Behind the Scenes – An Inside Look at the $3.5 Trillion Chronic Disease Industry

“Behind the Scenes” is a series focused on highlighting the unsung heroes – Operations teams. Their work is often critical to the operations of the company, yet few if any customers know they exist. Our goal is to bring these teams to light and surface the amazing work they do day-to-day to keep the products we love humming along smoothly.

We spoke with Shohini, Product Manager at Oscar Health – a health insurance company headquartered in New York City whose mission is to “do our part to dismantle and rebuild the country’s broken health care system and improve health outcomes for everyone”.1 Shohini’s team, Digital Member Experience, builds products to empower users to easily find the care that they need.

We discussed her thoughts on a current project at Oscar Health, how she thought through her career path, and her advice for new grads on how to choose a role or company.

Project Highlight – Chronic Disease, the $3.5 Trillion Industry

Shohini walks me through Oscar Health’s upcoming Virtual Care Program, a program that provides patients with no-cost telemedicine visits with an Oscar Health primary care provider and provides free downstream services such as labs, medical equipment, and prescriptions. Her focus is on managing care routing, mainly driving adoption and tailoring the user experience. 

Oscar’s unique positioning as an insurer, and now care delivery provider, allows them to disrupt the current service model – namely when a patient’s provider and insurer are two parties pitted against each other, with no coordination. Ideal especially during COVID, the program’s goal is to incentivize patients to exercise preventative care, allowing them to save on potential financial, emotional, and physical constraints that come from unmanaged diseases. 

The long term goal of many virtual care programs is to help patients manage and bring down the cost of chronic diseases. Chronic disease is defined broadly as “conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.”2 As the country’s leading cause of death and disability, chronic disease has affected 6 out of 10 Americans, lead to the deaths of 1.7 million Americans annually, and accounts for a whopping $3.5 trillion in healthcare costs every year.3  To make matters worse, the prevalence rate of chronic disease is increasing. With the advancement of medicine leading to longer lifespans, as well as existing risk factors such as poor nutrition, smoking, and excessive alcohol use, the effects of heart disease, cancer, and stroke (top chronic diseases) has led to a greater impact on the wider American population and has thus attracted a greater focus from the healthcare industry. 

Many within the industry are aiming to solve the problem of chronic diseases – some remedies being chronic disease focused primary care, Medicare payment models, and even tech investments focused on Medicaid populations. Medicare is a federal insurance program that provides health coverage for Americans 65 years or older or younger and disabled. Given the older population, Medicare sees a higher concentration of chronic diseases across its participants. In contrast, Medicaid is a state and federal assistance program that serves a low-income population, another hub for potential high rates of chronic disease due to structural disadvantages.

The main pain point here, Shohini highlights, is the ruthless cycle of poverty, where healthcare is more often mixed in with other economic, educational, and social gaps. For example, a low-income American would have access to low quality housing and food, leading to greater likelihood of contracting diseases. This circumstance would ultimately lead to greater time spent having to go to doctor’s appointments, more money lost given the increased number of visits, and low productivity due to the physical, emotional, and financial stressors. Care is needed, but financial incentives make it difficult to distribute to those most in need. Oscar Health, through its focus on easy-to-use and no-cost preventative care, hopes to test a different economic model for healthcare that actually incentivizes preventative care in the general population. In focusing more specifically on tackling chronic diseases and addressing social determinants of health, Oscar’s new program will hopefully lead to a brighter, healthier future for the American population.

Shohini’s Background – Why Oscar Health? 

Shohini’s career is threaded with the principle of “working to build and expand upon basic services for people”. Coming from UC Berkeley with an initial focus on International Relations and Policy, she pivoted into tech by interning for Oscar Health as a Product Management intern focused on insurance infrastructure. She then transitioned to an operational role at Savvy, an early-stage healthcare startup based in the Bay Area. Both experiences brought their respective learnings and perspectives.

Upon experiencing both an early-stage startup and larger-scale company, Shohini details the different pros and cons she experienced from both. The startup allowed for flexibility, quick decision-making and re-prioritization but at the cost of less structured experimentation. On the flip-side, the larger-scale company had access to a broader range of healthcare experts and ample data. As a side effect, however, more stakeholders led to greater time spent gathering project feedback and buy-in.

Ultimately Shohini landed back at Oscar Health, charged with broader experiences and fresh learnings, ready to help tackle the company’s mission of making virtual care and healthcare concepts more accessible. She rejoined excited to learn more broadly about healthcare and to continue her personal mission of “expanding basic services”. Not only is she able to be part of a company that aligns with her personal mission, but her function allows her to play a pivotal role in actively building products to improve the care experience for the user.

Advice for New Grads – Materialize the Change You Want to Make 

Shohini speaks to her internship experience at Oscar Health and her approach to understanding whether or not the company was the right fit. Driving projects given to her were of course learning experiences, but going beyond the assigned work allowed her to fully maximize her time there. She grabbed coffees with people and teams outside of her scope in order to explore her interests. She dug into understanding which projects (outside of her day-to-day) were prioritized as a company. She socialized with colleagues after work, observing to see if the company would be a good culture fit. All were factors that played important roles in having Shohini choose the right company, the right team, and the right product.

Zooming out, she provides three actionable principles she used to help her decision-making process for choosing a company/role:

1) Have a clear idea of the outcome you want to create. 

2) Understand what the gaps are of the company and whether that’s exciting to you. 

3) Pick a mission or product that you’re building over a specific role. It’s easy to be drawn towards specific companies for the sake of the title or prestige, but at the end of the day, choose based on your passion and interests. And that is what will provide long-term impact.

In summary, Shohini’s Virtual Care project, journey of navigating different companies and functions, and thinking through culture and company fit, all highlight the importance of mission and impact – execution for the the sake of execution can take you only so far, but execution with a purpose leads to greater momentum, longevity, and well-being.

Interested in learning about Oscar Health’s COVID resources? Click here: https://www.hioscar.com/covid19

To learn more about Oscar Health, you can find more information here: https://www.hioscar.com/about

To learn more about Savvy, you can find more information here: https://www.gosavvy.com/

Flowdash’s mission is to bring happiness back to the workplace by changing the way people create software. We’re making it easier to build applications without code so that individuals within every organization are empowered to create the tools they need — the tools they deserve.

  1. “About Oscar Health”, accessed August 18, 2020, https://www.hioscar.com/about.
  2. CDC, “About Chronic Diseases”, accessed August 18, 2020, https://www.cdc.gov/chronicdisease/about/index.htm#:~:text=Chronic%20diseases%20are%20defined%20broadly,disability%20in%20the%20United%20State.
  3. CDC, “About Chronic Diseases”, accessed August 18, 2020, https://www.cdc.gov/chronicdisease/about/index.htm#:~:text=Chronic%20diseases%20are%20defined%20broadly,disability%20in%20the%20United%20States.