old_BB-Apix |

Apixio

Vendor Review

Overall Assessment
Basic Info
Leadership Medicaid Experience
Brand Perception
Clarity of Value Proposition
Scalability
Funding Model
Review Methodology

Overall Assessment for Domain: Scalability

Growing / Ready to Scale

Why this analysis matters to you

Points possible:

Points earned:

Employee base

Trends in hiring (Organizational growth path)

Largest Medicaid project identified

Operations team assessment

Product / Solution development team assessment

Strategic partners assessment

Annual revenue

Summary of Black Book Vendor Review Methodology

Our review consists of 55 different analyses conducted by our team of industry researchers and analysts. These analyses span 5 domains we have found to be critical indicators of successful vendor partners in the Medicaid space:

Leadership Medicaid Experience
Brand Visibility and Reputation
Clarity of the Value Proposition
Scalability
Funding Model

While much of the review process is proprietary, there is much we can share. For example, the domains are weighted differently in the overall assessment.

As you can see in the chart of domains, we feel that the Medicaid experience of the leadership team is paramount in predicting how effective a vendor partner will be. Most health plans and state clients tell us that vendors without meaningful Medicaid experience add additional time and cost to the relationship for 2 main reasons: 1) they have to be trained on Medicaid by you and your staff; and 2) they overstate their experience during the sales process which masks risks and costs.

To see why we think each of the domains is important, click the "Why this analysis matters to you" book icon in each of the related tabs.

What is the source of data used for the analyses?

Our teams use a wide range of data sources as well as direct interviews.

Can reviewed companies provide context to the analyses?

All companies reviewed in Medicaid Black Book are given an opportunity to conduct an in depth interview with our team. For those that do, an additional 25 points are awarded for transparency.

Can reviewed companies sponsor or in any way influence reviews in the Medicaid Black Book?

No. Medicaid Black Book is sold strictly as a subscription service and entries can not be sponsored. Reviewed companies are not made aware of results during the optional interview. They are also not given results outside of purchasing their own subscription.

Can Mostly Medicaid consulting clients be reviewed in the Medicaid Black Book?

Yes. When they are reviewed, we conduct the analysis in draft form and allow them the choice of whether to publish the results. We do not in any way alter the results if they choose to publish them. Any Mostly Medicaid consulting client reviewed in the Medicaid Black Book is clearly labeled as a client to maintain integrity and transparency of the review process.

What are the analyses conducted for each vendor review?

Leadership experience review for CEO, COO, CIO/CTO, CFO, Sales/Growth Executive and Product/Solution Executive- An extensive set of reviews of the career data available for each of the C-Suite team members. Leaders are assessed in terms of Medicaid, Medicare, and healthcare experience.
Thought leadership assessment-
Brand and reputation assessment-
Clarity of value proposition assessment-
Scalability assessment-
Funding model assessment-

Have there been any Medicaid-specific thought leader publications from the leadership team in the past 3 years?
Has anyone on the leadership team spoken as an expert at a Medicaid conference in the past 3 years?
Medicaid thought leadership subtotal
Did the leadership agree to an interview?
What is the overall impression of the company in the market?
What are the weaknesses of the company as perceived in the market?
What are the strengths of the company as perceived in the market?
Are there any negative press items in the past 3 years for the company?
What do glassdoor reviews suggest about company culture?
Are there any discoverable legal battles or contract disputes?
What level of brand visibility does the company currently have?
What solutions are offered? (are they unique; hard for a plan to do on their own)
Who else offers similar solutions?
What press releases has the company provided in the past 6 months?
Is it clear the business problems the solutions offered attempt to solve?
Is it clear the way success of solutions is measured? Are the outcomes specific and unique (not just reduce ED, etc)
Does the company use buzzwords or otherwise non-unique language in materials?
Are solutions clearly tailored to Medicaid plans or do they seem to retro-fitted from other verticals?
Is it clear who benefits the most from the solution?
Does the company show how the plan can connect solution costs to member outcomes?
How many employees do they have?
What is the biggest project they have had?
What is their current client base?
What is the experience of their operations team? (mid level mgmt, ie directors, etc)
What is the experience of their product / dev team?
What strategic partners do they have that can help them scale?
What has been their recent organizational growth path?
What is their annual revenue?
What type of ownership model?
If private, what stage are they in?
What is the trend in investment rounds?
Who are the major investors?
What other healthcare investments does the owning firm have? (are there other firms in the fund that can bring additional help?)

Using Our Overall Assessment System

We hope you find our assessment a valuable tool in your overall vendor management process. Here's how we recommend using the results of our overall assessments:

Stop Light Color	Recommended Usage
	Green- Prioritize sales / pitch meetings with this vendor if you have a need for similar solutions within the next 6 months
	Yellow- If approached by the vendor, request materials for review and evaluation by junior staff as a pre-condition of discussions with decision makers
	Red- wait until a later time when vendor offering and/or capabilities have matured and become more fit for Medicaid health plans

Why this analysis matters to you

The unique complexities of the Medicaid space are almost universally misunderstood by those seeking to do business with Medicaid health plans but have not themselves worked specifically in the Medicaid space.

When engaging with vendor partners with limited Medicaid experience, you risk 2 major items: 1) nuanced but important details that drive success in the Medicaid space will be missed by the vendor, and 2) your team will end up spending significant time educating the vendor about Medicaid. The vendor will get on the job training at the expense of your staff time.

Unfortunately, most vendors are either unaware of their own limits with regard to key Medicaid subject matter expertise or gloss over them during the sales and implementation phases. Having a clearer picture of the actual experience of the leadership team can help set expectations earlier in the relationship.

Understanding the color coding for Leadership Medicaid Experience

Color	Explanation
	Limited / None- Less than 5 years observable focused experience for the category
	Moderate- 6 to 10 years observable focused experience in the category
	Extensive- More than 10 years observable focused experience in the category

MMC_418_129_MCMCD2018_320X320-Schulte-Darren

LinkedIn profile

Darren Schulte, MD, has more than eleven years of industry experience in healthcare analytics and technology. Darren served as the Chief Medical Officer and President of Apixio prior to being appointed CEO in 2014. Before joining Apixio, Darren served in executive leadership roles at Alere, Anvita Health, and Resolution Health. Darren co-developed 25 clinical measures endorsed by the National Quality Forum to assess ambulatory care quality measurement using electronic data. Darren is a nationally recognized speaker on the topics of healthcare analytics and quality improvement. Darren received his Bachelor of Science from Berkeley, his MPP degree from Harvard, and his MD from Stanford. He trained in Internal Medicine at UCSF and is the co-author of one US patent.

LinkedIn profile

Meg is a seasoned healthcare professional committed to improving quality of care. She is a strategic thinker whose pragmatic and customer-centered approach has been cultivated from 25 years of experience with technology startups, service companies, and government agencies. Most recently Meg was COO at HealthLoop, Inc., where she spent four years building a team and a company and creating a new market of patient engagement solutions for healthcare. Previously Meg was VP of Business Operations at Epocrates, where she was a key member of the team that developed and launched the Epocrates EHR. Meg also held the role of VP of Client Services during a period of high company growth and profitability that culminated in the Epocrates IPO. Prior to Epocrates, Meg was a strategy consultant with Accenture’s Health Services Group and a Medicaid policy analyst with the Health Care Financing Administration (now the Centers for Medicare and Medicaid Services).

LinkedIn profile

John Schneider has more than 25 years of software technology and product development experience with special skills in cross-functional management across research, product, and engineering. Most recently John was the General Manager of the Adaptive Learning Products and the Chief Product Architect at Apollo Group. Prior to Apollo, John was CTO of CloudTalk, Inc., where his team developed a multi-tenant web and mobile messaging communications platform. At GE Healthcare, John was a director of software development and VP, developing instrumentation and informatics solutions that helped produce the human genome and discover gene function. John holds a BSE degree from Columbia University’s School of Engineering and Applied Science

LinkedIn profile

Tom has 25 years of experience building successful sales organizations for healthcare technology and analytics companies. Prior to joining Apixio, Tom served as head of sales for GNS Healthcare, Connance, and Silverlink Communications. He also led sales at HPR, a medical payments company, up to and through a successful IPO. Tom is a results-oriented executive who excels at motivating field teams, providing solutions to client requirements, and clearly positioning the value of technology services. He holds a BS from the University of Vermont and an MBA from the University of Chicago’s Booth School.

LinkedIn profile

Andy is an entrepreneurial product leader who uses data and a unique blend of technology experience, domain knowledge and leadership capabilities to drive rapid product innovation. He possesses a global mindset, exemplary organization/collaborative skills and the commercial experience to lead the transformation from an idea on a whiteboard into a product generating revenue.
Andy has a track record of creating and championing product vision/roadmaps and building the structure and discipline required to deliver upon them. He is able to leverage his extensive technical background to ensure that product and engineering work together in an integrated fashion
through product planning, construction, deployment and customer success.
Andy is customer facing, and eager to be the public face of the product supporting sales pursuits, industry events analysts and press briefings. He has a strong bias for action, is never satisfied with the status quo and is always looking for continuous improvement in people, products and process.

Andy is noted for:-
* Motivational Leadership: Established Industry Solutions team and grew from a seed staff of 4 people into a high performing global unit of 130
* Product Innovation: Conceived, built and launched a portfolio of 11 new products over 4 years. Worked collaboratively with sales teams to sell to over 300 customers and delivery teams to ensure customer success
*Listening to Customers: Firm believer that the answer to what product/feature to build next lies outside of the building and the only way to get to the answer is through conversations with customers & partners
*Data Driven Execution: Always ensuring that the team understands the “why” behind “what” they are building and “how” they are going to understand and measure success. Champion of the approach “the business model is the product”
*Lifelong Learning: Driven by a strong curiosity about how the “art of the possible changes” with advances in technology.

LinkedIn profile

Sachin brings over 15 years of broad experience spanning both healthcare and technology to Apixio. Most recently, Sachin served as Vice President, Finance of Vantage Oncology, a national leader in community oncology and value-based cancer care. Additionally, he served as Chief Financial Officer of Vantage Cancer Care Network, an innovative model for managing cancer populations. Sachin has prior experience with Citigroup Investment Banking and began his career in engineering roles with Cisco and IBM. Sachin holds a BS in Electrical Engineering from The University of Texas at Austin and an MBA from the UCLA Anderson School of Management.

Why this analysis matters to you

As you consider an innovation partner, it is important to know whether you would be one of the first clients to trust them with a project. It is also important to due preliminary vetting of vendors to ensure no discoverable negative items (i.e. bad press or litigation) come up later as surprises.

Many startups do not have an established brand, but assessment of interest in their solutions is possible. When other MCOs are showing interest in their solution, you can add another layer of confidence in your consideration of a relationship. When interest in the vendor appears limited to the investment community, or is not occurring outside of technology sectors, some concern is merited. There may be a general buzz about the vendor driven purely by finance and investment scrutiny or press.

Why this analysis matters to you

Most vendors entering the Medicaid space view a Medicaid health plan contract as a major strategic milestone. The project they work on with you will likely be one of the bigger projects (if not the biggest) ones they have done to date. The risk of failure during such a period is high.

By reviewing the skillsets and experience of delivery teams (the ones who will be leading efforts on implementations- but also maintaining existing client work), we evaluate the expected stability for new client projects that stretch the business model to the next stage for the vendor.

In addition to reviews of operational team capabilities, we look at trends in hiring to understand the overall growth path for the vendor in recent times.

LinkedIn profile

Role	*click for bios*	If not healthcare:
CEO	Darren Shulte
Operations Executive	Meg Holland
Information Systems Executive	John Schneider	Machine learning
Sales Executive	Tom McNamara
Product/Solution Executive	Andy Crowne	Technology
Finance Executive	Sachin Patel	Investment / Finance

Overall Assessment: Yellow