Smoking rates have declined over the decades by two-thirds since the Surgeon General warned of the consequences of lighting up more than 50 years ago. But today about 1 in 7, or nearly 13%, of adults in the U.S. still smoke, and among lower-income individuals, smoking rates have remained stubbornly high.
Adults who are enrolled in Medicaid smoke at more than twice the rate of people with private insurance—nearly 24%, compared with 10.5%. But despite the need, the Medicaid population is underserved and doesn’t get adequate help to quit smoking, according to Shalen De Silva and Jake Keteyian, co-founders of Vincere Health.
The Allston, Massachusetts-based health tech startup is looking to change that. Specifically, it’s aiming to help people on Medicaid—and other vulnerable or underserved patients—not only quit smoking but make other behavioral changes that will improve their overall health.
Vincere was one of the companies that competed in the Pitch Perfect contest at the MedCity INVEST Conference in Chicago. It was selected as the winner in the Care Coordination and Value-based Care pitch track by the judges, who are all active investors.
Jane Rho, an investor at DaVita Venture Group and one of the three judges, said what stood out to her was “Vincere’s focus on a behavior change that has been under-addressed in an underserved population.”
She added that she thought De Silva’s pitch was cohesive and compelling.
“What we appreciate about Vincere is … how compelling and easy it is to articulate what they’re doing around smoking cessation and behavior change in the Medicaid population,” Rho said.
Vincere’s platform offers everything from financial incentives to personalized coaching. The intent is to help people deal with the stressors in their life and make lifestyle changes that improve well-being while also giving patients the best possible chance to quit smoking.
Wanting to make an impact for people who were overlooked was really core to why De Silva, who is Vincere’s CEO, said he switched careers from being an investment banker to work with underserved populations in healthcare. He and Vincere president, Keteyian, first started discussing their ideas for what would become Vincere Health at Harvard Innovation Labs, where they founded the company in 2019.
Keteyian had past experience in health IT consulting working with payers, including Medicaid. He knew the behavioral health needs were significant for this population. But the solutions available to people who rely on the public insurance program didn’t match, he said.
“The care models and outcomes in that space were subpar,” Keteyian said.
Private insurance typically pays more to providers than Medicaid. But De Silva and Keteyian are convinced they can not only help the Medicaid population and other underserved patients, but have a business that thrives while doing so. Much of that confidence comes from what they see as their solution’s winning approach to helping a large patient population make difficult behavior changes.
A unique aspect of Vincere’s behavior change program is that the company built what De Silva describes as a sophisticated “micro-reward/nudge machine” to work in tandem with its human care team.
“Our clinicians can very simply define a personalized regime of daily breath tests, health assessments and synchronous coaching/counseling calls and assign custom reminders and conditional cash rewards to incentivize adherence,” he said.
Incentives can range from $50 to $300. Those external incentives are designed to help participants stick with the program, he said, until they realize the health benefits of making behavioral changes, including quitting smoking, and become more internally motivated to keep it up.
De Silva emphasized that the company’s focus extends beyond helping people quit smoking.
“We call ourselves a smoking cessation company because we don’t want to boil the ocean and there’s so much work to be done in that vertical alone. But the way we do it is very holistic,” De Silva said. “Our clinicians address a whole host of the patients needs.”
Clinicians build relationships with patients that allow them to better understand patients’ stressors and assist them in making improvements in other areas from sleep and how they eat to physical activity.
Although fewer solutions exist for Medicaid patients, there are other organizations that also serve this population. Wellth, for example—a company Jane Rho at DaVita said she’s invested in—is also applying so-called behavioral economics, using financial incentives to help people make impactful health changes and manage chronic disease.
But she sees ample opportunity in this area for startups like Vincere, and likes the company’s approach.
“I think financial incentives are a really interesting way to build that relationship,” Rho said. “Once you have that attention, being able to use that intrinsic understanding of the patient’s motivation and stressors at hand I think makes a ton of sense, especially for more difficult behavior change.”
Vincere’s clients include Medicaid managed care organizations, certain self-funded employers and state agencies. The company is able to put its fees at risk and get paid when it can verifies a participant quit smoking, De Silva said.
“The pricing varies depending on population, intensity of the program and level of risk we bear,” he said. “We earn up to $2,000 per participant in some instances when we bear risk on outcomes.”
To date, Vincere has raised $4.3 million. That includes $3 million in a seed round in 2021, $900,000 in pre-seed funding in 2020 and $400,000 in an angel round in 2019. The startup is looking to raise more money in 2022 and beyond, but hasn’t set a specific goal yet for that, De Silva said.
Looking ahead, he is confident Vincere’s holistic approach will help it stand out from other companies and reach more underserved patients.
“We’re trying to address the core of how do they cope with their everyday life and instill the trust in the health system that they lack, and make what we offer super accessible,” De Silva said. “This is at the core of who we are.”
Photo: Vincere Health