Gut Check: Tackling the GI Health Crisis in the Workplace
Bill Snyder, CEO, Cylinder Health
[00:00:01] Nicole: Welcome back to Healthcare on the Rocks: Employee Benefits with a Twist. I'm Nicole Belles, Senior Vice President of Product at Springbuk. Our guest today is Bill Snyder, the CEO of Cylinder. Bill works with Fortune 500 companies and national health plans across the U. S. to reduce gastrointestinal related healthcare costs, which total $136 billion per year.
Before Cylinder, Bill led commercial and health plan partnerships at Virta Health, and spent over a decade in leadership roles at Humana, where he oversaw a $500 million market.
[00:00:37] David: And I'm David Pittman, the head of marketing here at Springbuk. Bill is going to talk with us today about the escalating GI disease epidemic and the considerable impact that it has on health issues within our workforces. We will look at preventative care and discuss innovative employer strategies to manage those conditions, which as Nicole said, result in $136 billion of spending.
And just for a little perspective, that is more than the cost of heart disease, trauma, or mental health. Bill, welcome to the show today.
[00:01:11] Bill Snyder: Thanks for having me, David and Nicole. It's great to be on.
[00:01:14] David: Well, I'm the marketing guy, so I have to start by asking a little bit about your company. You recently rebranded the company, the name, the look, the feel, everything to Cylinder. So tell us how that came about.
[00:01:26] Bill Snyder: Yeah, so our brand, really, we, we wanted to make sure that it was an extension of the care that we're providing for our members, for how we work with our partners, and we wanted to make sure that it was very cohesive and we felt like Cylinder really represents the work that we're doing every day as we put our members and their guts first.
And when we think about the shape of a cylinder, it's innovative in design, but it's also simple. People understand it and people know what a cylinder is. And we've built our platform to be innovative in terms of the technology we provide, but very easy for individuals to engage with and use on their journey to better health.
So that was really the impetus behind the brand update. And we're really excited with how it came out. What was, what was great was the whole team was behind it. You know, the whole company, we had our countdown to the release of the brand. And since we've hit the market with it, the positive feedback from our members, from our partners, from our clients has been overwhelmingly positive.
So we're really excited to be out in the market at Cylinder.
[00:02:28] David: Congratulations. It's a big deal.
[00:02:31] Nicole: Putting guts first, I like, I like that a lot. because digestive disease actually ranks highest for workplace absenteeism, and is one of the leading causes of ER admissions and outpatient care. And it's actually the third highest cost condition in our Springbuk book of business data, right behind cancer and diabetes.
So help us understand a little bit more, the GI health crisis. What's going on and how prevalent are these conditions?
[00:03:01] Bill Snyder: Yeah. So the prevalence is really high. One in four Americans suffer from a chronic GI condition. And when we talk about GI and digestive health, that's a pretty broad umbrella. So you're talking about things like ulcerative colitis, Crohn's disease, irritable bowel syndrome, GERD, and a host of other conditions. You're also talking about a big population who are symptomatic of these conditions, but maybe don't have a formal diagnosis.
And so those patients are oftentimes suffering in silence. So they may have abdominal pain or chronic heartburn, and it actually impacts their ability to go to work. It impacts their lives every single day.
But for one reason or another, they haven't had a formal diagnosis. Maybe they're self-medicating with over-the-counter medication. Maybe they can't get in to see a provider. with there's you know access issues across the country in terms of getting in to see a gastroenterologist. So there's there's a host of reasons why people don't often have a formal diagnosis or an evidence based clinical pathway to help mitigate those symptoms. so huge in prevalence, massive problem, and we see these individuals kind of meandering through the healthcare system, oftentimes incurring a lot of claims and feeling alone, and helpless in some cases. I
[00:04:12] David: Well, you talked about the massive prevalence of it. There's also been a huge increase. So what do you think is contributing to that?
[00:04:19] Bill Snyder: I think there's a couple of things. So certainly our diet. Our diet in the U.S., the food that we put into our bodies every single day is impacting conditions across the board, but specifically around digestive health, we are seeing those increases in all of these conditions. We're also seeing increasing symptoms, and I think that a couple of things have been happening recently in the claims and, and data space, now organizations like Springbuk are doing a great job highlighting the fact that this is, a big deal, that we are seeing a lot of claims. Historically, it wasn't as easy to see those claims because there wasn't a specific CPT subgrouper which said, hey, here's all the spend associated with digestive health.
And so now I think, thanks to the work that organizations like yours are doing, employers are becoming more informed of, hey, this is a major cost driver. I think the, the conditions continue to increase in prevalence, because of our diet. and because people are starting to understand how digestive health impacts overall health.
You know, GI health is highly correlated to things like diabetes, to cancer, to mental health with the gut brain axis. We see very high correlation between stress, anxiety, depression, and GI flare-ups. And so, we know that, the digestive system is central to overall health. So, I think we're, people are recognizing that and seeing when they can get their GI health under control, it helps improve their overall quality of life and their health as well.
[00:05:49] David: And do you care to elaborate? Is that why you think employers and employees, frankly, are putting more focus into the digestive system?
[00:06:00] Bill Snyder: Yeah, I think it's, it's a combination of, of things which I'm really excited about. I think number one, there is a movement around gut health. And people are talking about gut health. This is stuff that historically has been difficult to talk about. People don't really like talking about what's going on in the bathroom.
It's, it's kind of hard. And I do think some of that, you know, the ability for people to share and to be more open and honest about these conditions has been, has been great, because there's been so many people suffering in silence. So I think that point one is, you know, digestive health is certainly having a moment.
I think point two is going back to that better analysis of data, where we can really start to see the drivers of these claims. And then number three is that connection from the GI health to their overall health and well-being. And, I think when you, when you see those improvements, you can prove that costs tend to decrease in terms of healthcare spend.
And people start feeling better, not only in terms of GI care, but reduction of stress, reduction of anxiety, and overall improvement in quality of life as well.
[00:07:03] Nicole: I was really excited when Cylinder became an Activate partner because as you indicated, Bill, Springbuk has the data and analytics and all these great episode groupers. So we had been showing our clients the opportunity they had with gastrointestinal disease, the impact it was having for other conditions as a comorbidity, and then also the drug spend related to treating those conditions.
So it sounds like though Cylinder provides a lot of great resources for members, including self-guided care, with an app, the care team, that one-on-one human connection care and guidance. Can you tell us more about how Cylinder works with members and then delivers care?
[00:07:48] Bill Snyder: Absolutely. I think one of the big things about what we've built with taking a technology first approach and building a dynamic platform is the fact that these conditions are, are, they're nebulous. You know, they are difficult to diagnose. They are a point in time care that's so important and essential.
So for us, when a member enrolls with Cylinder, the first thing that we do is an intake where we understand the clinical and personal needs of each member. So do they have a condition today? If they don't, what are their symptoms? What's their medical history? What's most important to them in terms of their care journey?
We take all that information and then we build evidence based clinical pathways based upon each patient's specific condition. And this is very different than kind of historical like telehealth 1.0, where it was, hey, let's connect the patient with a provider. This is, let's understand the patient, let's leverage technology to personalize the experience, and then make sure that we're iterating on that experience as the member goes through their care journey.
So it's not just, here's your pathway and it's set. Our platform is continuously learning every time that we're engaging with the member, so it adjusts live based upon that member's unique needs.
The second piece that we do is provide the, each member with a coordinated care team. So those folks are made up of registered dieticians, health coaches, gastroenterologists, internal medicine specialists, and more.
And so the idea is to make sure that there's a coordinated approach to care, where we're overseeing every need that the member has. Because in some cases, it may be true where we see someone who's high acuity, who needs a medication review, or a test ordered, and it will make a lot of sense to connect that patient quickly with one of our doctors.
In another case, it might make sense to leverage medical nutritional therapy, which are registered dietitians are licensed to practice in each state across the country. And we've seen incredible outcomes focused on MNT alone. Or for other cases, it might be the use of digital therapeutics. You know, we've built a digital therapeutic that is purely tech-enabled cognitive behavioral therapy for patients who suffer from IBS. So that's fully modularized, it's patient led, so they can go at their own pace. It's clinically validated. So the idea here is, making sure that we personalize the experience based upon the need of each user. And that's what technology allows us to do. So it's that tech-forward approach backed by that personal and human touch where they're always working with our coordinated care team.
so that's the, the focus of what we deliver to our members.
[00:10:14] Nicole: That's awesome. I know some research has shown that the personalized treatment plans really help with treatment compliance. Are you seeing that with Cylinder members as well?
[00:10:25] Bill Snyder: We are. We're seeing a great increase in compliance. You know, when we did, in one of our white papers, we talked about, approving reduction emergency room visits, reduction duplicative doctor visits, which aligns really well with the third-party literature in terms of some of the leading costs with these conditions.
we saw, also better adherence to medication. And so individuals are coming on our platform that had been prescribed the medication, but either weren't taking the medication correctly or weren't taking the medication at all. And so absolutely for us, we look at compliance as a core component of what we're able to drive for the individuals and that's leading to just incredible outcomes at scale.
[00:11:03] Nicole: How does Cylinder work directly with employers and health plans?
[00:11:08] Bill Snyder: We're really fortunate, you know, we're working with, marquee employers across the country. Again, we're available in all 50 states today, and so we've had tremendous success in being able to show reduced cost, great clinical outcomes for the members, incredible patient reported experiences as well, and we'll put performance guarantees to go fees at risk for all of those.
So I think that the market is, really responding to the solution. and at the end of the day, you know, we're just focused on improving the lives of the members we serve. So that's led to a lot of growth in the employer space. On the health plan space, what's been incredible is we are nationally contracted with leading health plans.
You know, we've had incredible launches with some of the Blues as well. And so I think what's great is we're We're seeing a ton of interest from these health plan, the health plan space that allows us to coordinate with them and allows us to look at claims for individuals. It allows us to bill as a claim as well, which is great for employers looking to add a benefit, but are worried about, for instance, point solution management.
They can say, Hey, we can work with, with Cylinder, through the health plan. And then the big thing for us is just finding great partners like Springbuk, who's able to surface the solution to the right patient at the right time. And support the needs of the employers across the country. So we, we look at relationships like that, as, really important, in terms of our ability to serve folks across the country.
[00:12:34] Nicole: Awesome. And what about the provider side? how does Cylinder work with a doctor that a member already has?
[00:12:42] Bill Snyder: So I think one of the things that we were really focused on in building the organization was making sure that we were being additive to the care ecosystem. And so we went out and we said, Hey, to all the GI docs there, we're not looking to replace you, because there's a lot of things that you do that are vital for a patient, that we cannot do, but what we can do is wrap them with this care on an ongoing basis and provide them point in time care, personalized based on their unique needs. But as an example, we can't scope. and so we're identifying patients who are high risk, who have not had a colonoscopy completed that should be going in and getting a colonoscopy completed.
So we're actually working with the providers to say, Hey, we've identified this patient they really should be getting in to get their colonoscopy completed. We work with the patient to help mitigate their fears about a colonoscopy, explain why it's so important, and also help provide direction into, areas where, there's great results.
So, best clinical outcomes at the lowest cost from a colonoscopy perspective. So, you know, for us, working within the care ecosystem, avoiding any siloed care. We've also set ourselves up to do bidirectional information sharing with providers, so we're able to share, hey, this is how this specific patient is doing in our program, so that they have a complete picture, so that we're not siloing any care.
That's, that's with brick-and-mortar providers. It's also with other solutions. So what's been really important to us is if we identify a patient, for instance, who is suffering from type 2 diabetes and they have a solution available to them, but they're not enrolled, we're able to say, Hey, did you know that you have this other solution available to you?
So we're making sure that we're coordinating that care, which is really important, for, for us as, as we continue to grow.
[00:14:29] David: You talked about some of the great outcomes for the patients themselves. What are the results that you're seeing with the employers?
[00:14:38] Bill Snyder: Yeah. So for the employers, we've seen, incredible traction, in terms of the participation and the engagement, so the first thing that we look at is, okay, are the employees within a given employer responding? Are they signing up? Are they interested in the program? And, and what we've seen is, much higher participation rates than other chronic condition solutions.
So that's been really interesting and it validates our hypothesis that not only is there this core group with a diagnosis with an unmet need, but there's also this big population who are suffering in silence. So point one was, okay, we're seeing a ton of participation and active engagement in the solution.
Point two is then, okay, what are we hearing from the members? Are they liking the experience? is the feedback that their symptoms are reducing and that their condition is improving? and the answer has been overwhelmingly yes. you know, our NPS scores are, top tier for any digital health solution.
And then we see, for instance, in our last survey, 92 percent of individuals surveyed said that, thanks to Cylinder, their digestive health symptoms had mitigated. So we're seeing great improvements across the board. And then the third component is cost savings. And again, we put performance guarantees on hard cost ROI because we know that we are able to do things like reduce those emergency room visits, reduce duplicative doctor visits, improve adherence to clinical protocol.
And so, across the board, we're fortunate to work with some amazing employer partners, and they've been very happy with the solution. And so, we continue to grow with our great employer partners across the country.
[00:16:16] David: And the NPS score, if anybody isn't familiar, and I'm sure some of our listeners aren't, that is, that is for people who are promoters. They, they would refer you to their friends and their family members.
[00:16:29] Bill Snyder: It's absolutely right. So the net promoter score is a great indication of how we're doing with those individuals. And then I think what's even more exciting is the advocates that we've been able to create within these employers. And again, digestive health is not something that people historically have been really interested in talking about, and we have these great member stories.
You can go to our website and look at these testimonials where individuals have said, Oh, I'm more than happy to share my story. and we had some of our members fly out to our last, summit. So we do an all company summit and the best part of that summit when we all come together and talk about the impact that we're having and the problem that we're solving was having some of our patients flown in to tell the company how life changing this solution has been for them. and, and that's really, why we've been able to attract such incredibly talented individuals is because they know that this is a serious problem that they're conquering. And to hear the impact we're having on patients' lives every day is, is incredible.
[00:17:27] David: Yeah. That, that, that really helps motivate all of us, right? If we know we're making a difference. Yeah.
[00:17:33] Bill Snyder: Absolutely.
[00:17:34] David: So you were talking about the gut health and you touched on weight and weight loss and GLP-1s and, and just all of that. So how do weight management and weight loss factor into the whole discussion around digestive health?
[00:17:48] Bill Snyder: Yeah, you know, it's definitely, again, like, very highly correlated, in terms of weight and GI issues, we see, you know, the use of GLP-1s and kind of the explosion of GLP-1s, causing, a couple things, you know, number one, the number one side effect of GLP-1s, is digestive health issues. So we definitely see a lot of members and a lot of employers saying, Hey, we know all these members are jumping on these GLP-1s, can you help facilitate mitigating their symptoms? so I think that that's really important and we do that today.
The second piece that we see is when you think about medical weight loss and you think about the use of GLP-1s for some patients, they can be a miracle. They can be extremely helpful, which is great to see.
What the early studies are showing is that individuals who start on these medications have a really difficult time either, staying adherent to the medications, or when they get off the medications, they're, they're gaining weight back. And so for us, when we look at our solution where we've got registered dieticians working with every patient, where we're licensed in every country, I'm sorry, in every state to practice medical nutritional therapy where we're rooted in long-term behavioral change, we know that we can create this great opportunity to work with patients for their long-term medical weight loss journey.
So we look at supporting them today. We are working, you know, with individuals on GLP-1s, both just on the adherence side on mitigating symptoms, but also on that long-term sustainable behavior change in terms of their weight management.
[00:19:21] Nicole: You just touched on this a little bit, but can you expand a bit more on how Cylinder helps members navigate this whole environment of weight management, weight loss, whether or not they should use or take a GLP-1? I mean, it's constantly in the news. I imagine a lot of people think, like you said, it's a quick fix, miracle drug. so how does Cylinder help them navigate all of that?
[00:19:44] Bill Snyder: Yeah, so for us, we're always going to follow AGA clinical guidelines, so we're going to stay up to date, you know, our clinicians are trained to look at the needs of the member and follow the latest literature in terms of any prescribing methodology or deprescribing methodology. and then I think the core focus is to make sure that the patients feel supported in their care journey and personalize that approach, right?
Because, there's, you know, many different reasons why people are taking GLP-1s. And so, customizing the approach to how we support those individuals is really, really important. And what's exciting is that's something that technology can help us do. We can understand the needs of the member. We can understand how they're reacting real time.
It's not a, hey, let's check in in six months. We know daily how they're doing, how they're feeling. Are they having side effects? Are they getting dizziness? Are they getting chronic constipation? All these things that we hear, we're, we're getting that real time. And we have a point in time carry that can then work with the member to say, time to titrate a specific medication or, Hey, look, we've been working on your medical nutritional therapy protocol. We had identified that, this specific food group, may cause flare ups for you, for your specific condition or symptoms. So let's reduce that or eliminate it altogether and see if that, gets you feeling better. So it's that type of personal touch, with real time technology that I think is going to be really important, in partnering with our patients.
[00:21:12] Nicole: And why would an employer select or choose a gastrointestinal health solution versus other solutions?
[00:21:20] Bill Snyder: I think the reason that so many employers are launching with Cylinder and have launched with Cylinder is, is, I think about it kind of threefold. Number one is, the prevalence in cost. It's a massive problem that's impacting so many of your employees and their family members. So it's, it's really big in terms of scope.
Two, is cost savings. You know, they're focused on solutions that work, that have great clinical outcomes that can prove cost reduction. and that's certainly something that Cylinder has been able to show at scale. So that's where they've gotten really excited about our approach.
and then, and third is the overall around patient experience. You know, when you have patient-reported outcomes and you have them talking about how much they love a solution, it's very rare for somebody to talk about healthcare and talk effusively about how life-changing it's been and how great it's been.
And so I think, the culmination of those three things, just the prevalence, the cost reduction, and the incredible patient experience that we're able to drive for employees is really why so many employers have chosen Cylinder as their partner.
[00:22:26] David: All right, Bill, we've peppered you with a lot of questions. You have had excellent answers, very educational today. Before we let you go though, I just want to find out, you know, you're in a hot space. the market is expanding, it's an important service that you're providing. What's next for Cylinder?
[00:22:46] Bill Snyder: So for us, today, you know, we definitely wake up every day, with our mission of revolutionizing digital health, gut first on our mind. So how do we just impact the lives of our members every single day? I think, we're also looking at how we're expanding and best supporting our employer partners, our partners like Springbuk, our health plan partners.
So making sure that out in the market, we're doing the best that we can, not only for our members, but also for our partners. but I do see us, expanding our scope of coverage. You know, I think that for us, we're talking about things like medical weight loss for patients with, chronic GI conditions.
We're doing that today. but I think that's going to continue to expand in terms of the impact that we can have. And what we can do for our members both short-term and long-term. So that's the focus for us, but again, each day we just wake up thinking about how we can best serve our members.
[00:23:37] Nicole: Awesome. Well, Bill, thank you so much for joining us today. If people want to learn more about Cylinder, how could they do that?
[00:23:46] Bill Snyder: Our website's great, www.CylinderHealth.com. please stop by, check us out, look at those patient testimonials, and, and get in touch with us because we'd love to tell you more about the work that we're doing.
[00:24:00] David: Alright, and we'll have a link to that in the show notes. So make sure you click through and visit Cylinder Health.
That is it today for another episode of Healthcare on the Rocks: Employee Benefits with a Twist. If you enjoyed this episode, please take a second to let us know what you thought about it and maybe give a nice little rating or review on your podcast player of choice.
[00:24:22] Nicole: And remember, you can find all of our previous episodes at springbuk.com/podcast, or in your favorite podcast player. While you're loading up other episodes, hit the subscribe button so you don't miss any future episodes. Until next time, stay healthy and stay informed. And thank you so much for listening.
