Covert - Risky Benefits Podcast S5E12

In this episode of Risky Benefits, we discuss the opioid crisis with Nico LoDolce, founder of Dolce Vida Consulting, and Jose Bracero from Champion Health. The conversation introduces Covert, a groundbreaking platform that helps organizations proactively address opioid addiction by analyzing medical claims to detect early symptoms of withdrawal. The platform ensures privacy by de-identifying employee data and targets prescribers to update them on safe opioid prescribing practices. Success stories, including significant cost savings for a Florida school district, underscore Covert's impact. The episode highlights the importance of early intervention and the substantial benefits it provides to both individual health and organizational productivity. 

To listen in and subscribe to more episodes, visit our website: fbmc.com/podcast.

Transcript

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Hey everyone. Thank you for listening to Risky Benefits and welcome to this week's episode. Our guests this week are Nico La Doce and Jose Ro, representing Champion Health and an advocate for clever Benefits featuring a game changing platform called Covert. So today we're tackling a very serious topic that touches. Every industry and every community, the opioid crisis, but we're not just talking about the problem, we're showcasing a powerful, proactive solution. So thank you both for coming on. Why don't we start by you guys telling us a little bit about yourselves and what you guys do. First off, thank you so much for having me. I'm Nico a Dolce. I'm the founder of Dolche Vida Consulting, and I work closely with the teams at Champion Health and Clever Benefits. So we provide proactive solutions for organizations of all sizes, both public and private. And actually personally, I grew up in Johnsburg, Illinois, so really small town and at the. Age of 21. I drove myself down to Orlando, where I currently live ever since. So just what spurred that? Yeah. During the height of COVID, I had an, an opportunity, a friend of mine that I grew up with in Illinois was going to UCF, and he was actually in benefits and he was doing well, and he told me, if you wanted to try it, you could, but you gotta move to Orlando. I was like, no way. And then long story short. I visited Orlando three months later. I drove myself down as a 21-year-old. Awesome. Absolutely. Um, but just really thankful for the journey and the opportunity to make a positive impact here. Very good. Thanks. Yeah, so I started off as a business owner for 10 years, ran a sales consultant company. We built up sales teams for some of the largest companies in America. When COVID hit. We got very lucky, was able to exit successfully on that business. Took some time off, had some babies, and then decided I wanted to get back into the tech world. So, uh, started working in technology companies. Eventually met with Nico. Saw that his solutions have technology behind it, and you know, that we could do something with this type of technology and then decide to partner up. Very good. Well, happy Father's Day. Thank you, belated. Thank you. Did you have a nice day? Yeah, I had a great day. Good, good. Yeah. Very good. So let's get into it. The big picture, um, the opioid crisis is that it's obviously very devastating to everyone families. It's overwhelmed the healthcare system and driven up costs for employers. It's not just a personal tragedy, it's a massive financial and operational challenges for businesses and public entities. So can you guys speak on that a little bit? Absolutely. So I think something that gets missed too is 75% of people that get addicted to opioids and enter treatment. Actually started with a prescription written by their doctor. Mm-hmm. So I'll share some more real numbers with you guys that we're seeing on our end. So we analyze about 50,000 members claims each month. And what we're seeing on our end is about 10% of plan members get prescribed an opioid in a year. Of those, 30% of those members end up. Suffering withdrawal symptoms severe enough where they seek outside coverage or care. Think like emergency room visits urgent care and more. And this one's shocking too. Patients managing severe opioid withdrawal symptoms account for up to eight to 10%. Of the total health plans cost in a year. That's crazy. And the reason for that is because on our end we're seeing that someone that is abusing opioids costs a health plan$10,000 more in a year than compared to others. So imagine you're a large organization with a ton of employees, that adds up very fast. Okay, so how does Covert help? Yes, so Covert is a pet and pending solution that basically analyzes medical claims and is able to detect opioid withdrawal symptoms very, very early on. And what's very unique is we need no personal health information, so we don't even know who the employee is. It's all de-identified. What we do though know, what we do know is the. Provider prescribing the opioids. So then our team is able to go and reach out to that per prescribing provider, like a dentist, a surgeon, a doctor, and we're able to tell them the most up-to-date protocols and practices for safe opioid prescribing. What's what we're really proud of is 98% of providers actually adopt what we are suggesting based on the numbers. That's obviously extremely high number and really proud of that. Yeah, absolutely. Why do you think that is? I think because the numbers don't lie. Right? And when they've seen something they've never seen before and we have proof, I think that's why, and I do wanna add it really important to understand there's four stages to opioid use. The first is pain management, second is chemical dependency, third is abuse, and fourth is addiction. Why I bring this up is because we have a 75% success rate. With provider intervention in the first two stages, it is so important we get this early.'cause if we don't and it progresses to abuse or addiction, success rate drops to under 10%. And if somebody's addicted, it's basically 0%. It's too late. Wow. So that's why our window to help is in stages one and two. Yeah, that makes sense. On a personal note, like we've seen so many friends and family members, uh, especially on my side or my generation who are no longer here because they fell into stages three and four, and it's very little to no help at that point. Yeah, absolutely. Absolutely. Wow that's impressive. I mean, those numbers are really. Really crazy. Mm-hmm. Mm-hmm. So, that's a very powerful strategy and it sounds like it's not just about helping one person, but it impacts the whole health ecosystem. absolutely. Yeah. Yeah. A great example I like to point out and funny, I actually have the memo printed here. I'll kind of go into it. Yeah. But up. Yeah. May I? Yeah, absolutely. Just'cause we're really proud of this, but I was gonna acting like Joe Rogan, where it's like, uh, could you show this on the podcast please? Yes. But no, but basically this is just a thank you memo that I'll get into in a second. But the school district of. Osceola County here in Florida. They're in Orlando where I am or near Orlando, and they have thousands of health plan members. They've been using Covert since 2019. So they're a proud client and in the first year alone, they saved$1.45 million on their health plan. Wow. Mm-hmm. Not only that, but emergency room visits went down and urgent care visits went down as well. And the head of risk and benefit manager there she wrote us that thank you memo, just explaining how it saved them a ton of money and it prevented opioid addiction and all of these great things. Yeah. In addition, as a reminder, each intervention. Saves$10,000 on average in a year, right? So not only is covert saving lives, but it's also a positive return on investment for organizations. Absolutely. And I can imagine that if you are catching them in those phases, one and two, that the employee engagement side is a lot better, less absenteeism, more people, you know, able to come into work and Absolutely, yeah. Healthier, more productive. Mm-hmm. So, so the thing about opioid disorders. Is that it's sometimes it's undetectable to the naked eye, right? The person that's on it, you won't notice until like they hit really drastic measures and then they start nodding out at work or spacing out at work or taking longer breaks or this, that, and the third, and by then it's already too late. So the goal is. You know, they're probably gonna get it prescribed to them by a doctor and it's normalized, especially here in America to do so, you know, they get into a car accident, back hurts, whatever that looks like to them. And then we wanna make sure that we could catch it right up front because again, like the numbers don't lie. Right. And, and it's super important to make note of that. If you have an entire organization that's on it, God forbid I don't think that organization would last long, but but for sure, you know, it's all about how can we be as proactive as possible to help that organization for time to come. Mm-hmm. Yeah. And do you guys have like any education pieces that go with this to help, the employers look for those signs and know when people are potentially reaching stages three and four? So covert is actually more so on the. Backend, it kind of operates as a safety net without anybody actually knowing, right?'cause there's no employee identification or interaction. And it doesn't, it also doesn't have to for material. It's honestly all gonna be come from our prescribing professionals. Our team of pharmacists that reach out with the. Provider. So all that education's actually gonna go to the prescribers. Not so much hr, et cetera. Okay. They are aware of these new mitigation policies that are gonna happen. Mm-hmm. But that's kind of as far as they, they know. And of course we do partner with folks that provide these types of trainings and help with educate businesses with this. So we could always refer them to them, but we're just not the experts on that side. Right? Mm-hmm. Okay, good. That's I really incredible stuff. So what can HR leaders, school districts or other brokers how can they explore the solution? Absolutely. well actually, so for anybody listening please feel free out to. Please feel free to actually just reach out to me over email or connect with you on LinkedIn. I'd be more than happy to walk through how COVID works and how it could save your organization. Not only lives, but money as well. I. And is there anyone, like, is, do you guys have a target audience for this or? Yeah. So if, whether it's a school district or a municipality or just an organization with a large workforce those are who we impact the most. All right. Well, is there anything else? Yeah, actually I do wanna add one more really important thing I like. No I. So most health plans actually rely a lot on their pharmacy Benefit manager or PBM to help prevent opioid addiction or for claims to pile up. But to be frank, by the time that actually is alerted, it's usually too late. That member is most likely already addicted to opioids. So Covert is able to catch it before any other tool out there. And once again, that's where we make the most impact, is actually proactively not reactive. I love the name Covert. How did you guys come up with that? Covert, behind the scenes? Not really detectable. Yeah, just operating behind the scenes. Okay, cool. Anything else for. No, I think I think we hit it all. Okay. Well thank you guys. And I think what you're doing really sounds like a very innovative solution and a game changer, so thank you. And for our listeners, if you wanna learn more, please contact Nico or visit our homepage@www.fbmc.com. And remember, you can find us and subscribe on any podcast app. Thank you. Thank you so much.