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Where we share our weekly news debriefs and discussions with industry experts. These are lo-fi recordings aimed at giving our readers more opportunities to engage with our analysis and a view into some of the conversations that shape it.
Martin: I am gonna bring
forward our next guest, Amanda.
Hey Amanda, welcome to the show.
How are you?
Amanda: I'm doing well.
How are you?
Ah,
Martin: doing great.
Doing great.
We were just talking a little bit about
AI in Utah, but we're excited to be
hearing from you about, um, some sort
of different technological applications.
So you are the CEO and co-founder of Bold.
Can you give us a quick overview
of what Bold's technology
does and then we'll talk Yeah.
About Access and some of the other Yeah,
Amanda: so Bold is an AI, uh,
platform focused on healthy
aging and there's two components.
We have an AI clinic really dedicated
to serving Medicare members as well as
AI powered, um, lifestyle programming.
So that's exercise, education, behavior
change tools and support, and some
community services to actually help
someone between those clinic visits
actually adhere and sort of take control
and build those healthy habits that
add up to changing how someone's aging.
Martin: One of the things
I found, oh, sorry.
Sorry.
You go, you
Kevin: go Martin.
No, you
Martin: go.
I was gonna say, one of the
things I found interesting was
the focus on false prevention.
So my mom was a false prevention
coordinator for a while, and it is a
very challenging behavior change project.
Yeah.
Right.
Behavior change is one of those things
that is the silver bullet in healthcare.
If you can get someone to change
the behavior, you can do a lot.
I'm curious how, what your sort of focus
is when it comes to, or approaches when
it comes to sort of changing behaviors.
Amanda: Yeah.
So, um, you're, you're right that we
started with a focus on falls and for us,
our, our big mission has always been close
the gap between health span and lifespan.
So where there's been a lot of
longevity focus on adding years, we
were focused on how do you make most
of those years as healthy as possible.
And falls are often that moment where
you see a split between how healthy
someone is and how, how a, a steeper
decline once they've had a fall.
I think falls are so ubiquitous that
everybody actually has somewhat of a
latent awareness and fear of falling,
um, or fear of falling is quite common
and can actually feed into fall risk.
And so our initial proposition, and
as we've expanded the other types
of things like musculoskeletal pain
management or chronic chronic condition
support, weight management, all goes
back to what are some of those big
barriers or things that start to become
really top of mind as you're aging.
And I think fundamentally
behavior change requires someone
to want to make the change.
You can't sort of like force a change.
And so by finding ways to speak and
connect to, um, a topic like falls,
but not make it, uh, we're gonna
bubble wrap you and try and keep you
from falling by sort of controlling
you and instead saying, Hey, you
actually have a lot of agency.
If we can help you with tools, build
strength, balance, mobility, then you
can keep doing the stuff you want.
You can go out, run errands, go go
to the gym garden without feeling
un unsteady or, or off balance.
And I think that sort of.
Approach to tapping into a problem
in aging that's maybe not fun to talk
about or maybe has been talked about
in a, um, more tense or, or sort of
like, uh, uh, confrontational way
applies to many other topics in aging.
And so it's really about building
for that Medicare member who I
think, um, you know, before Bold,
not many digital health companies
said we're gonna start with Medicare.
It's often we'll build for a different
population and try and copy and paste,
and I don't think that works as well.
So really knowing our Medicare members
and being able to build and support
them and, and grow and learn from
them, I think has helped us be the most
successful at unlocking those longer
term engagement and behavior change ones.
Kevin: Amanda, I'm curious.
When I, when I first started hearing
about Bold, going back a few years, I
had in my mind, okay, fitness benefit.
And when I think fitness benefit,
Medicare, I think Silver Sneakers,
and I'm like, okay, like kind
of alternative you to that.
And then now I hear about it and I'm
like, okay, kind of more virtual MSK
type model and entering into that space.
Can you help me with like, what's
the right conceptual model there
at a very high level and how,
how, help me think about that.
Amanda: Yeah.
I'd almost say it's really actually around
that bigger umbrella of lifestyle change.
Yeah.
What are the changes that happen and
what are the, the actions that need to
happen between your clinical touch points?
We started with exercise
and movement is medicine.
Movement is medicine encompasses both
fitness benefit and more intensive,
you know, programmatic, clinical,
uh, musculoskeletal interventions.
But our thesis was movement is medicine is
a great, it's like the number one thing.
If you could, um, ask any primary
care physician exercise should
be started part of someone's care
plan and it's the least adhered to
part of most people's care plans.
And instead there's a focus on
med adherence or, or you know,
nutrition is also very important.
But the feedback loop of, I used
to be active, I'm less active.
If we can restore activity,
it's not just falls.
It's not just fitness benefit,
loyalty to a, an MA plan, it's
actually a transformation.
'cause exercise positively impacts
every organ system and there's very
little downside to increasing activity.
So I, uh, Kevin, it's a great question,
but I would say it fits within, Hey, how
do you actually drive lifestyle changes
and, and deliver lifestyle programming?
With an eye towards aging.
It's not sort of a near term shift,
it's not around optimizing for
some long-term ROI, our ROI and our
sort of transformation can happen
in a matter of months, right?
Single digit number of months.
And that's really different and it's
pretty cool from a prevention lens.
Um, as far as you know, where the
appetite has been in the market for
that has historically been within
MA and I think that's why you, the
SilverSneakers comparison is, is
worthwhile because it's been, um, there
have been dollars in benefits to attract,
uh, members to sign up for MA plans.
However, I think where we compliment the
a silver sneakers type solution is our
real sort of area we shine is getting
non exercises to convert to exercising.
So it's not go to a gym, take 45 minutes,
Zumba, it might be do 10 minutes seated
of pain management for your, you know,
your knee and over time that individual's
now doing 30 minutes three times a
week from 10 minutes twice a week.
And so that's how you think about
longitudinally sort of adding up and
why that's worked for MA plans is it's
been not the same users that have always
been gym goers before they signed up and
then after they've joined, it's tapping
into how do we actually bend the cost
curve for the harder to engage members
historically by giving them something
that feels great for them to engage in.
Martin: I am curious, so you've
been working with Medicare
Advantage folks for a while.
Access gets announced as
a, as a concept from CMMI.
There's a lot of
excitement in the industry.
Yeah.
Scanning through the list you like, I
think a lot of, some of the other big
SK digital health players chose not to
participate, they said financial concerns.
How are you seeing the opportunity?
Like talk us through what
you're seeing there and how
Bold is approaching this model.
Amanda: Yeah, I can't speak to sort
of what other company's decision
processes have been for us.
It makes a ton of sense and it,
it really naturally fits with what
we've already been proving out.
So, um, digital First Tech led, right?
It's not around synchronous touchpoints
or having, you know, PTs in the loop.
It should be a compliment.
And we've always wanted to be a
compliment where if you have bold,
maybe you see less PT utilization,
or you can manage, you know, reducing
wait times for those PT visits.
Um.
So that idea of can you predominantly use
software, AI powered software to drive
clinical outcomes has been something that
MA has historically been more willing
to, to sort of figure out and pay for and
invest in primary secondary prevention.
Um, what's great about Access is
we've seen for the last few years,
we've seen a ton of demand from
original Medicare members that
have wanted to sign up for Bold.
And there just weren't codes, right?
There wasn't something that allowed
you to, um, more preventatively
and without having, um, lots of
synchronous touchpoints with individuals
invest in, in sort of lifestyle
changes or more digital engagement.
And so I'd say there's been hundreds
of thousands of like expressed
interest and we've just said, sorry,
unless you're on one of our partner
plans, we aren't able to support you.
And so last year actually we, we
launched the, the virtual clinic
with an eye towards it's time
to build for this population.
Now that was a little bit ahead
of access then being announced
at the end of last year.
And we were thrilled because I think,
um, you know, kudos to CMS right now
for saying lifestyle and prevention and
things like exercise and nutrition are
those levers where if you can really
scale them at a population level.
We can all see a cost reduction.
And I think that's just a, an
exciting opportunity for us.
But one we've been primed for because
we've been through engaging Medicare
members and proving those outcomes time
and time again, where it's longitudinally
showing, you know, fewer inpatient,
outpatient doctor's visits, self-reported
improvements, um, and I think that
puts us in a great position to say
access is just creating a new way for
us to get, um, reimbursed and expand
our business to, to more individuals
for doing what we've been doing.
Kevin: Amanda, it's a fascinating data
point on, um, Medicare folks reaching
out to you and, and building the
virtual clinic to, to support them.
One of the questions we hear often is
about this concept of cost of acquisition
and how we're gonna drive awareness
with folks of the access model, the
cost that folks are gonna incur as
part of that cost of acquisition.
But it almost sounds like you've got,
you've already kind of cracked that nut
in a really interesting way, and it's now
just an opportunity to meet that demand.
I, I'd be curious, how are you getting
in front of these patient populations
today in terms of traditional Medicare?
How do you view that changing under
access, and how do you think about that
concept of CAC within those two settings?
Amanda: Yes.
Okay.
So a lot, a lot in that.
I think historically, um, you
know, we, we do partnerships with
the health plans and the ACOs that
we've worked with to do direct
outreach, right, to eligible members.
That's really efficient.
You get one degree away where
it's like, I love this program,
I really want my friend to do it.
Oh, she's not on the same plan as me.
And so we actually get quite a bit
of word of mouth or friend of friend
referrals where it's like, how do
you get as ubiquitous as possible?
And yes, we wanna keep expanding our
partnerships on the B2B side, but
fundamentally, 50% of folks effectively
are just on original Medicare.
And so we were starting to see, um,
more and more, you know, inquiries
in addition, when we do other
acquisition channels through, you
know, Facebook or YouTube or organic.
'cause we do, uh, we do have a
newsletter that we've been, um, sending
out, um, for a number of years now.
Those individuals have also said,
Hey, how do I check my eligibility?
And when they go through, we kind of are
able to say, okay, we're now understanding
what the profile is of who's.
Expressed interest heard about
us, but we're not able to serve.
And, um, I think that we're really excited
with access launching in a, a couple of
months that we'll be able to reach back
out and say, Hey, we're available and
now, now there's a way for you to engage.
Of course, it's um, you know,
I think this initial iteration
will be a more narrow subset.
It's, you know, particularly
focused on chronic pain.
I think the direction that this sets
up is more and more broadly, how do
you, um, how do you support, you know,
more frontline prevention of exercise?
Maybe could we engage people before
the pain is chronic or with other
types of diagnoses or risk factors?
Um, but, uh, you know, I
would say so we have a lot of.
Built up interest.
But I think continuing to, to be able to
say, Hey, there's now more people that
do those eligibility checks are going to
get that instant moment of, oh great, now
I can just go straight in to click away.
What I also think is great about access
is it doesn't necessitate that you have
that provider referral, but we've done
a lot of work with provider groups and
some MSSP ACOs where I expect that that
will also be an awesome channel for us.
And, um, there's always
clinicians that are, are really
advocating for exercise already.
And as they find out about Bold, they
wonder, how do I refer people in?
And it's tough when you say, well, a
subset of your patients can use Bold, but
you're gonna have, like, it's unrealistic.
They're not gonna sort of
filter through the funnel.
And so being able to take original
Medicare members is gonna be huge,
um, to unlock the power of some
of those partnerships as well.
Martin: We only have a couple more
minutes before we have to let you go.
I'd be curious to hear the sort of bold
philosophy on devices like I, I know for
some of the other tracks it makes a lot
of sense to have someone have a blood
pressure cuff or a wearable of some sort.
What is the interaction
mechanism for, for bold?
Like how are people interacting
with it and how are you sort of like
measuring some of those met, measuring
some of those data points for access?
Amanda: Yeah, so to the first
part on devices, we've been
device agnostic and I think.
More with an eye towards, like,
we're in an ai, AI first world now.
Um, there's so much data and there's so
much data that doesn't require necessarily
a wearable or like an additional device,
or folks already have those devices and
so you don't necessarily need to, uh,
be shipping or supplying, um, versus
helping them make sense of all the data
that those devices are giving them.
And that's inclusive of your mobile phone.
So there's a ton of activity, gate data,
um, you know, heart, heart rate, sleep
data existing on phones that you kind
of have with you all, all of the time.
Our primary interaction has
been somebody signs up for bold.
We create a hyper-personalized program
for them based on their clinical needs
and risk factors as well as their
just personal preferential, right?
You have a thousand people.
There's maybe a thousand different
reasons why they wanna take that
action to change how they're aging.
But at the core, you know, it kind
of boils down to what are some of
the, the ways you can start building
a mind body connection around how
to use exercise to manage pain.
How do you rethink about exercise fitting
in your life or movement, um, supporting
you in hitting some of these goals.
And so those, the AI sort of, and
the foundation models our team has
built as well as using off the shelf
models, is taking all that data,
whatever someone's comfortable sharing.
Um, and some of it might be, you
know, unlocking existing device data.
Some of it might just be
desire to log new things.
Um, and putting that together to
have a program that isn't just
one time personalized but is
continuously updated and personalized.
And I think that's also where we
see longer term behavior change on
lock is you need to be dynamically
checking in with someone because
things can change really quickly.
Um, and so the question for us is really
how do we make the data make sense
for someone and make it actionable
for an individual more than, how
do we just amass more data that is
interesting for our team to look at?
We always start with, well, what is
someone comfortable with and how is
it going to immediately improve their
recommendation, improve their program
experience, or improve their sort of
accomplishment or sense of progress
is how do we show people after just
a few sessions like they're reporting
less pain or they're doing more
sophisticated movement patterns that
show that they're seeing, they're
seeing their own progress and growth.
Where I think oftentimes as we
age, it's more around preservation
and not around progress.
And I think that for us, has been
something that our members tell us
is really special about Bold, is they
feel really celebrated that they're
unlocking new things as they're engaging.
Martin: This has been
hugely helpful, Allison.
Excuse me, Amanda.
Um, thanks so much for your time today.
If folks are interested in learning
more about Bold or if they're an
MSSP, the a CO and they want to get
in touch on how they can get bold in
the hands of their seniors, what's
the best way for them to do that?
Amanda: Um, you can send a, a message
through LinkedIn to me or through, um,
our website, which is age bold.com,
and we would love to, to talk
more around how we can support.
Martin: Really appreciate your time today.
Thanks.
Fun time
Kevin: today.
Amanda: Thanks.
Good to see you both.
Take care.
You
Kevin: too.