Connect with John Criswell:
About the Guest:
John Criswell, MBA
Founder, Chairman and CEO at Porter
John’s newest transformative healthcare solution is Porter. Porter transforms the care-at-home journey for payors and their most vulnerable members. Powered by AI-derived insights, a dedicated clinical team, and a sleek member-facing platform, Porter delivers a smarter, faster, and more personalized way to navigate the complex at-home healthcare journey. John was the Founder, CEO, and Chairman of Pulse8, the only healthcare analytics, and technology company delivering complete visibility into the efficacy of risk adjustment and quality management programs. Pulse8 revolutionized AI, machine learning, and analytics covering Medicare Advantage and Medicaid, and was the leader in creating analytics for the Affordable Care Act (ACA)—reducing unnecessary and wasteful interventions. John was recognized by The United States Patent and Trademark Office. Criswell, John, et al. Method, and Apparatus for Risk Adjustment, United States Patent No.: US 11,373,248 B1. Pulse8 was acquired in 2019 by a publicly traded company.
Before Porter and Pulse8, John was a Director at Inovalon, a leading provider of cloud-based healthcare platforms growing it multifold. Before that, each time as COO, he doubled the revenue of Righttime Medical Care, and more than doubled the revenue of Applegate Farms, Inc. John’s career has spanned multiple industries including healthcare, consumer products, and supply chain management. John is an active investor and advisor to several healthcare organizations. John earned his MBA from Johns Hopkins University and his BA in Political Science with a Minor in Business and Finance from Mount Saint Mary’s University. John is an active investor and advisor to several healthcare organizations and spends his time cycling (both road and mountain), fishing, and enjoying the outdoors with his two boys (14 & 11).
About the Episode:
For episode 80 of Entrepreneur Rx, John welcomes back John Criswell, founder, chairman, and CEO of Porter, a transformative healthcare solution that aims to improve the home healthcare journey for payers and their vulnerable members. John Shufeldt’s venture capital firm, Xcellerant Ventures, also recently invested in Porter.
Porter utilizes AI-derived insights and a dedicated clinical team, along with a member-facing platform, to offer a personalized and efficient way for health plan members to navigate the complexities of at-home healthcare. The company focuses on driving better outcomes, improving quality, optimizing risk adjustment, and increasing member retention for payers.
In this interview, John Criswell highlights the challenges of navigating the healthcare system and emphasizes the need for simplification. He explains that Porter aims to streamline the process and provide support for patients and caregivers. John then talks about how he started Porter right in the middle of the COVID-19 pandemic and notes the challenges of managing a startup during such a time. He also discusses the transition to a post-COVID leadership style and the impact of remote work on new entrants to the workforce.
John goes on to address the changing dynamics in healthcare and explains that Porter’s focus on care coordination and support during transitions of care can help reduce medical malpractice risks for hospitals and providers. He wraps up by offering advice for first-time entrepreneurs and expressing his optimism for the future of Porter.
Entrepreneur Rx Episode 80:
- Learn how CMS and OIG drive accountability and member-focused care for better healthcare outcomes.
- Simplify and navigate the complexity of the healthcare system to improve patient care.
- Discover the impact of remote work and workforce changes in the healthcare industry post-COVID-19.
- Explore innovative approaches to address social determinants of health and enhance patient well-being.
- Embrace the importance of continuity of care and care coordination for a seamless healthcare experience.
- Gain insights on how to be a first-time entrepreneur.
00:00:05 – Welcome to Entrepreneur RX
John Criswell introduces Porter, a transformative healthcare solution that uses AI and a dedicated clinical team to improve the at-home healthcare journey for payers and vulnerable members.
00:01:19 – Success and Growth of Porter
John discusses the positive outcomes and value that Porter is delivering to payers and members. They focus on driving outcomes, supporting quality, risk adjustment, and member retention.
00:03:20 – Simplifying the Complex Healthcare System,
John emphasizes the need to simplify the healthcare system and make it easier for patients to navigate. Porter aims to provide a more streamlined and personalized approach to achieve better patient outcomes.
00:04:57 – Challenges of Remote Work,
John shares his experiences with remote work during COVID-19 and the challenges it brings. He mentions the lack of uninterrupted time and the impact on mentorship and connection for younger employees entering the workforce.
00:09:50 – Hiring and the Great Resignation,
John discusses the influx of applicants in the healthcare industry, particularly in high-demand roles like nursing. He notes that the “Great Resignation” hasn’t been significant in his market but sees tightening in other industries for hiring talented individuals.
00:15:35 – CMS Emphasis on Member Engagement and Insurer Response,
CMS emphasis on member engagement has resulted in insurers becoming more engaged in providing additional support and benefits to members, such as transportation and housing. This focus on the member’s needs is leading to better outcomes.
00:16:29 – OIG’s Concerns about Payment Mechanisms and Evidence of Care,
OIG has raised concerns about payment mechanisms for payers, stating that 90% of services occurring in the home have no evidence of treatment. This has led to investigations and audits by OIG and CMS to address these payment models.
00:17:59 – Future Trends: Risk Adjustment and Member Emphasis,
The future is likely to see risk adjustment incorporating social determinants of health for payment. There will also be a continued emphasis on the member, inspiring payers to offer more valuable benefits. Senior members are becoming more aware of the benefits being offered.
00:19:40 – Porter’s Role in Reducing Medical Malpractice Risk,
Porter’s involvement in care coordination and transition of care can help reduce medical malpractice risk for providers. Their support and follow-up calls can prevent issues from escalating and improve patient outcomes.
00:21:31 – Advice for First-Time Entrepreneurs: Grit and Self-Awareness,
First-time entrepreneurs should possess grit and be prepared to pivot and change their ideas as they explore product-market fit. Self-awareness is crucial in recognizing the need for adaptation. Gaining real feedback from others can