Making Health Benefits Understandable at the Front Desk

Jeremy Bluvol is CEO and co-founder of Anagram, a Los Angeles company that builds software to help people use their health insurance benefits. He grew up in Canada, trained as a biomedical engineer, and worked in medical devices on research into detecting and treating cancers with ultrasound and MRI guidance. His interest has always been in healthcare and making it more empathetic.

About Jeremy Bluvol

Jeremy Bluvol is co-founder and CEO of Anagram, which, in his words, was built to increase the affordability of healthcare for patients and providers by unlocking insurance benefits and other payment methods so people can pay for services on the spot. Anagram is the leading software in the vision care industry.

The Problem

Jeremy and his co-founder started the company about six years earlier after their own medical billing troubles. Health insurance is too hard to understand: most people don’t know what is on their plan or even what insurer they have, since coverage usually comes through an employer, and doctors have no good way to know how much a patient owes. That’s how you end up with confusing collection statements and “this is not a bill” notices. He sees insurers, as the main payers, as surrogates for patients that determine which services are reimbursed, which has made it hard for people to understand and use their benefits.

Three Names in Six Years

The company started as Bauxy, short for “billing auxiliary,” then quickly became Patch, as it saw itself patching the healthcare system. A patch.com in New York objected, and the name felt small and temporary, so it rebranded as Anagram: a word that can be rearranged into another word, as the company sees itself rearranging the healthcare system.

What Anagram Does

Historically Anagram has been a SaaS business serving eye care doctors and their patients, processing out-of-network insurance benefits. When a patient arrives, the doctor typically would need to phone the insurer to get benefits, with no way to pull eligibility or follow a claim. Anagram’s software sits behind the desk, pulls benefits, calculates how much the insurer should reimburse (which most doctors don’t know), and files the claim digitally.

Jeremy said it generates, on average, more than 30 percent additional revenue for practices, because patients who think they’re out of network or have no benefits often don’t show up, and Anagram brings them in. It also saves the administrative costs of billing and front-office staff who would otherwise spend hours on the phone with insurers. For patients, it helps them access benefits and buy at a cheaper rate.

Funding and Scaling

Anagram raised its Series A at the end of 2019, just before COVID, and was raising again. Jeremy mentioned a new initiative in stealth mode that he said would be transformative for the insurance industry and promised to come back to it. The first round let the founders, who started in a San Francisco condo filling out claims by hand while the product looked automatic to doctors and patients, build the automation. The next round scaled the sales and marketing organization, and he said the company now has product-market fit and a repeatable sales team, with a larger Series B planned for 2021. The team is over 50 people.

Advice for Health Insurance Startups

Health is hard, Jeremy said, because it has extra stakeholders (patients, providers and payers, “the three Ps”) and extra regulation, and not all players act rationally even when it is in their interest. Many investors don’t understand health insurance, so look for investors who get excited about the niche. He also noted the healthcare startup community is small even though the spending is astronomical, and people in the space generally want to help one another.

Gilad raised insurers acting as a proxy that effectively decides treatments. Jeremy agreed, adding that they create incentives for doctors that may not be in the patient’s best interest, which he said is evident in vision care and evidenced by the existence of Anagram. He admired GoodRx as an example of transparency in drug pricing that bypasses insurance in some cases.

Remote Work and Venice Beach

Jeremy rides his bicycle down to the beach in Venice, and Gilad mentioned Ex Machina as a coffee spot. When COVID hit, Anagram got rid of its office and went fully remote, which investors received well; much of the team had been remote from day one. His tips: separate the sleeping space from the working space, keep technology out of bed, create a dedicated desk, and check in on team mental health. The company also created a remote work benefit to help employees pay for internet, a better chair or desk, in place of gym benefits.

Advice: Breath

Jeremy recommended Breath by James Nestor, about nasal breathing and the author’s experiments, and has been trying Wim Hof breathing. His other advice is simply to stay mentally and physically healthy.

Key Takeaways

• Anagram gives eye care practices software to check out-of-network benefits, calculate expected reimbursement and file claims digitally.
• According to Jeremy, practices see on average more than 30 percent additional revenue as patients who would have walked away come in.
• Insurers act as surrogates for patients, which creates confusing incentives; that is the gap Anagram exists to fill.
• The company renamed itself twice (Bauxy, Patch, Anagram), reached product-market fit after its Series A in 2019, and planned a Series B for 2021.
• Health startups face extra stakeholders and regulation; find investors who understand the niche.
• Anagram went fully remote and replaced gym perks with a home-office benefit.