ll let you know.
David Ezeobinwa (17:04) Yeah, man. I appreciate it, Chris. You take care and have a good rest of your day.
Chris Stokowski (17:08) Yeah, thanks for your time, dude.
David Ezeobinwa (17:09) That’s it. You take care bye.