This $2.2 Billion Startup’s GPT-4 Powered AI Bot Demystifies Health Insurance

Forbes

Livongo cofounder Glen Tullman has promised his latest startup Transcarent will use AI to help people navigate and pay for healthcare services, but it may be just another Band-aid for America’s growing $4.5 trillion healthcare bill.  Read the full story on Forbes: https://www.forbes.com/sites/katiejennings/2024/05/15/glen-tullman-transcarent-gpt-4-ai-bot-for-health-insurance/?sh=309b670b70d9  Subscribe to FORBES: https://www.youtube.com/user/Forbes?sub_confirmation=1  Fuel your success with Forbes. Gain unlimited access to premium journalism, including breaking news, groundbreaking in-depth reported stories, daily digests and more. Plus, members get a front-row seat at members-only events with leading thinkers and doers, access to premium video that can help you get ahead, an ad-light experience, early access to select products including NFT drops and more:  https://account.forbes.com/membership/?utm_source=youtube&utm_medium=display&utm_campaign=growth_non-sub_paid_subscribe_ytdescript  Stay Connected Forbes newsletters: https://newsletters.editorial.forbes.com Forbes on Facebook: http://fb.com/forbes Forbes Video on Twitter: http://www.twitter.com/forbes Forbes Video on Instagram: http://instagram.com/forbes More From Forbes:  http://forbes.com  Forbes covers the intersection of entrepreneurship, wealth, technology, business and lifestyle with a focus on people and success.

Transcript

00:00 Here's your Forbes daily briefing for Tuesday, May 21.

00:05 Today on Forbes, this $2.2 billion startup's GPT-4-powered AI bot demystifies health insurance.

00:16 Glenn Tolman believes telehealth, as we know it, is dead.

00:20 The future, according to the venture capital investor and serial entrepreneur, is not video-based,

00:26 but text-based.

00:27 He estimates that in three years, 80 to 85 percent of all telehealth interactions you

00:32 have with your doctor will be written.

00:35 He told Forbes, "All of the virtual care we're doing now is all going to move to chat."

00:42 It's a bold prediction from the same man who sold his last company, Livongo, which made

00:46 managing diabetes care easier, to telehealth giant Teladoc for $18.5 billion at the dizzying

00:53 market highs of 2020.

00:56 Now Teladoc has a market cap of just over $2 billion, which Tolman blamed on "poor

01:02 leadership" and a high-cost, labor-intensive structure due to the demand of staffing video

01:07 visits.

01:08 He said that text-based care and insights, with help from the latest advances in generative

01:13 artificial intelligence, will cause a "Titanic shift."

01:18 Now he's teasing a new AI chat bot built on the same technology that powers chat GPT,

01:23 as part of his latest venture, called Transcarent, which announced a $126 million Series D at

01:30 a $2.2 billion valuation earlier this month.

01:34 The bot will aim to answer the health insurance-related questions that regularly stump more than half

01:38 of Americans, like "How much will I have to pay for this doctor's visit?"

01:42 "What's my deductible?"

01:43 "Can you help me find a doctor?"

01:46 It's part of Transcarent's goal of becoming a one-stop shop to help average Americans

01:51 navigate the opaque and oftentimes infuriating $4.5 trillion U.S. healthcare system.

01:57 Transcarent, which offers an app with 24/7 chat-based primary care services, lower-cost

02:03 drug options, referrals, and second opinions, has raised $450 million since its founding

02:09 in 2020 from investors including Tolman's firm 7Wire Ventures and General Catalyst.

02:16 It also works directly with health systems to get better rates for major health events

02:20 like surgeries or cancer care.

02:23 But experts say Transcarent's business may be more of a Band-Aid than a panacea, even

02:28 though there is a growing market to help people navigate how to find and pay for healthcare

02:31 services.

02:33 Grandview Research estimates that market is worth $10 billion.

02:38 G. Bai, a healthcare accounting and policy professor at Johns Hopkins University, told

02:42 Forbes that the only reason this opportunity exists is due to the dysfunction of the U.S.

02:47 healthcare system.

02:49 Bai said, "It exploits a structural weakness of the current healthcare system, which is

02:54 extreme complexity and the information disadvantage of patients."

02:59 She added that navigation services are more of a "tweak" than a "fundamental change,"

03:04 but there's so much waste in the system that "even a small tweak can still make a difference."

03:11 Most healthcare navigation services depend heavily on human call centers, which have

03:15 high labor costs.

03:17 That's where Tolman sees the greatest potential for his new AI tool — to cut the cost in

03:22 half.

03:23 The bot is currently built on top of OpenAI's GPT-4 large-language model and includes in-house

03:28 specialized models that can determine if a user has asked a medical question or is experiencing

03:33 an emergency, at which point a human needs to take over.

03:37 Tolman said companies are currently paying $10 to $15 per employee per month for human-based

03:42 navigation services, while he plans to offer them for $5.

03:47 Tolman said, "This is truly a generational step.

03:50 We've gone from boring navigation, which wasn't really interesting, to one place

03:55 to get all of your care."

03:58 Transcarent will start offering the tool to its customers in January 2025.

04:02 Those customers are largely employers, as Transcarent is targeting a specific type of

04:06 health insurance — self-funded plans.

04:09 Around 134 million Americans receive health insurance benefits through their employer.

04:14 In trying to crack this market, Tolman is facing off against a mix of startups, such

04:19 as Karam Health and Included Health, and incumbents like Quantum Health and publicly-traded Accolade

04:25 Health.

04:26 For full coverage, check out Katie Jennings' piece on Forbes.com.

04:32 This is Kieran Meadows from Forbes.

04:34 Thanks for tuning in.

04:35 [MUSIC PLAYING]

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