Employer Solution Series: How Gravie Gives Small Companies More Options

The company's first CMO, Dr. Greg Burrell, adds medical expertise to the start-up's benefit and service suite.

A little more than one month into his tenure as chief medical officer at Gravie, Dr. Greg Burrell shared a few key takeaways with HealthLeaders:

• What it means for Gravie to add its first-ever CMO to the executive team.
   
• The multiple service areas that Gravie has bundled for employers, brokers, and consumers.
   
• How this combination can help offer large-company health benefits to small business.

As CMO, Burrell will "develop and lead Gravie's care strategy, building innovative clinical programs and ensuring that members are happier and healthier as a result." In the announcement, Gravie adds: "Dr. Burrell will work closely with providers and members as he oversees the integrated clinical operations and population health at Gravie, ensuring the delivery of the most effective and affordable medical services to members."

Gravie was founded in 2013 and remains a private startup, raising more than $90 million in July 2022 in its latest funding round.

Gravie offers two core services to self-insured employers—the Comfort health plan and support for the new defined contribution model ICHRA (Individual Coverage Health Reimbursement Arrangement).

Gravie describes Comfort as "the nation's first-of-its-kind health plan that provides zero-deductible, zero-copay, and 100% coverage on most common healthcare services" (e.g.,  primary care, generic prescriptions, labs). Other services (e.g., emergency, specialty drugs, inpatient care) have defined copays or are available no cost after the employee reaches their OOPM.

To support ICHRA, Gravie offers a marketplace for employees to purchase a health plan using the defined contribution their employer made toward the cost of coverage.

Burrell notes that the company wants to be smart about innovation. Gravie's Comfort plan and ICHRA marketplace reflect three market developments:

• More small to mid-sized employers are turning to self-insurance to lower healthcare costs.
   
• More benefit design is focused on wellness and prevention.
   
• Defined contribution is a viable alternative to traditional models where employers offer specific benefits and plans.

HealthLeaders: Sometimes it's difficult to tell what an innovator actually does and how it's different. Gravie sounds like a combination third-party administrator, benefits navigator, and marketplace platform. Is that accurate?

Burrell: All of the above is basically true. Gravie started about a decade ago with the ACA mandate as a Marketplace plan, then moved to ICHRA and saw common challenges. The company then built its own plan, Comfort. This allows smaller employers to be self insured by paying Gravie a premium to administer benefits.

HL: How is the addition of a CMO a selling point for employers and brokers?

Burrell: In many cases, we're already proving ourselves with our offerings. The extra benefit is knowing that there is a medical leader looking at plans, benefits, and the analytics needed for a quality offering and high-quality care. It lets employers know that there is medical oversight through the entire process.

(In its announcement blog for Burrell, Gravie notes: "With this new medical and clinical thought leader on our team, we'll continue to grow and innovate while focusing on improving the quality and efficiency of healthcare delivered to members, and ensuring it's worth the investment for both members and employers.")

HL: What types of employers does Gravie pursue and why?

Burrell: Today we serve about 1,000 employers. Our sweet spot is companies with 50 to 500-ish employees—sometimes a little larger and across a broad variety of organization types. One commonality might be employers that are interested in accessing things that were only previously available to larger employers. This includes more robust, personalized plan design and unique point solutions.

HL: What are some examples of those point solutions and your decision-making process?

Burrell: We offer a couple of point solutions at no cost as part of our Comfort plan. Sword, for example, is a virtual musculoskeletal (MSK) clinic for customers needing physical therapy and/or are experiencing pain or discomfort. We also use Teladoc for mental health and therapy services.

Callout Quote: "Innovations can take different forms. Some are care delivery model innovations, some are technology innovations where we have a new way to meet members where they are (telehealth). In general, we're trying to be smart about it."

Burrell: But when you're thinking about real people, they often have mix of things going on—an MSK component of pain plus depression or anxiety. The question is whether and how to prioritize or to address simultaneously. There is a point at which there can be too many handoffs and we might think about in-house development of our solutions to ensure a good customer experience and care journey. It's a case-by-case decision.

The CMO, an advisor to early-stage health tech companies and former co-founder of Carbon Health, concludes: "Gravie offers no-cost care beyond the annual exam. This is important to me because I'm a primary care physician by training. I'm passionate about patient experience, access, and preventive care."