urban street Cityblock Health

Innovators Worth Watching: Cityblock Health


Oct 25, 2017

Our “Innovators Worth Watching” series spotlights interesting and potentially disruptive players across a spectrum of industries.

Another tech giant is throwing their hat in the ring with the goal of making an impact in healthcare. Amidst the rumors of Amazon’s healthcare aspirations, Google’s parent company, Alphabet, has been unveiling an initiative to lead their foray into healthcare delivery via their new startup Cityblock Health. Rather than pursue markets with high rates of privately insured citizens in search of the highest possible fees, Cityblock is taking a different approach: targeting underserved communities in order to disproportionately reach Medicaid and lower income Medicare beneficiaries first.

The startup hopes that building strong relationships with their members will translate into more successful social service and behavioral health interventions. Cityblock Health president and co-founder Iyah Romm explains:

We will apply leading-edge care models that fully integrate primary care, behavioral health, and social services. And we will use our custom-built technology to enhance strong relationships between members and care teams, while simultaneously empowering and incentivizing the health system to do better.

Could Cityblock be onto something? Time is not the only thing that will tell whether their launch in 2018 will precipitate disruptive success relative to traditional care models. We put Cityblock to the six-question test to better determine whether they are primed for disruptive success.

  1. Does it target people whose only alternative is to buy nothing at all (nonconsumers) or who are overserved by existing offerings in the market?

Yes. Cityblock Health is wagering that many people are overserved by traditional healthcare modelspaying more than they would rather for a product or service that exceeds their true demands.

Because of this, they only seek out healthcare when they present with symptoms that urgently require medical attention. Too often, people have nowhere practical to turn to address other social, environmental, and behavioral concerns that on average account for 60% of a person’s health status, and thus, end up forgoing support entirely—until more medical care is all but required. Whole zip codes are being neglected in this manner, and disproportionately so in communities struggling with issues such as poverty, racism, housing and food insecurity, violence, and inadequate transportation infrastructure. These are the communities Cityblock Health intends to target.

  1. Is the offering not as good as existing offerings as judged by historical measures of performance?

Probably. We can’t say for sure, as we have not yet seen Cityblock Health in action. But it is worth considering beforehand, based on what we do know, how Cityblock is likely to measure up to historical metrics of performance. Traditionally, judgement of healthcare system’s performance is related to volume of medical services. Cityblock’s goal will in fact conflict with this typical measure of performance as their model intends to minimize medical service volume. Thus, we can surmise that Cityblock will likely meet this criteria.

  1. Is the innovation simpler to use, more convenient, or more affordable than existing offerings?

Unclear. This question too remains to be seen, but for a person seeking a solution that coordinates the delivery of social, behavioral, and medical care, it will likely be more simple than existing offerings, as the alternative in many cases is little to no assistance at all in seeking out and coordinating such integrated care.

  1. Does the offering have a technology that enables it to improve and capture a larger market over time?

Yes. In Disruption Theory, “technology” includes the processes that companies use to create value. Cityblock intends to leverage key processes that set them apart from traditional models. They plan to anchor their integrated care model around behavioral coaching and chronic disease management. To do this effectively, they plan to employ Community Health Partners to spend time engaging members, meeting families, and building relationships with members. If this model works in lowering overall medical costs for members, and continually improves over time, Cityblock stands a chance to be a prominent player in state Medicaid markets and hold potential to grow further into Medicare.

  1. Is the technology paired with an innovative business model that allows it to be sustainable?

Yes. Cityblock also leverages a digital network platform called Commons, upon which communication and engagement with members will be facilitated alongside the Community Health Partners. These two aspects of the business model push the locus of member engagement away from costly appointments at clinics and hospitals and into the community, significantly improving access to and lowering the cost of building strong member relationships. These patient relationships are the backbone of any high functioning healthcare system and key to building long-term trust and continuity of care between patients and caregivers.

From here, the sustainability of the model hinges upon whether these relationships will translate into stronger adherence with preventive regimens in order to minimize hospitalizations among their members. If so, there may be room for a margin between their costs and capitated fees.

  1. Are existing providers motivated to ignore the new innovation and not feel threatened by it at the outset?

Yes. Cityblock is targeting those at highest risk of high cost, who also happen to be enrolled with the lowest paying insurer (Medicaid). Existing providers will likely ignore the startup in pursuit of a more profitable payer mix.

Cityblock thus far is clearly positioning itself for a potentially disruptive entry into healthcare delivery. They plan to make a concerted effort to reach Medicaid patients by proactively addressing other determinants of health that are too often ignored by traditional care models, while leveraging new technology to lower the cost of care as opposed to increasing it. Cityblock, sporting a unique care model and the backing of a tech giant, is clearly an innovator worth watching in 2018 and beyond.

For more, see:
Health for hire: Unleashing patient potential to reduce chronic disease costs

As a Research Associate, Ryan investigates potentially disruptive healthcare delivery models and the technologies that will enable their success. He is particularly interested in health information technology and is currently researching Disruptive Innovation in the space of electronic health records.