Speaker 1: 0:00

Raising children might be easier if they came with an owner's manual, but they don't. How can plans help employee parents get on-demand answers to on-demand problems? We'll find out on this episode of Shift Shapers.

Speaker 2: 0:15

Change either energizes or paralyzes. The choice is yours. This is the Shift Shapers podcast, bringing the employee benefits industry interviews with individuals and companies who are shaping the industry shifts. And now here's your host, david Saltzman.

Speaker 1: 0:36

And we're here in Salt Lake City at the Ascend Conference and I've caught up with Hans Kohlberg, hans' CEO and founder at Avocado Health. Hey, hans, how you doing.

Speaker 3: 0:46

Hey, david, nice to be here with you.

Speaker 1: 0:48

My pleasure, my pleasure. So we always like to start out by asking how'd you end up doing what you're doing today? Because in this business, everybody's got an interesting story and it's rarely a straight line. So how'd you get to be here?

Speaker 3: 0:58

So, first of all, david, I'm a father of five and, as with any parent, we've been through our own circumstances, challenges across the life cycle of our own parenthood journey, and really this has been born out of a passion of mine to ensure that every parent is equipped and empowered with the tools necessary to meet their questions and really with validated, evidence-based information at the right time.

Speaker 1: 1:23

Have you been in the insurance space forever and ever? I've not, I you, been in the insurance space forever and ever?

Speaker 3: 1:26

I have not. I've been in the pediatric space for the last five years, but really in the insurance space. What we've learned is that employers care a lot about working parents, not just from a psychological standpoint, but also from an economical standpoint.

Speaker 1: 1:39

Yeah, and we'll get into that as we go along in our conversation, because I think it's sometimes something that's overlooked and yet it's pervasive, because almost everybody has not everybody, but almost everybody has kids and it's a problem to deal with. So let's talk a little bit about this what kind of problem are you solving and what's the scope of it?

Speaker 3: 1:57

Yeah, so 60% of working employees are parents, and they usually have a number one job.

Speaker 3: 2:04

That's really their home life, so what we're really addressing is their five to nine.

Speaker 3: 2:08

When they're not in that workplace, how are they able to actually answer all of their questions and concerns?

Speaker 3: 2:14

Whether it's a new parent, or whether it's a child with a developmental delay, or whether it's a teenager that has anxiety and stress, we know that parents will likely drop everything, work included, if there's any concerns on the home front, and so what we're doing is really able to answer and address behavioral, developmental, minor medical and even everyday challenges that working parents face at any point in time, whether it's 2 in the morning and your kid's not sleeping, or 2 in the afternoon and you're worried about your child that might have autism. We're doing that in the most accessible format possible, which is via text message, and so the big problem right now is working parents are going down the rabbit hole of Dr, google or Instagram influencers or TikTok right All because it's accessible on their phone. Ideally, they love to go to their trusted pediatrician or provider, but it takes days, if not weeks, to actually get in front of them, and really we're bridging that gap with the right information at the right time, in the right format, which is text message, in addition to that validated information that they need.

Speaker 1: 3:17

So that's kind of the impact on parents. But let's talk about it from an employer's viewpoint viewpoint, because most of our listeners are advisors. They're trying to bring really useful and meaningful solutions to employers who, by and large, are trying to find really great solutions for their employees. What kind of a toll does not having this information and having to deal with the children problems take on employers and their plans and their businesses?

Speaker 3: 3:43

Yeah, so the biggest problem is really the productivity gap and among those there's three main ones attrition, absenteeism and presenteeism. Among those, presenteeism is the biggest one, where it costs employers on average $8,000 per employee every year. Lots of different factors go into that, but for working parents, whether it's being physically in the office, in the workplace, but maybe mentally absent Mentally they're checked out, they're somewhere else, maybe they're sleep deprived or maybe they're trying to search down the rabbit hole of Dr Google trying to get answers for their child Presenteeism is a really huge $300 billion problem here in the US that, when we talk to people leaders, hr leaders say this solution immediately addresses you know what we know. This is not a caregiving solution, it's not, you know, it's not a Teladoc solution. But what we are doing is really answering parents' questions that they really need to be answered. Other than that, it's also being able to kind of mitigate a lot of medical claims, a lot of high-cost claims that actually come through ER visits, urgent care visits and also developmental delays.

Speaker 1: 4:50

So, from an employee standpoint, once an employer says, yes, this is something I want to add to my array of benefits for employees, do they get like an app? Do they just text someplace and say, hey, my kid's got this and that. And the next thing, what do I do? How does practically, how does it work?

Speaker 3: 5:04

So the user experience is like texting with your best friend, who's the most knowledgeable pediatrician, therapist, parent coach and social worker that you know, right there on your phone.

Speaker 1: 5:14

So part of the reason that text messaging is what you say is the most effective is because it's accessible to everybody and it's easy to use and pretty much everybody knows how to send a text message. Do you have to do any more education on the employee side?

Speaker 3: 5:31

No, absolutely not. So. Text message receives a 98% read rate very high response rate as well. We know, as parents, parents are very busy and being top of mind is the most practical way to get in front of them. In terms of education, it's really like having a conversation with your best friend, who happens to be the most knowledgeable pediatrician, therapist, parent coach that you know, and so, with regards to education, everyone really knows how to text. We're making that assumption, but, in terms of effective communication, what we're able to do is really make sure that they're getting that benefit that they need and deserve.

Speaker 1: 6:05

Now, one of the reasons that people like going to their friendly pediatrician is because of the empathy that they they're able to provide. Do you lose the empathy if you're sending text messages?

Speaker 3: 6:17

Yeah, so we incorporate incorporate empathy even in our text message platforms. So we are not just AI, we're a hybrid of human and AI component. We lead with empathy. We think that's a very important part of understanding who the parent is, what problems that they actually have, and really addressing those concerns. For about 97% of questions, we're able to answer that with AI. For that 3%, we'll actually come in with a human care advocate and let them know that hey, we're on this case. We're going to help you, solve and walk you through whatever challenge that you're facing.

Speaker 1: 6:50

And then, if you get to the point where it's something that the care advocate can't handle, do you mesh with the employer's plan and help them find a provider, or what's that next step?

Speaker 3: 7:03

Yeah, absolutely, and one of the big things that we're doing with employers is really taking a look at their health plan and their benefits on the health stack and being able to increase adoption and awareness and also utilization of those existing benefits. So an example is if a mother has postpartum depression and we're able to pick up on that we don't have providers that are looking at that from our side, but we're able to say, hey, did you know that your employer provides this mental health benefit and you can go ahead and book an appointment by just clicking here. By that simple access of bringing that information that that member might have not known beforehand, increases in awareness and then utilization of even existing benefits, which is a huge thing when we talk to benefit directors.

Speaker 1: 7:50

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Speaker 3: 9:54

Yeah, and so one of the big things that we're doing is really extending the onboarding education in really the first seven days, and so making sure that the member knows you know what we are, what we do and what resources are available is very important. But also getting that not in a course format but more so in bite-sized snippets, and so one text message every day, in addition to a very short video explaining what questions they can ask, but also helping guide them through that parenting journey. So one of the things we do is ask reflexive questions to really help coach that parent through whatever challenge they have, as well as give age and development-related information relevant for that.

Speaker 1: 10:39

Can you give me an example of what one of those reflexive questions might be?

Speaker 3: 10:42

Yeah. So one reflexive question is tell me about a moment today or this week that you really connected with your child. Why was that special and how did that make you feel there's no right answer? It's a rhetorical question, but what it helps that parent do is really stop, take a moment and really connect. Connection is a really big part of parenting. It's just one of many different facets, but what we know is that an empowered parent is one that's informed in knowledge and also understands their child in a very unique way.

Speaker 1: 11:17

Can they, for lack of a better term, kind of press a panic button if they know they've reached a point, with whatever's happening with their child, that they've got to go see somebody or take the child someplace? Everybody's looking to have friction removed from processes these days.

Speaker 3: 11:42

Do we create friction there or do we remove that friction and give them a way to hit the eject button? Yeah, so certainly for any major crisis, critical emergency instance, we're going to redirect them and say emergency instance. We're going to redirect them and say, hey, call 911 and go to emergency room because we have a threshold of situations that we can actually talk and address. But we know that there's a lot that's out of our scope. And so a very poignant example of that we had a member who had their fifth child. They were six months old and she was having wheezing and really difficulty coughing or even breathing. It seemed like a typical run-of-the-mill cold, but when they started asking Avvo they realized that this was a more urgent scenario and the suggestion was go see your provider. One trip to the pediatrician. The realization was that it wasn't just a ear infection but it was also RSV. Rsv at that age can be even fatal.

Speaker 3: 12:34

So a couple medications of antibiotics and the baby is fine, good to go. And so that very small example was a way that it probably reduced or mitigated a hospitalization visit, a big medical bill for an employer, but also that time and stress for that parent.

Speaker 1: 12:54

Is this generally only applied at the plan level, or is it a voluntary?

Speaker 3: 12:58

piece. We're flexible on both sides. We'd love to be at the plan level and embedded and incorporated within that, but we know that there's different priorities, different budgets, different circumstances. Our mission, really at our core, is to empower all parents with accessible, informative and actionable parent support, and so, by that definition, we are flexible at the voluntary.

Speaker 1: 13:20

And can it run alongside a fully insured plan?

Speaker 3: 13:22

Absolutely can. We can absolutely be flexible on the fully insured plan as well, and that's within our scope.

Speaker 1: 13:30

So if you kind of look out into the future four, five, six years where do you see this going? Where do you see the evolution of this?

Speaker 3: 13:39

Yeah. So we're really starting, david with employers, because we know that working parents and employers have the biggest to gain as well as biggest to lose in terms of liability attrition, productivity, et cetera. You know our mission is to help over a billion humans around the world. And where do we start? We start where the need is the greatest, and so you know, ideally we'd love to be in all health plans. We'd also love to work with payers, such as even Medicaid and local city state municipalities, where there is a societal cost of not ensuring that parent has the maximum amount of support and that child has the best foundation to really start their life. And so we are flexible with text message, whatsapp as well, soon to have Spanish capability in other languages later down the road.

Speaker 1: 14:33

You know we didn't talk about Medicaid, but there's a lot of underserved areas and whatnot. It seems that this would be a real boon to folks in those kinds of areas and or in rural areas where you know there aren't hospitals. The rural hospitals have all pretty much been bought up by the big chains and closed, so is that a target area?

Speaker 3: 14:55

Absolutely Rural and lower income is a really big target area down the road for us and we're building with the end in mind, knowing that that user base is probably the highest amount of need.

Speaker 3: 15:06

It's also a longer cycle, longer timeline just to really get in front of them. But when we look at we've talked to rural pediatricians you know they're inundated, they're swamped, they have, you know, thousands of patients that are on their panel, but what they say is we don't really have time for every single patient. And we have, you know, we have parents calling in the middle of the night, but we don't have a pediatric nurse. How do we actually address that? You know here's a wraparound service that you can actually offer at a fairly minimal cost to actually have a scalable impact. Same thing on the Medicaid side, where we know, even with budget costs and the crisis that are happening, we know social workers that are having to be laid off. How do you actually address, you know, that gaping hole with a tech forward solution that's scalable, in a cost effective manner, to make sure that single parent who's raising a child by himself isn't left by the wayside, right, and so that's a really huge opportunity for us in the future.

Speaker 1: 16:02

Juan, that's a great place to end our conversation for today, but we do hope you'll come back as things evolve. Hans Kohlberg, CEO and founder at Avocado Health. Hans, thanks for sharing your expertise with us.

Speaker 3: 16:11

Thank you, david, really appreciate it.

Speaker 1: 16:18

I want to give a quick shout out to our sponsor and our producer, hatcher Media. Hey, if you need podcast production or professional graphic design, josh Hatcher is the expert to contact For more information. Visit him at HatcherMedianet. That's H-A-T-C-H-E-R Media dot net.

Speaker 2: 16:36

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