What does “free” really mean in healthcare? Less access to care? Selling people ads for medicines they may not need? If Mirae costs a patient nothing, what is actually being sold, and to whom? We built Mirae to help reduce patients’ burdens in a sustainable way, which means that we need to make money without cost to patients and without patients into the product. So, we want to be radically transparent about exactly how we make money (this could also be relevant to you, future investor).
Who actually pays
Mirae is paid by the health systems and payers that carry the cost of a patient’s care, not by the patient. We partner with risk-bearing health systems, organizations that are financially responsible for the total cost of care for a population, of the kind we described in “Predictive modeling of complex chronic disease using more than just a receipt”. These are systems operating under value-based or at-risk arrangements, which means that when a patient’s chronic disease is managed late and badly, the system loses money along with the patient losing time: an avoidable hospitalization, a therapy switched months after it should have been, an escalation that never came, a surgery arriving a year after the moment it would have changed the course. The gap between how a patient is actually treated and well-timed care is precisely that gap that costs a health system money.
Mirae’s disease and symptom modeling exists to close that gap, to help the right clinical decision arrive at the right time. By doing so the health system saves money it would otherwise have spent on the consequences of a disease left to progress unwatched. That saving is shared between the health system and Mirae. The precise split, or share, is part of the negotiation along with any administrative fees Mirae charges for setting up our program, onboarding clinicians and enrolling patients. We are paid out of the value we help create, measured in outcomes and in avoided burden, never in a fee charged to the patient.
Why that keeps us honest
We are paid only when the pool of enrolled patients in Mirae achieve remission faster, thus reducing their total healthcare expenditures to the risk-bearing health system. Simply put, the faster patients get better and the longer they stay better, the more we get paid. We believe that our technology is the fastest path towards remission, so in addition to being idealogically incentivized to provide patients with the best possible experience, we are also commercially incentivized to do so
Gain-share arrangements are not new to healthcare, and value-based care has been trying to align incentives this way for years with mixed results. We think it is the only commercial foundation that provide a real impact to both the patient and the bottom line.
The longer game
The same data that lets patients understand their disease better in the app also helps turn a broad diagnosis into precise, novel patient phenotypes. Our predictive-modeling article (linked above) described the process where researchers characterized a biological mechanism, such as the interleukin-10 autoantibody signature linked to HLA-DRB1*01:03 that our clinical advisors, Professor Travis and Dr. Walsh’s, published in the New England Journal of Medicine. As we understand biology better for IBD and as we are able to define more accurate patient phenotypes through the use of our application, more of our patients can be routed toward the therapy actually matched to their biology, rather than the therapy matched to their diagnosis code. This is the ambitious vision of how a technology native care delivery business becomes a drug discovery partner to pharma in the future. Gain-share funds what Mirae is today. Precision medicine, pursued honestly and over years rather than quarters, is what we hope Mirae becomes.
Last thing
Living with IBD and other autoimmune conditions is incredibly challenging. We built Mirae in order to significantly improve the lives of patients, and through our business model, we are betting our company on being able to make it happen. At Mirae, you’re not the product, you’re our purpose.
- Anuj Patel
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Let Mirae guide the way forward
Bring your symptoms, food, medications, lab results, and questions together so you can understand what is changing and prepare for your next care conversation. Mirae is always free for patients. There is no paid patient plan, no trial period, and no card needed to start using the app.
