Why don’t healthcare companies say what they do?

What does this even mean?‎ No one knows what it means, but it's provocative.

I get some form of this question a lot.

“Why don’t healthcare companies actually say what they do on their site?

“How come press releases don’t explain the details of what they’re doing?”

“What does Commure do?”

I figured I’d answer some of this and talk a bit about jargon in general, which is the antithesis of Out-Of-Pocket.

The business reason of confusion

There are a few business reasons why companies wouldn’t exactly say what they do. Largely, it’s because there’s very little upside to explaining what they do and potentially a lot of downside.

Some specifics:

Sales don’t really happen on the website - Have you noticed how few companies in healthcare have some sort of self-serve option for companies to mess around with themselves without having to go through a salesperson first? Very, very few healthcare companies are actually getting their customer conversions from a website unless they’re a direct-to-consumer company delivering care online.

If anything, the website’s existence is meant to show the customers they’re reaching out to that the company is legitimate, because nothing says legitimacy like shades of purple and a stock photo of a doctor. Most sales in healthcare are happening with slide deck sales presentations for management in dark, smoke-filled rooms (or awkwardly lit conference rooms where the IT never works).

The site is more about conveying, “hello I am real and legitimate and your boss will like you if you show them this site” than it is about making it very understandable to a healthcare plebeian. Embedded much deeper into the site are usually public links that sales/marketing people will send to prospects or they’ll find as they’re poking around the site, but even those are usually jargon-coded in a way that only people within that slice of the industry understand.

Press releases are about drumming up interest - People think that press releases are for the public, but they are not. The point of a press release is two-fold.

The first is to get vendors, investors, and employees excited about potentially working with a company because it’s innovative or has legitimate partners it’s working with. Press releases or mentions in articles make people think you’re “crushing it” because our reptile brains have no other way of assessing if your company is doing well as an outsider. Also a press release can be an excuse to reach back out to a prospect that went cold and get them re-excited.

The second is to explain what you’re trying to do so other companies interested in the same end goal will reach out. Because no one is sure what everyone else is working on, the best way to find out is by saying what you’re trying to achieve and then people from those companies will reach out to figure out specifics.

A bonus third is to annoy the shit out of newsletter writers by bombarding them with “embargoed news” that we absolutely do not care about.

Press releases and news articles are about a company building its momentum and creating legitimacy if customers google them. The dirty secret is that most funding rounds happen months or sometimes even a year before they’re announced, but they get announced when it’s advantageous for the company so they can sequence it with product launches. Or sometimes a press release is announced before there’s any actual solution, because a company is trying to gauge if there’s enough interest or demand in what they’re trying to do.

Most of these announcements are designed to straddle the line of enticing enough for people to wonder what the company is doing, but vague enough that you actually have to reach out to find out. This is actually a preferable sales strategy for healthcare companies because…

The services offered are ever changing and maybe gray area - The other reality is that there isn’t a standard set of services to show. Many startups don’t even have a real product yet and are trying to figure out exactly what they should be selling based on inbound interest. “Oh your company also needs a custom EHR built? Wow actually we do that too, what a coincidence. And you want someone to separate the compost from trash in the kitchen? That’s actually in the premium tier.”

In many other cases there’s a solution but then tons of custom work hours that are added on top. Every customer demands something specific to their issue, and it’s also a good time for the company to upsell them into different services that might not even exist yet. Writing out clearly what your company does online can limit you to just those products, so it’s better to be vague in the solutions and then figure out what package you want to sell when you’re talking to the customer.

On top of that, the uncomfortable reality is that what healthcare companies are selling can get interpreted poorly by the public  and might seem unsavory, even illegal. Is the business model selling de-identified patient data? Does the company ensure proper “utilization management” aka. make patients jump through hoops for things they might not need but their doctors says they do? Do they “recruit the right patient at the right time for clinical trials” with ad targeting on FB/Google?

All of these just…don’t optically look that great. So why even invite that level of scrutiny from people that aren’t even potentially customers?

Wording has to be extremely careful - There are some pretty strict guidelines around what you’re allowed to say in healthcare. For example, you can’t suggest patients are getting free stuff, that would be considered inducing patients to get care. You also can’t make certain claims unless the right governing body (e.g. the FDA) says you can. To avoid risking setting off a regulatory tripwire, many companies opt to stay extremely vague in their language, especially on the med device and pharma sides.

This is also true if you work for or with public companies especially. I’ve worked on press releases with large public companies that require multiple PR teams to oversee them and they’re very careful about the different word choices between “partnership”, “joint venture”, “collaboration, etc. because of how that will be perceived by public markets. Most times the smaller company will err to the verbiage that explains the least because it’s the fastest way to get the large company to approve the wording and get the announcement out. Internal comms people at large companies are wizards at turning useful language into textual diarrhea and they use their powers to the fullest.

The companies or announcements are actually not that impressive - The reality is that if they put the actual solution, most people would be unimpressed. If you said “we’re able to send patients automated SMS messages”, a lot of people would just respond “oh…we couldn’t do that already?”. It’s much sexier to say “we’re engaging in a multi-year collaboration with X health system to reduce admin burden and meet patients where they are”. The unfortunate reality is that most healthcare solutions are actually very boring, so they’re spiced up to actually seem more interesting than they are. Like a product manager’s Hinge profile.

The ideological reason - jargon and pseudo-professionalism

So there are business reasons you wouldn’t put all of this publicly. However, a big part of this is that people in healthcare are never taught to be good communicators because they never had to be. Their business is largely moved by others deep in healthcare, not consumers or press.

When I write sponsored posts about companies, it’s always surprising to me how hard it is for the founders of the company to explain how their company works. Like…don’t worry bro, it’s just me and you now you don’t need to say “personalized medicine”. But many of them are so knee-deep in the problem that they forget regular people don’t have the baseline knowledge to understand their solution.

A key issue is that there’s so much jargon, which I think plagues healthcare and causes a lot of ambiguity in communications.

Why does healthcare have more jargon? One part is the complexity of the industry - it’s annoying to say “company that processes pharmacy claims and also negotiates drug rebates” and much easier to say “PBM” if both parties understand that. But that doesn’t quite explain it for words like “operating system”, phrases like “cross-functional”, or linguistic chicanery like “social determinants of health” which basically just means basic living necessities.

Another part is that it has an enormous number of niche consultants and people whose entire role is “expertise” in navigating a specific part of healthcare, including doctors. Every decision in healthcare feels high consequence because it’s dealing with patient lives, so understandably, people want to make sure they’re making an informed decision and rely on people with that expertise approving it. The experts are constantly trying to make up terms or use jargon to sound smart because if everyone else could understand it, their role becomes less needed.

The flipside is also true. People who are confused by the jargon will repeat that jargon so that they themselves don’t sound like they’re out of the loop. The unfortunate byproduct of this is that most people actually don’t know the things their company does, they just know the tasks they’re assigned.

And finally, I think the jargon lets people feel like the work they’re doing is grand. “Change management” or “running the platform function” sounds like a high social status thing when you’re describing your job to other people. The reality is most of us (myself included) have kind of fake email jobs and we just don’t want to feel like that’s what it is.

Sorry, too real?

Some tricks to suss out what a company does

Just because a company doesn’t outwardly say exactly what they do on their website doesn’t mean you can’t piece it together yourself.

A few tips and tricks to help:

Filetype:pdf and case studies - If you google “filetype:pdf” and the company name, you might find case studies, flyers they send to patients, presentations they give at conferences, etc. that tend to be much clearer. For example, I just googled “Transcarent filetype:pdf” and the first thing that popped up was this flyer that explained the Transcarent benefit for employees. It’s way easier to understand than the press releases.

Public company filings - It’s not really a secret, but if a company is public, then their S-1 filing usually has a much easier and deeper breakdown of what a company does. Do you know what agilon does? The S-1 still uses a lot of buzz words, but you can see in the summary and prospectus that there’s a high level overview of what the business does and capabilities they offer their doctors.

API docs - Healthcare companies frequently need to work with their customers' engineers to get something up and running. And look, I love my engineering peeps, but they really need things to be walked through step-by-step and don’t understand the business jargon at all. I’ve talked to engineers who literally had 0 idea how their company made money, and that’s the kind of locked-in 10xer I fuck with.

This works in our favor, because the developer documentation is frequently much more specific in what a company does and gets past the jargon. Look at the Change Healthcare’s solutions page vs. their actual documentation.

Youtube - A lot of companies will post walkthroughs or training videos on YouTube that are very easily findable. For example, Privia “empowers physicians” and “delivers tools to transform healthcare” on their site but if I search on YouTube for “Privia Training video”, I find this one with 7 views that shows a lot of their tools that send forms for patients to fill out, take pictures of their insurance card, pull in the patient data about medications, and more.

Reddit and substack - “site:reddit.com” or substack + company name on Google yields some pretty interesting results if the company is big enough. For example, here's a Reddit thread complaining about the Virgin Plus employer incentives, the forms they have to fill out, and metrics they have to hit to get bonuses/gifts. Some people actually chime in about the incentives they get and how it’s super different per company.

Or someone will do a full breakdown of a company on their newsletter, which you have to take with a grain of salt. The writer needs to know what they’re talking about. But sometimes you’ll find a gem, like if I search PatientPing substack, this excellent article from Josh Elkington comes up.

Conclusion

For all the talk on panels about a consumer-centric healthcare system, not a single consumer can read any of these websites. If companies and the people working at them are serious about being “patient friendly”, they can start by making it clearer to patients what their company does.

I also think with large language models essentially training on all of the material on the web, this will essentially happen by force. Instead of those techniques I listed above, that information will already be a part of the trained models so when people ask “what does X company actually do”, it’ll be able to spit out a coherent response. So companies can choose to do it proactively themselves now and control that messaging - or relinquish it to an AI that might potentially communicate the wrong things about the company.

We as an industry should push to have clearer communication because it’s already confusing enough as it is. Let’s just be more direct with each other, it’s the most small and tangible way any of us can improve the healthcare system.

Thinkboi out,

Nikhil aka. “English motherfucker do you speak it?”

Twitter: @nikillinit

IG: @outofpockethealth

Other posts: outofpocket.health/posts

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