Startup ‘Pair Team’ Bolsters Work of Community Health Centers

Pair Team, a healthcare startup that partners with community health centers to improve patient care, has raised $10 million to date to expand its model. In a recent interview with Healthcare Innovation, CEO Neil Batlivala discussed the services his company offers, including personalized, high-touch care experiences while also seeking to address social barriers to better health.

Founded in 2019 by Neil Batlivala, a healthcare technologist, and Cassie Choi, a registered nurse, San Francisco-based Pair Team provides tech-enabled care teams and digital assistants that act as a virtual extension of community health centers to improve access and clinical outcomes for their communities. Batlivala and Choi had previously worked together at another primary care startup called Forward.

Pair Team's approach has attracted the backing of several high-profile healthcare leaders. including Andrey Ostrovsky, M.D., the former chief medical officer of Medicaid; Shantanu Nundy, M.D., chief medical officer of Accolade; and Drew Crenshaw, chief population health officer at Oak Street Health.

Batlivala said that in founding the company, they were responding to several trends. One is a re-centering around primary care nationally, and the healthcare system recognizing it needs to move its resources to primary care to keep people out of hospitals, be proactive, and move to collaborative care models, and do it efficiently and effectively with both virtual and in person models of care.

“The second thing we saw was all of the innovation happening in Medicaid,” Batlivala said. “We saw these regulatory changes spurred on by the public health emergency, allowing virtual care at community health centers to be reimbursable, combined with a greater focus on health equity.”

CalAIM, the Medicaid transformation program under way in California, “is actually a big reason we're focused in California,” Batlivala said. “I like to say if the 2010s was the decade of Medicare innovation, with Medicare Advantage and accountable care organizations, the 2020s is the decade of Medicaid innovation, and actually promoting health equity and moving our community health centers and rural health care into value-based arrangements.

(CalAIM will begin paying for community support services, which involves helping patients do housing navigation, helping them with substance use programs, transportation insecurity. Another new feature is enhanced care management — looking at whole person care for high-need patients in need of transitions of care.)

Batlivala said that when he looks at Medicaid, he sees our community health centers as the unsung heroes. “The critical problem they have is not a technology problem; it's a staffing problem. “They don't need another tool to log into,” he said. “They are in firefighting mode.”

“Cassie and I realized that from our experience at Forward, we knew how to build high-impact clinical operations in this hybrid virtual remote world. We partner with community health centers to act as a remote extension of their clinical team.” Pair Team has clinical staff that come in — nurse practitioners, care coordinators, outreach staff — to help extend their operations, engage their communities, and provide access to virtual routine care or urgent, urgent medicine. “We help not only offload and have automation that takes away things like documentation reporting burdens from our community health centers, but also sees this huge backlog of patients who are waiting sometimes weeks to see a doctor. We are helping combat those delays and helping address the end goal by avoiding hospitalizations down the line or managing complex care needs. We can address things like social barriers to care as well.”

So what is the business model? “We all get paid on the outcomes that we provide,” Batlivala said. Engaging patients for quality-focused visits drives billable encounters to the FQHC, as well as quality payments. “We help them engage more of the community — follow up on chronic care more effectively. We're even going to be bringing integrated behavioral health onto our team. We are extending the actual care team that we bring to the clinic, which increases their capabilities and drives revenue, and then we take a share of the revenue with the FQHC. We actually pay very close attention to financial sustainability. We want them to make more money to invest back into their community for mobile health clinics, for dental services, for support programs.”

The first group they worked with was a three-clinic organization in the Bay Area that had 60 to 70 percent of its patients in Medicaid. “We were able to triple the rate of annual wellness exams,” Batlivala said. “We did COVID outreach programs to better engage those communities, and ultimately, increased the quality scores for population health management at the clinics by 40 percent in five months in 2020. In 2021, we did a quality improvement of 60 percent, so that translates into meaningful dollars that they can reinvest back into their communities.”

Batlivala said they are in the process of signing up other large FQHC organizations in California and another one in Texas. “We also have one clinic in New York,” he said. “We've also seen a pretty strong interest from health plans that want us to get to partner with their clinics. We've partnered with Molina, Inland Empire Health Plan and Care First in Washington, D.C., and the Virginia area.”

He said they have to meet the clinics where they are in terms of fee for service and value-based care, and be aligned with what they want to do in terms of what's best for their patients. They are happy to work with FQHCs that are open to exploring different ways to get paid and have more flexible ways to spend their dollars. “Sometimes the best way to spend $500 isn't for another prescription that probably won't work,” he said, but instead on a fridge so the patient can eat healthfully.

“We say, ‘Let's just start where you are right now. Let's build trust over three to six months. let's show you that we're here for you.’ Then we can start having those conversations without being rushed to do it. Because trust takes a little time to build.”