Gladden longevity — Episode #67

Steve Reiter: Welcome to Age Hackers with Dr. Jeffrey Gladden, MD, FACC, Founder and CEO of Gladden Longevity. On this show, we want to help you optimize your longevity, health, and human performance with impactful and actionable information by answering three questions: How good can we be? How do we make 100 the new 30? And how do we live well beyond 120? I'm Steve Reiter and, Dr. Gladden; we just wrapped up with Joe Baffone, who's the co-founder and CEO of Annexus Health.

Because we talked to Dr. Ernie on your staff, and we talked a little bit about his transition out of traditional medicine and hospitals and the administrator problems in that, bringing Joe on right now is a great time to talk a little bit more about the underbelly and what really goes on in healthcare, and how Annexus Health, A-N-N-E-X-U-S health.com, how they're helping patients.

Dr. Jeffrey Gladden: Yeah, this was an interesting conversation for us because we don't spend a lot of time in traditional healthcare space, and we decided to speak with Joe because he's actually taking an angle of trying to help patients navigate the healthcare system to get actually the coverage that they need, the resources that they need to be able to succeed in their treatments across 14 different diseases. And it's a really interesting conversation. You'll learn a lot about the system and how to navigate it. And it comes away with some very practical advice on how to do that. So, if you have somebody or yourself even that's having to deal with the traditional healthcare system with regards to cardiovascular disease, oncology, rheumatology, gastroenterology, and things like that, you'll find this a really informative podcast. It's some really good stuff.

Welcome, everybody, to this edition of the Gladden Longevity Podcast and the Age Hackers Plus Podcast. I'm your host, Dr. Jeffrey Gladden. I'm here with my right-hand person, Steve Reiter.

Steve Reiter: Your right hand [inaudible 00:02:05].

Dr. Jeffrey Gladden: Steve, good to see you today.

Steve Reiter: Good to see you too, Dr. Gladden. I'm doing good.

Dr. Jeffrey Gladden: You look like it's cold where you are. You got your video in there?

Steve Reiter: Yeah, it's late March, and it's been snowing a bunch here in Colorado.

Dr. Jeffrey Gladden: Okay. Is there snowing in the studio over there? Because it looks like you're ready for it. Anyway, but hey, we have the pleasure of welcoming you to the show, Joe Baffone, and Joe is a very interesting guy. Joe, I want to just kind of dive in. You have an interesting story here that includes everything from being a college baseball player to an avid surfer to having some sort of a love affair with pandas to doing some really revolutionary things in the healthcare space. So, welcome to the show.

Joe Baffone: Thank you. I feel like I was set up with the questions you asked prior to this.

Dr. Jeffrey Gladden: Okay. Yeah, you've been set up. There's no doubt about it.

Steve Reiter: For our audio listeners, I was laughing because Joe was shaking his head while Dr. Gladden was mentioning pandas.

Dr. Jeffrey Gladden: Yeah, exactly. Well, somehow, it got in Joe's bio, and I'm not going to let it go. So, Joe, just walk us through a little bit. You started out, obviously, as we all did going through life, and I'm just curious to know what was your journey a little bit that got you to where you are now as the CEO and co-founder of Annexus Health?

Joe Baffone: Yeah, I think the personal journey, and for the listeners, we were talking a little bit before we went on air, and Steve was sharing some personal stuff. And the personal stuff, Steve, to be honest with you, Dr. Gladden, listeners, is what really rocked me to my core. And it was folks that were really close to me, right? My mother, I was the primary caregiver when I was a very young man. I was in my twenties. I learned so much and became really frustrated with the healthcare system in the United States, which there are great portions to our healthcare, but there are really a whole lot of things that are [inaudible 00:03:58].

Dr. Jeffrey Gladden: Let me just interrupt for a second, Joe, and clarify this because I'm not sure. So, you were the primary caregiver for your mom. So, are we saying your mom was really sick, or your mom was financially in need, or how did all that come to fruition? How did that arise?

Joe Baffone: Yeah, thanks for clarifying. So, primary caregiver as a mid-twenties person may be overstating it, but I was the one that was really working with my mother, standing side by side with her on her decisions around Non-Hodgkin's Lymphoma.

Dr. Jeffrey Gladden: Okay.

Joe Baffone: That was years and years ago, and it was before in the healthcare space, we had really proven that we could cure Non-Hodgkin's Lymphoma, and thank God she was cured, but she was part of a clinical trial that had her randomized to a really overly aggressive regimen that took a massive toll on her and almost killed her at least three times during her journey.

Dr. Jeffrey Gladden: Wow.

Joe Baffone: But really, when I say caregiver, it was managing the things that, as an organization, we help manage, and it's the administrative and the logistical challenges or things that need to be taken care of as a part of that diagnosis, right? You get the diagnosis, and it's completely overwhelming, but there's so much to the decision and the journey.

Dr. Jeffrey Gladden: Right. So, I can see this as there are decisions and things that need to be taken care of with regards to her health insurance and her deductibles and her copays and all this kind of thing. And then there are things that need to be done in terms of applying for these different research protocols and being accepted and office visits and follow-ups and all those clinical things. And then there's the whole psychological element of it that takes place at home, how she's dealing with the illness and depression and anxiety and all of that piece, somebody to stand shoulder to shoulder with you is a massive piece there. And then there are probably some other elements I've left out, but are those the things that you're talking about?

Joe Baffone: Absolutely. And as a young man, I was overwhelmed by that. I thought: ‘Man, there should be more organization around how you're able to tap into certain things that you need as a patient or as a caregiver, or a community.’

I had another situation with my grandfather. He passed away from colorectal cancer. And because of the lack of guidance, I don't want to blame or point fingers, but I think some really bad decisions were made. And then, fast forward, I had a chance to work within the pharmaceutical industry for years, and I got to do many things in that space.

One of the really cool things that I did, and I think was really professionally shaping for me, was the opportunity for me to lead the relationships with the pharma company I worked with and advocacy groups. And watching the people that were advocates, and maybe they were survivors and thrivers, or maybe they were part of families that were on a journey with a patient, but ultimately watching them commit their entire professional life to the journey of the cancer patient, or the journey of that patient that got diagnosed with a very significant, weighty diagnosis.

So, as I started to look at that, and I spent a lot of time in pharma, I thought: ‘Wow, why am I spending this much time in pharma? If I really care about healthcare and I want to make a difference, why don't I think about stepping out as an operator?’ And that's what I did. Does it look like [inaudible 00:07:31] question there?

Dr. Jeffrey Gladden: Yeah. Well, it's a massive thing. The audience has heard me talk about my story. My older sister became a special needs person, so that was discovered when she was five. So, I'm just thinking the impact that any of these kinds of things have on a family, where all of a sudden somebody becomes a special needs person with a diagnosis of cancer or heart disease or dementia or any of these things, there's a whole structural rearrangement to the family that has to occur, and there are financial consequences and implications, and it's a whole cultural shift to the family, quite honestly. I don't think it's really characterized that way or really even understood by the medical... I mean, it's like you walk in, you're here, you're a patient, we give you this, you go home. But I don't think people understand that, really, when somebody has a diagnosis like this, that there's a massive shift in people's priorities and obligations, et cetera, et cetera, and there's no education around that.

There's no checklist like: ‘Oh, you've been diagnosed with this. Let us walk you through the 20 most important things for you to make sure that you're being taken care of, and here are five resources for you.’ I don't think anybody's doing anything like that.

Joe Baffone: Not that I'm aware of. You're absolutely right. So then, there were some really cool things that happened in my career that educated and informed me where I wanted to go as an operator and who I wanted to do it with. And so, some of the things that I was able to experience and do were: leading payer teams, leading reimbursement teams, working on the strategy of access for cancer patients, and what could pharma and others do in this space to improve that. So, leading, actually, relationships with large healthcare organizations in the US, where we were working with the AmerisourceBergens, the USOs, the McKessons, the Cardinals, and the on-and-on healthcare that provides services or drugs or data to help with the healthcare process.

Dr. Jeffrey Gladden: This is a really big deal, and I'll tell you why, if the audience isn't aware of this already, and that is because cancer drugs are expensive. They are not cheap. There are some drugs out there, I don't know, you can correct me if I'm wrong, but it can be a hundred thousand dollars for a course of this medication or more.

Joe Baffone: Some are more, yeah.

Dr. Jeffrey Gladden: $500,000, maybe a million dollars, who knows? So, unless you're a billionaire or have a hundred million dollars in the bank, how does anybody swallow that and do it easily? I know that pharma companies, in general, do take a tack of trying to get access to these drugs to people that can't afford to pay for them. And I know they have many programs and many discount programs and all these other things. And it sounds like you were kind of heading that up. But you had to be right there at the interface of the pharma scenario where they've got these drugs, they've spent billions of dollars to develop them, and they're trying to recoup their investments, so to speak. And then you've got people that would benefit from them and certainly can't write those checks, and the insurance company will only pay for some portion of it.

They're caught in the middle, right? And as a human being, you're kind of caught in the middle too. Your heart's going out to them, and you're working for pharma. So, how did you balance that? How did you make that work for yourself?

Joe Baffone: So, for me, it's pretty easy. Because I really do believe in the therapeutics that are available to really make a difference for patients. I'm a capitalist at heart. I'm doing what I do and making money. Personally, it's what we do with the money, though, right? I feel like I can make money doing a lot of different things. I want to make money to make a difference. I want to make that money to help me make more of a difference. So, I have no problem with making money. I have no problem with businesses making money, and it's all perspectives, and no one's 100% right, but if we did not have pharma investing billions of dollars in research and swinging and missing many, many, many times, way more often than they're hitting, we wouldn't have the benefits of the therapeutics that we have in the space that are groundbreaking.

Some of the stuff that is really interesting is the personalized immunotherapies in the space, and getting to the place where we're getting those drugs to market has taken years and years and heavy investments. So, I have no problem with the economics of healthcare. I think it's how we administer the economics of healthcare that is challenging. And to that point, I'm not here to solve for it, but the economics of healthcare, it is a problem for patients.

And so, I was exposed in my professional career to some of those issues around accessing care, and that became a big part of what I did professionally. So, when I stepped out, to get back to your original question, how did I land here? I stepped out as an operator with a really cool group of people that basically was working on data solutions to help life science companies help provider organizations get a better handle on what's getting paid for, what's not getting paid for, how do we get it paid for, so patients can get the care they deserve.

While we were doing that, we were really just repurposing data from other sources and started to think about with my co-founder, Brad Frazier, what are some things that we can do, own the intellectual property and really generationally disrupt the space? And that's where really the early days of Annexus Health began, and we started to build the technology back in 2014 that we utilize today. We incorporated a services division.

And ultimately, the bottom line of what we're doing is we are creating a really unique way to skin the cat. Because as you mentioned, pharma plays a big role not in just producing the therapeutics, but they also play a massive role in providing solutions that allow people that can't afford care to get that care. The problem is that there's just so many different places. It's very fragmented and disparate, what's available from an assistance perspective, and that creates administrative toxicity that actually is a big part of the financial toxicity.

Now, what I mean by that is there's a lot available that no one ever accesses, or you have a select group that are accessing what's available. And so, what we've done as an organization is we've created a tech solution and offering, and a services division that really gives provider organizations in these complex disease states the ability to completely manage, start to finish, what needs to occur not just to find something, but to make sure it's fulfilled.

So, that's what we've done. I feel so professionally fulfilled. So, personally, a job doesn't fulfill me, but as it relates to professional fulfillment, I feel so fulfilled because I get up every morning feeling like whatever I bust my ass at, if I'm setting my priorities right, I'm making a difference in cancer patients lives, and that's important.

Dr. Jeffrey Gladden: Yeah, you're having an impact. I'll just take a swing at pharma for a moment. I think in this space, quite honestly, there are some expensive drugs. I have some exposure to people that worked in the pancreatic space, and they would come out with a drug. It'd be fairly expensive, and the data would show that the person would live two months longer. And it's kind of like, ‘Well, what's the point, right?’ I mean, really, what's the point? I mean, we need better therapies than that.

And so, I think pharma is not perfect either, right? For sure. But I also think that when you actually have worked on that side of the fence and then also seen from your own personal experience, and then also these groups that you were meeting with, it sounds like you're giving access to providers to be able to map this out, but are you also giving access to the patients and their families? Can they access this too? Or how does this work for them?

Joe Baffone: So, we started in cancer, and ultimately the reason I believe we're successful, and the reason we've been able to solve for this before others were able to solve for it, now we have competition that has followed us into the market, which is good, right? If we don't have competition, then we're not [inaudible 00:16:11].

But ultimately, in a disease state like cancer, to be patient-focused, you have to be provider-centric. And why do I say that? Because in the cancer world, the economics are provider organizations make money and have massive costs around drug infusions around their pharmacy dispensing operations. So, they have skin in the game. So, because they have skin in the game, they have to manage assistance. Because assistance is like a payer for these patients.

And so, if like we did, you go in, and you're provider-centric, and you create a really valuable, comprehensive tool that gives provider organizations to manage any assistance that's available in the spaces that we step into… I told you we're in 14 disease states, but we started in cancer, and we did that for years. And so, ultimately, we are making a massive difference in patients' lives because we're providing the tools to comprehensively manage what's available at the provider level, and they're the ones that ultimately manage this wholly and completely for patients because providers that don't do this well, they're saying: "Oh, you might want to call this number or look this up."

Dr. Jeffrey Gladden: So, you're basically allowing a provider to turn away fewer people, to actually bring more people in and actually make sure that people get access is really what you're doing. By actually showing the providers that there are routes where they can actually tap into, or services they can tap into through this app or whatever it is you've developed, so that they can actually see their way clear to be able to take care of these people who otherwise they might have felt like they had to turn away.

Joe Baffone: 100%, Dr. Gladden. And to put it, like I said earlier, just to go right along with and sit my comment alongside of that, is think about someone going into an oncologist and getting a cancer diagnosis and not having insurance, or having suboptimal insurance, right? Then that payer isn't going to make that provider a whole. Well, there are these assistance options that serve as a payer. So, what we do is we give provider organizations the ability to rev cycle what's available from a financial perspective.

Dr. Jeffrey Gladden: So, by rev cycle, he's talking about revenue cycle. He's basically talking about how do- When I was practicing cardiology, which I did for 25 years and ran the heart group, we took care of a lot of uninsured people. We gave away literally millions of dollars of care every year to the uninsured because we were working in rural Texas and Oklahoma and places like that. And there were just a lot of uninsured people.

Now, there were people that had Medicare or had insurance, but you end up giving away care. And if somebody walks into an emergency room and they're wanting care, the EMTALA laws, basically, you can't turn them away as a hospital or an organization, which means the doctors are then obligated to take care of these people too, whether they're getting paid or not.

So, there's a whole culture here we could talk about, people talk about universal health insurance and all of the things that are trying to come to some way to navigate this, but in the short term, knowing that there are avenues for people to actually get help, which then enables the provider to see more of these people…

If we had known that if we went through this, this, and this, there was some way for us to at least be paid for something for our services so that we weren't completely upside down… And we didn't mind giving the care away, we really didn't. My heart was always with these people. I was like: ‘No, this is part of our service here; we'll donate this care.’ But nonetheless, it's a business, and everybody's got to thrive in the end, or you shut your doors. That doesn't service anybody. So, I think what you're doing is really helpful. You must be really well-liked by these provider organizations, is what I'm thinking. They must really think you're like their best friend.

Joe Baffone: Yeah, I hope in most cases, I don't want to personally say that's the case, I think it's obviously the team at Annexus Health, but as we think about Annexus Health and the entity, that's exactly how I see it. You're right.

Dr. Jeffrey Gladden: Right. It's interesting to do this from the provider level. It seems like there could be an opportunity to do it at a patient level also, where you make patients aware of the fact that you're finding resources for their provider to be able to provide them services. So, you're kind of closing the loop on that. So, they're not out there sitting there worried that ‘I only have this insurance, and the provider understands that they'll figure it out’, but they're still left in the dark about what's happening. Is there any kind of thought about being able to close that loop for them, or where does that stand?

Joe Baffone: Yeah, so a critical part of our development and what we're building is patient outreach. So, omnichannel outreach is going to be an important part of the process. But philosophically speaking, again, in the disease states that we operate, the caregiver, the leader, is the provider organization that they're getting their cancer treatment from. They're getting the treatment for their GI disorder, their rheumatoid arthritis, their nephrological disorder, whatever it may be.

So, these complex disease states, the quarterback is the provider. So, what we want to do is provide that comprehensive tool that also serves us really well related to the data. So, if we want to get smarter as a healthcare organization, we need to maybe do a better job of capturing data. So, ultimately, capturing the data for these patients is better served through the provider organization that they're being treated through.

Now, we have to do just basic patient outreach things. We need signatures for consent. As we expand into other areas, we plan to solve for more than just financial assistance. We want to tackle the administrative and logistical challenges or provide the platform that sits alongside like an enterprise platform like the EHR, the rev cycle, and the pharmacy dispensing software. We want to create this enterprise platform that is for the administrative and logistic portions of the patient's care journey. Access services are what we're doing right now. But the cell and gene space is heavily laden with administrative functions. The testing, diagnostics, genomic profiling space, and the remote nature of patients on oral therapeutics, those areas are so heavily laden in administrative logistics that provider organizations are collapsing. They're not able to get paid for this, so they can't continue to staff it. So, we are creating our technology to expand into those other areas and help. Obviously, the providers make sure that the patients are guided and managed appropriately.

So, we do believe firmly it comes through the provider, but omnichannel outreach to make sure we're connected with the patients, so they do know, so that we do get [inaudible 00:23:31] to them that they need, so that we do get the data points, we do get the information that they actually did take their medication, didn't just fill it, those type of things. So, I would say outreach is critically important, but we still do believe it funnels through the provider, and we want to capture it in that provider-centric system so that we have the data to know that things are being managed effectively.

Dr. Jeffrey Gladden: So, do you work with other organizations then that are more patient-centric, like with different social work organizations or patient advocacy groups or any of those kinds of things? Do you kind of interface with them so they're aware of what you're doing on their behalf, and it kind of revs them up to take the ball on their behalf and do the things so that they're educated in a way to be able to talk to patients, so that they know that, hey, if my doctor does this, then it'll be helpful. Or if I go to this doctor who's dialed up on this, that'll be helpful, kind of thing?

Joe Baffone: Yeah, I've presented at a few different advocacy meetings. As part of what we do, charitable foundations are critically important. They're a massively important part of assistance to patients. So, we are constantly working to develop those relationships. We need to minimally develop a technological relationship with them, and here's why. So, our business model is provider-centric, and we charge a licensing fee or a percent of collections to providers, but we have a life science-facing portion of what we do. And ultimately, we take the programs and offerings that they provide access services, financial assistance, and free drug, and we create APIs, so electronic communication channels, to allow for automation and simplicity of sharing information. So, everything's happening like this, and we know where it is versus the way I described it before, fragmented.

Dr. Jeffrey Gladden: Yeah, no, it's a mess. It's very fragmented. It's very hard to know. I'm wondering if there's any-

Joe Baffone: Actually, Dr. Gladden, to answer your question, we need to do that with charitable foundations. The nonprofit world is a little more challenging to work through to get to the decision-makers to make sure that we're not making it too resource-laden to allow them to do these things with us. These things that make things easier, faster, and better. Sorry, I didn't want to cut you off, but I did want to-

Dr. Jeffrey Gladden: Yeah, no, I'm just thinking that if I'm sitting there as a patient and I'm feeling overwhelmed by this diagnosis I just got, that if I knew that there was a group, Annexus Health, that was actually working with my provider to be able to source funds, if you will, to be able to provide the care that I need proportionate to my coverage or lack of coverage, I would find that good news. I mean, that would be good news to me, and I would want to step forward on that.

I just feel like, in what I've heard so far, it seems like there's still an opportunity for you to step into that space, maybe in a bigger way, or have an arm of what you do to do that. Because I know that if part of the win for the provider here would be patients knowing that they could get care. So many people sit at home because- I can't tell you the number of people in cardiology that sit at home with a heart attack because they can't afford to go to the hospital, or they sit at home with cancer and that thing growing on their neck because they can't afford to go to the hospital. And so, if there was information for the patients that let them know that, ‘No, you can get care, and the providers are winning because they're now being paid on some level for that care’, all of a sudden now you're starting to spin up a flywheel of having more impact for more people.

I understand [inaudible 00:27:20] provider-centric, which is key to the economic engine being able to run and not basically blow up or stop running. But it seems like the more patients that knew about this, it seems like that would just be super helpful as they come into the practice, is that the practices are being paid. So, anyway-

Joe Baffone: You know what? You're right. Whether we agree with it or not, look at the ads that pharma takes out, and they say at the end of almost every ad: "If you have a challenge or you believe you'll have a challenge, or there is a likelihood that you won't be able to afford your medication, contact…", so you're absolutely right. There is absolutely a patient portion of this and a patient awareness portion of this.

Dr. Jeffrey Gladden: Yep. No, it's a big deal. Okay, so you're in the middle of this. I understand your business model. And then you've moved into 14 different disease states. What are your plans going forward? Do you plan to move into more, or do you feel like you're hitting the top 14, or what are your thoughts about that?

Joe Baffone: No, it's interesting; when we decided that we were going to start in oncology, and it was because of the backgrounds of the co-founders, and our professional lives were heavily developed in the oncology area, we started to run into a situation where the providers we were serving were asking for us to go into other areas, other disease states. It's because they were serving as quasi-infusion centers.

So, you had patients coming in for their cancer treatment, they were also on an RA drug or a GI drug, and so they were being infused in the oncology clinic. So, that forced us to start expanding our content because we can't do anything well unless we've got the content right and unless we know in real-time what's available and the changes that are occurring. So, that started us going into a different direction.

We knew that ultimately, to serve institutions and health systems, we were going to have to step into additional disease states, but we had identified about eight really complex, sophisticated disease states that we thought if we managed really well, we would address the institutional and health system market. But when we started to work with health systems and institutions, they said: "No, we want it for all." So, no, we're not going to stop here. We're going to continue and expand.

And ultimately, I think in the other disease states where it's not as much of a burden or a process to manage care, where it is more acceptable to be managed remotely, I think that patient outreach, or not just outreach, making sure that we are identifying a better way to reach patients where they're not going to have to be dependent upon the provider organization to manage folks. We will continue to expand into other disease states, but the real expansion and growth for our organization is what I mentioned earlier. It's being able to tackle through a work list and tasking environment. So, to create spaces for us to layer in more things related to the administrative, logistical nightmare of managing the patient's care journey.

So, I mentioned cell and gene, the remote nature of patients on oral therapeutics, the testing, diagnostics, genomic profiling space, that's where we're going. And ultimately, what we see ourselves creating is this technology network that is using our administrative enterprise platform that communicates really well with their other systems, their EHR, their rev cycle, and their pharmacy dispensing software, which in turn makes the providers more efficient. But for us as a capitalist, what it allows us to do is to really own the ecosystem by which these services that need to get to the place that it needs to get to, to make sure the areas that I mentioned that we're going to be concentrating on occur and are managed really, really effectively. So, our business model is primarily driven by that work of allowing services to be fulfilled and data solutions to be fulfilled more wholly and completely. So, that's our expansion.

Dr. Jeffrey Gladden: So, let me ask you this, and it's a mental health question because we know the people that are dealing with these complex diseases are also struggling typically with anxiety, depression, poor sleep, lots of mental illness that goes along with these. And some of these disorders are actually exacerbated by poor mental health. Certainly, if you're depressed, we all know that the prognosis for anyone that's depressed with any complex illness is significantly worse than somebody that's not depressed. Same for having social support or even belief systems that we know that people that have faith or that believe in things, they do much better.

And so, I guess the question I would have is, ultimately, you're helping the provider, but really you're actually helping the patient at the same time. So, I guess the question is, as you're sourcing things for the team to be able to be reimbursed, is there any focus on mental health, to be able to get these people mental health services, to where the mental health providers can be reimbursed on some level to take care of these people? Because that's as much important to the prognosis and their outcome as anything else, quite honestly.

Joe Baffone: Amen to that. And actually the charitable foundations, there's some great offerings, the psychosocial side of this through these charitable foundations. So yes, we connect patients to those services through our work with providers. But I do want to take a step back, Dr. Gladden, absolutely, the reason we're doing this is the patient, and we just skin this cat a little differently so that, again, we could be or allow the industry to be more organized around their patient focus. We just think the provider centricity that we afford, that comprehensive ability to meet-

Dr. Jeffrey Gladden: Yeah, I get it.

Joe Baffone: ... things is really important, but mental health is massive, and it's not us being that smart. It's these organizations that are trying to serve and meet the needs of patients, like the charitable foundations, that offer those things. And in our system, patients can be connected to those services.

Dr. Jeffrey Gladden: Okay. Yeah, it's actually a boon for the providers as well as the patients because those are things that typically the providers don't have time or even the expertise, necessarily, that their heart may be behind it, but they don't have the bandwidth to do it, and then the patients need it desperately. And you have this workflow platform, Assist Point. Assist Point is that something that basically providers access; that's how they access your ecosystem, your platform, but it's not an assistance point for patients. So, if somebody's listening to this and they have cancer, they wouldn't go to Assist Point to try to get some information, or would there be information for them there too?

Joe Baffone: No. Yeah. Assist Point is our technology. We're a SaaS with our technology, right? So, we're software as a service. So, we provide software to providers, and that's what Assist Point is. Our team is the services division that actually does the financial counseling, the social work, the pharma tech, and the administrator work to manage these types of services for patients. And there is patient outreach in that.

So, no, if I am a patient listening to this, the one thing that I would say is just to make sure, no matter what we're talking about, you own your healthcare. And as you're owning your healthcare, understand there are options to help you with things like the psychosocial challenges but the financial challenges as well. So ask, and make sure you get good questions, not "I think there's something available." Make sure you get to a provider organization that knows how to care for you, and part of that care is understanding-

Dr. Jeffrey Gladden: How would they find that? How would they discriminate and be able to find that provider organization? I understand that it does make sense for them to take charge of their own healthcare, and it's nice for them to know that this is, in a sense running in the background, things that can help them. But they may walk into a doctor that just got hired last week and who doesn't know anything about anything, and so they get kind of a cold shoulder, they get a ‘no’ or whatever. So, is there a way that they can actually go in there more prepared and say: "Hey, look, we know this is available," kind of thing?

Joe Baffone: Yeah, so being prepared is just understanding, if you have commercial insurance, that [inaudible 00:35:56]-

Dr. Jeffrey Gladden: And by commercial insurance, just so people understand, that's Aetna, Blue Cross, Blue Shield, Cigna, whatever.

Joe Baffone: Let's just call it non-governmental insurance. So, I'm not on Medicare, I'm not on Medicaid. Ultimately, and if you've got a [inaudible 00:36:11] like you described, every single pharma manufacturer has a copay program that serves the needs of those patients, meaning there will be copay assistance to help you with your responsibility as it relates to that therapeutic. So, just go in knowing that no matter what therapeutic option that is chosen for you, that you need to be able to say: "Can you please enroll me in copay assistance?" And if it were me, I would call the provider organization and say: "Do you have financial counselors on staff? Do you have social workers on staff? If I'm on an oral, does your pharmacy have pharm techs that are responsible, or financial counselors that are responsible for helping me navigate this?"

If they say yes, that's a good sign. If they do say yes, your further line of questioning if you're a Medicare patient that doesn't have a really great secondary and you feel you're going to be on the hook for a significant portion of your care, I would say: “What is your knowledge of charitable foundations in this space?” That line of questioning, if you get, ‘Hmm, we have a couple phone numbers for you,’ versus, ‘Oh, we can help you with that. There are five to eight to 10 organizations in this space that we can help you contact, or we can give you information on.’

Now, I understand that the funding opens and closes really rapidly, so I don't want to create false hope around that because that's one of the things that we do really well. If there's not assistance available for that Medicare patient that doesn't have a secondary at the time of the intention to treat, we're going to keep within our system identifying, looking, looking, looking. When the assistance's available, boom, we're going to generate the application to make sure that we go and get that assistance for that patient. So, I don't want to stress people out. There are layers and levels to everything. But the base level of owning your own healthcare is to ask some of those questions that I provided you, Dr. Gladden.

Dr. Jeffrey Gladden: Yeah, no, I think there are many patients out there willing to own their own healthcare. What they don't control is they don't control the back end of it. And so, that's where they feel their vulnerability. And so, I think those are good questions to ask. I guess another way to come at this would be: Is there a list of providers that you work with so that they could select a provider off the list of people that they know that you're working with, knowing that you're helping to optimize this for them on the back end?

Joe Baffone: Yeah, that's a great question. It's not something that we make publicly available, but right now, we're working with close to 20% of the entire oncology universe in the US. So, it's still a small number, but we're easy to access. If folks go to annexushealth.com and they fill out a contact request, my folks will get back to them and help them with that. That's a great suggestion, Dr. Gladden.

Dr. Jeffrey Gladden: Okay. Yeah, because I think if people are taking control, they want to take control, and so they want to try to navigate the system instead of having it dealt to them. So, I think that's a great takeaway for the audience. If you're dealing with something like this, you could go to annexushealth.com and reach out to them and get some insight as to where you might go that you could get assistance that could be helpful. So, that would be great.

Joe Baffone: And in terms of an informed patient, and I just think about some of the stuff we've been talking about, from a patient's perspective, if you don't feel like the provider organization you're currently with is doing a great job with this stuff, make a suggestion. Ask them if they've looked into Annexus Health. Now, that is not a shameless plug from my perspective. I am a businessman. But ultimately, we want to be exposed to these provider organizations so we can affect the care that is trying to be delivered to the patients that are listening to your program.

Dr. Jeffrey Gladden: Yeah. No, I get it. Yeah. I mean, there's no harm in a shameless plug. But if you're out there doing this and if you get connected to their group and it improves their care, I mean, that's a win all the way around. And so, that's kind of how the world moves forward. Yeah. Well, that's great. That's great. So, hopefully, that's helpful to the audience. So, before we finish up here, Joe, I got to ask you about the Panda. What's the story on this panda thing? Why did that show up in your bio? Do you have one in the backyard, or what's going on? Do you like bamboo or, I don't know, what's happening?

Joe Baffone: You nailed it. I love bamboo, but as a little kid, I just think about the shows that I liked as a child, like National Geographic, right? Those types of things. I was just always enamored by the pandas sitting there, kind of rolling around, chilling, eating bamboo—so really interesting story. I got a call today from somebody that's doing work at our house. I actually had to go to court because of the-

Dr. Jeffrey Gladden: The Panda. The Panda was bothering the guy [inaudible 00:41:12].

Joe Baffone: [inaudible 00:41:15] The bamboo that has been planted around my property actually is a little intrusive. So, I got cited, I had to go to court, and I had to basically have somebody out there right now with this massive trench digging a trench so they can create the barrier, so it doesn't proliferate. Well, come to find out, I'm not there, and I get a call from a contractor that's kind of gone into the neighbor's yard.