Clarify and Its Journey to Draw Data Across 300M Individuals

Clarify has an uncommon success story that is yet to be told. Let's take a look at what attracted such huge attention around this health star!
Clarify co-founders and the product is used by professionals
Courtesy: Clarify
By | 8 min read

These days, the rapid increase of data collected from today’s clinical and operational information systems paves the way for new digital approaches to health care delivery, health tech innovation, and clinical decision making.

With a view to empowering better care, therapies, and outcomes, in 2015, Clarify has founded and an actionable patient journey insights to payers, providers, and life sciences companies with enterprise analytics and value-based payments platform was born. The products of Clarify shed light on feasible opportunities for accelerating expansion, maximizing value-based care performance, optimizing networks, enhancing care delivery, managing population health, and bringing therapies to market.

Let’s take a look at the original story of Clarify, which has attracted huge public attention, before diving into its business model.

Insights into Health Disparities Through a Software and Analytics Platform

Clarify was founded by Jean Drouin and Todd Gottula. Gottula is a forward-thinking technology leader whose accomplishments in the high-tech industry have spanned more than two decades. Along with that, Drouin has over 25 years of experience in healthcare management, technology, operations, finance, and cultural change. Drouin and Gottula same focus on creating an atmosphere that enables the company to fulfill its mission of delighting customers and building a great team.

With a mission to power better care by optimizing every patient’s journey, Clarify provides the most actionable patient journey insights and a value-based payments platform, they aid payers, providers, and life sciences companies in improving care, therapies, and outcomes. Big data efficiencies and self-service, on-demand enterprise insights provided by Clarify illuminate the path to higher-value care.

In my opinion, what makes Clarify different is due to its market knowledge, concise strategy plan, and forward-thinking vision. Clarify is the market leader in providing insights into health disparities thanks to its data assets and capabilities. They are in the process of releasing their health equity analytics roadmap, which is a strategy to enhance or incorporate nuanced health equity analytics into their entire product portfolio. Furthermore, their data-driven solutions will assist in closing gaps. It not only determines the underlying causes of systemic disparities in diagnosis and treatment for specific patient journeys but also rewarding provider behaviors that drive equity through alternative payment models and incentives.

Through a software and analytics platform that provides real-time insights and nudges to patients, family members, and clinicians, Clarify Health enables health systems to provide care that is both more satisfying and more effective.

The Forward-Thinking Vision: To Draw Data over $4B+ Care Journeys across 300M Individuals

Clarify leadership team in an interview at conference
Courtesy: Clarify

On the earliest days, Clarify faced the challenge of ensuring that its organization’s infrastructure keeps up with changes in technology advancements, preferences, and standards in addition to preparing for the upcoming changes in healthcare delivery. To achieve success, you need insights that can be put into action now more than ever. However, siloed systems and disparate data sets have led to insight gaps across organizations, slowing down decision-making and making it difficult to spot opportunities. Implementing the right enterprise analytics can improve downstream workflows, empower better decisions, and drive strategic initiatives.

Additionally, purchasing and combining formulary data from various sources to gain insights and efficiency are additional major obstacles. The reporting procedure is a manual one that is time-consuming, labor-intensive, and susceptible to human error, and consulting firms play a significant role in it.

Also, Todd Gottula stated that the way to improve healthcare outcomes is governed by a set of specific decisions, and people will receive much better outcomes if those decisions can be made with more knowledge. Consider a referral from a primary care physician to a specialist as an illustration. All subsequent care will be much better, much more efficient, and ultimately lead to a better outcome for the patient if that referral can be done in a much more personalized manner to a specialist who has positive experiences treating the patient, like the one that is being referred.

Clarify offers healthcare data analytics solutions to health plans, providers, and life sciences companies. From now, customers can explore metrics and benchmarks on-demand and at a granular level thanks to the company’s solutions, which draw data from over 4 billion care journeys involving 300 million unique individuals to provide precise insights at unprecedented scale and speed.

The Creation in The Process of Incorporation Data into Patient Journeys

Accordingly, Clarify team was driven by a passion to make healthcare what it should be – delightful, high quality, accessible, and affordable.

At first, the company’s founders thought about how to serve a mission that reduces the total cost of care and keeps our communities healthy. What exactly is its creation? The company prefers to serve it in a layer cake. The data is the first step. They have gathered information or signals about each and every person. Therefore, they have at least some ideas of how each individual in this room and across the nation has experienced the American healthcare system in the past, and we have all of their information for a subset of them. This is extremely hard to identify because it focuses on their healthcare, not who they are. However, Clarify is then able to incorporate all of that data into patient journeys thanks to that base data layer.

Like when you consider that a single individual is attributed to their primary care physician, all of the specialists that they have seen, and all of the facilities with whom they have interacted, you now have an incredible ability to compare any particular patient journey or set of patient journeys to all of those others once you have all of the patient journeys, which total approximately 15 billion different patient journeys.

Clearly as Gottula said, “you can create which we have done, the most case mix-adjusted high-fidelity assessment of where there’s value creation or destruction in the healthcare system. And then once you know where opportunity exists, you can put that opportunity in the context of the workflows, through business applications, to ultimately drive value.”

360-Degree View of The Patient Journey: Purpose-Built

As far as I know, a set of highly automated, self-service business applications run on the Clarify platform. These applications help healthcare organizations boost growth, improve care delivery, optimize networks, manage population health, maximize value-based care performance, and successfully introduce therapies to market.

Many partners are very satisfied with the service at Clarify. They all said that Clarify brings to life the hidden potential of deep healthcare analytics. The platform’s one-of-a-kind cloud-based methods for enriching and sequencing healthcare data yield precise insights at an unprecedented scale.  “We believe that Clarify has a huge opportunity to maximize the intersection of patient, clinical, and financial outcomes. We look forward to supporting the team as they scale up to deliver on this opportunity.” said Hilary Gosher, Managing Director at Insight Partners.

By digitizing the key terms, methods, and metrics used to determine contract performance, align incentives, and motivate the right behaviors, this business solution makes contract design and modeling simpler. It helps achieve better outcomes by providing a 360-degree view of the patient’s journey, including the medical and social needs of populations to ensure that patients are provided with the right care interventions. The concept of a 360-degree view of a patient simply means you have a comprehensive picture of the patient based on data collected from various points along their care journey.

staff at HCA hospital collaborate in a lab
Courtesy: HCA

It compares provider performance using advanced case-mix adjusted benchmarks, identifies opportunities for improvement at the level of discrete clinical behaviors, and identifies drivers of unwarranted variation using AI. In conclusion, it digitizes settlements by conveying a framework carefully designed for overseeing esteem-based agreements and installment compromise.

Clarify Health Solutions raised $328M in funding over 4 rounds and its last round of $150M in series D funding helps it unlocks the promise of value-based care with end-to-end intelligence on every patient’s journey.

Through its patented automation processes for machine learning model generation and performance benchmarking, Clarify generates insights 30 times faster than conventional methods. Its implicit, industry-driving grouper innovation protected case-blend change technique, and phenomenal capacity to represent social determinants of well-being factors increment the accuracy and significance of bits of knowledge.

From Self-Service to The Path of Care and Outcomes Improvement

Clarify discovered savings opportunities worth over $5,000 and improved outcomes in a high-risk population with PMPYs ranging from 18 to 19,000. As a result, preserving quality, lowering utilization, preventing unnecessary clinical interventions, and ultimately enabling people to live their best lives are all goals.

 And how does the company achieve that? Clarify teams accomplish that extremely effectively. The final illustration is a national carrier that can construct effective networks eight times more quickly, enabling them to enter the market in a manner that enables them to then attract new business, guarantee that those members are receiving the high-quality care that they deserve, and significantly shorten the amount of time it takes for them to enter the market, significantly increasing their overall return on investment.

From point-solution and manual analytics to self-service, rapid generation of enterprise insights that illuminate the path to improved care and outcomes, healthcare organizations can leapfrog Clarify. Clarify drives relevant and high-value decisions by providing a personal preferred network and tailored recommendations based on individual provider patterns, value opportunities, credentialing, and distance, and by leveraging peer comparison and social norming.

For that reason, with Clarify, healthcare organizations can move from traditional analytics that were time-consuming and laborious to self-service analytics that quickly generate insights that improve health and outcomes.

The Healthcare You Have Received, Not Who You Are

“Clarify Health stands out in its understanding of the market, clear strategy roadmap, and forward-thinking vision,” said Delfina Huergo, Research Analyst, Health & Life Sciences, Frost & Sullivan. The company is energized by the pace of innovation in the healthcare industry as they partner with health plans, providers, and life sciences companies to change the way healthcare is delivered and paid for. For that, Clarify Health was recognized by Frost & Sullivan as a Healthcare Data Analytics Market Leader in 2022.

In addition, Clarify Health Solutions has a career opportunity rating of 4. The company believes that a happy, diverse, and impact-driven team is critical to its mission of transforming healthcare. So, they welcome applicants and employees from all walks of life, even those from traditionally underrepresented groups.

With Clarify’s insights platform, other businesses can identify variations as they emerge, support their provider partners with granular insights, and identify opportunities to act to ensure their success. “We have at least some indications of what their historical encounters have been with the American healthcare system, a subset of which we have all of their information available.”  said by Todd Gottula. 

Notably, the company does make enormous contributions to social wellness. Within six months, they identified over $285 million in addressable opportunity, which is being implemented for clinicians in the workflow. They are also more than a quarter of the way to achieving that ultimate objective. Because it is a system of continuous learning, that is only the first step. Once they have adjusted to the new performance level, they look for the next set of opportunities to keep driving value, keep providing better outcomes, and ultimately enable or empower individuals to live better lives.

Bottom Lines

Through the years, Clarify has been able to identify areas where the industry can achieve fast, tangible impact using advanced patient journey analytics to fully crystallize the elusive patient journey.

Its platform powers highly automated business applications that not only enable customers to drive growth, maximize value-based care performance but also commercialize pharmaceutical and biotechnology products – all of which depend on a superior understanding and trending of individual patient journeys and cohorts.

  • About: Katie Le
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