Flume Health - Comprehensive Analysis Report

Summary

Flume Health, founded in 2018, is a healthcare technology company operating as a digital third-party administrator (TPA) and benefits management solution developer. The company's mission is to revolutionize the operations of payers, TPAs, and solution vendors by addressing administrative inefficiencies. Flume Health aims to streamline operations using data integration solutions, thereby simplifying data orchestration within the health supply chain and easing the burden of data interoperability for its customers.

1. Strategic Focus & Objectives

Core Objectives

• Flume Health focuses on simplifying complex integrations within the healthcare industry.

• Their platform automates data operations, connects systems and vendors, and streamlines workflows, enabling organizations to launch modern health plans faster and operate at scale.

• The company aims to modernize payer operations and reduce the administrative burden and costs associated with data integrations between payers and various systems and vendors in the healthcare industry.

Specialization Areas

• Data integration and automation in healthcare.

• Streamlining workflows for payers and healthcare providers.

• Modernizing payer operations.

Target Markets

• Payers.

• Third-party administrators (TPAs).

• Solution vendors in the healthcare industry.

• Organizations seeking to modernize their health plans.

2. Financial Overview

Funding History

• Total funds raised: $40.1 million.

• Series A: $30 million (2022-03-04), led by Optum Ventures with participation from Cigna Ventures and existing investors.

• Seed Round: 2019-05-02.

• Accelerator/Incubator: $100K (2018-01-08).

Funding Rounds

• Series A: $30 million (2022-03-04), led by Optum Ventures.

• Seed Round: 2019-05-02

• Accelerator/Incubator: $100K (2018-01-08)

Investors

• Optum Ventures.

• Cigna Ventures.

• Route 66 Ventures.

• Accomplice.

• Founder Collective.

• Primary Venture Partners.

• ERA's Remarkable Ventures Fund.

• Wormhole Capital.

• Crosslink Capital.

• Entrepreneurs Roundtable Accelerator.

Flume Health intends to use the funds to scale its offerings.

3. Product Pipeline

Key Products/Services

• Flume Relay: Is designed to systematize the complex solution integration process involved in designing, launching, and administering a health plan.

• Automates vendor integrations needed to administer and manage a health plan, including provider networks, chronic disease platforms, maternal care, and pharmacy benefit management, to payers' core operating systems.

4. Technology & Innovation

Technology Stack

• Unified integration platform built to automate data exchange, eliminate operational bottlenecks, and serve as a universal translation layer across systems and formats.

• Focuses on automation and interoperability connecting point solutions, legacy systems, and new vendors to ensure seamless data flow.

• The platform combines plan administration, vendor integration, and member data management to launch custom health plans.

Proprietary technologies:

• Flume Relay: An automation platform that acts as a universal translation layer for information exchange between payers and vendors.

• Health Plan as a Service (HPaaS) operating system: A fully managed central nervous system for any health plan, allowing for ease in novel plan building, point solution integration, and real-time member visibility.

Significant scientific methods:

• Data Orchestration: A platform that helps payers and solutions integrate with the multitude of services that make up modern health plans.

• Data Exchange Automation: A platform built to automate data exchange, eliminate operational bottlenecks, and act as a universal translation layer across systems and formats.

5. Leadership & Management

Executive Team

• Cedric Kovacs-Johnson: Founder and CEO. He founded Flume in 2019 to make healthcare more affordable and easier to use, starting with how insurance operates. Previously, he co-founded Spectrom, a full-color 3D printing startup acquired by Makerbot in 2015. He holds a BS in Chemical Engineering from the University of Wisconsin - Madison.

• Casey Hancock: SVP of Engineering. He leads the Engineering, Security, and IT teams at Flume, driving innovation and reliability across the company's technology infrastructure. He is the architect behind Flume’s platform.

• Richard Fu: Chief Growth Officer. He is responsible for Flume's expansion into new strategic growth areas. Previously, he served as Chief Strategy Officer at Blue Cross Blue Shield of Kansas City.

• Grant Parker: VP of Sales. He determines and executes the go-to-market strategy, explores new business opportunities, and provides strategic guidance with client contracting and negotiations.

• Courtney Holden: People Operations Lead.

Recent Leadership Changes:

• Richard Fu joined Flume Health as Chief Growth Officer in June 2022.

• Casey Hancock was promoted to SVP of Engineering.

• Grant Parker was promoted to VP of Sales.

• Andrew MacGill joined Flume Health as Vice President of Product.

• Ann Joo Kim joined Flume Health as COO.

6. Competitive Analysis

Major Competitors

• PDHI.

• RubiconMD.

• TigerConnect.

• GetWellNetwork.

• Pager.

• Eden Health

• WebTPA.

• HealthComp.

• MHK.

• Clarest Health.

• Cognosante.

• SonderMind.

7. Market Analysis

Market Overview

• Flume Health operates in the health insurance and health tech market.

• The company's platform is designed for organizations looking to bridge gaps between legacy and modern healthcare systems, drive operational efficiency, and support better collaboration between systems and vendors.

8. Strategic Partnerships

• Firefly Health.

• Radion Health.

• Self Fund Health.

• K2.

9. Operational Insights

• Flume Health's platform enables health plans, third-party administrators, and solution providers to integrate and move data efficiently, modernizing data operations.

• The platform automates data operations, connects systems and vendors, and streamlines workflows, helping organizations bring modern health plans to market faster and operate at scale.

• Flume Health's tools can reduce cost and time for insurers, accelerate development, eliminate complexity, and enable insurers to focus on the member experience.

• Flume Health distinguishes itself by focusing on automation and interoperability in a fragmented sector.

• Its tools connect point solutions, legacy systems, and new vendors, ensuring seamless data flow and easier management for health organizations looking to modernize their infrastructure.

10. Future Outlook

Strategic Roadmap

• Flume Health is focused on advancing its Relay software, a data exchange platform purpose-built for payer-related information.

• The company is poised to reduce administrative burden and costs associated with data integrations between payers and the plethora of systems, vendors, and health solutions in the industry.

• Flume Health aims to shape the future of payer operations by eliminating friction in the exchange of data between all parties that need to administer care.