Rippl Care CEO: ‘Our System Is Not Ready’ to Provide Mental Health Care to Aging Population

The American health care system is ill-prepared to care for the growing aging population and the mental health challenges that come with it, according to Kris Engskov.

This is why Rippl Care started.

As its CEO and co-founder, Engskov runs a start-up company that seeks to combine highly specialized care, technology and in-home services to address the mental health of older people in a way that keeps them at home longer and out of care. long term. mod cons.

Rippl Care came out of stealth mode last week with $32 million in seed funds. The round was led by two venture capital firms: Chicago-based ARCH Venture Partners and Cambridge, Massachusetts-based General Catalyst. Engskov and his fellow founders had mocked the publication of more information about the company in the week before the investment announcement.

BHB first reported on Engskov company in March as he sought to build the company’s leadership team. She co-founded Rippl with Inca Dieterich, who has been an associate at ARCH Venture Partners since 2020. She is also vice president and partner of strategy and innovation.

Engskov, a former Clinton White House administrator and longtime Starbucks Corp. (Nasdaq: SBUX) executive, left as chairman of Aegis Living, a Bellevue, Wash.-based senior housing company, in September 2021 to start an unnamed startup.

The following questions and answers have been edited for length, clarity, and style.

BHB: What is Rippl Care? What does Rippl Care do?

Engskov: It is a highly specialized, technology-enabled network of people who help keep people at home and out of the ER who have a range of mental health conditions beginning with dementia.

What are you doing? I’ll try to answer this in the context of what we think the differentiators are. This does not exist today, what we are trying to provide. It doesn’t exist primarily because fee-for-service health care doesn’t pay for it. And that’s why we’re trying to approach it in a values-based way.

We may not start based on value, but that’s the ambition because we want to be paid for results and for doing it less expensively, which I’m sure we can do.

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First, we want to provide 24/7 behavioral crisis support to patients and families.

Second, we want to provide care navigation and coordination, and that’s the big problem that Medicare doesn’t pay for fee-for-service. How do you help people through the journey? Because it is long.

In addition, specialized medical management. Most of these people have multiple chronic conditions. And often, those are not seen comprehensively.

Ultimately, we want to provide psychotherapy to both the patient who has the ability and the family because we know that the tipping point often for long-term care is that the caregiver is not the patient.

In the longer term, we are going to add remote patient monitoring.

It seems your team was very successful in fundraising. You’re calling this a seed round, right?

Yes, it is a seed round. I recognize that it is a big seed round.

We incubated the company within Arch Ventures.

While I understand that the initial condition you are looking to address is dementia and other cognitive needs, why would we classify Rippl Care as a behavioral health company?

I think we’ve been much more consistent in saying mental health because it’s a broader category and more broadly represents what we’re trying to do.

We’re starting with dementia and neurocognitive, but hopefully we want to help people with depression and anxiety. Older people experience these broadly defined mental health conditions in a very different way than most other groups.

We hope to have a broad impact on mental health conditions in this category.

So the services you provide aren’t just limited to people with dementia or other neurocognitive issues? Let’s say an older person is really struggling with life transitions and is exhibiting depressive symptoms. Would Ripple Care help that patient even if they don’t have dementia?

Absolutely. Dementia is just a starting point for us because we believe there is a very urgent need. We hope that the psychiatric services we will offer will be applicable to a wide range of conditions. That is the reason for having the specialized team that we are building.

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Does Rippl Care already have providers coming into homes?

No, we haven’t started the service yet. We hope to begin service sometime later this fall. But we’ve built a team, we’re hiring physicians, primarily advanced nurse practitioners, licensed social workers, and community health workers.

We hope to see our first patient later this year.

Does your team have goals for the first rounds of hiring in terms of the at-home workforce?

I hesitate to speculate because we will take the amount of time required to learn how the model works best. We have been inspired by many of the collaborative care models out there and there have been several that CMMI has tested over the years that have shown truly impressive results.

But this model is different in terms of how it uses technology, how it deploys people (both virtual and on the ground), and the like.

In terms of broad categories, what types of technology does Rippl Care use?

We are so early. I can’t give you many details.

But what I can say is that we hope to build our own proprietary platform to do the work that we’re going to do, which is really intended to deliver on our mantra about obsessing doctors. If I had to describe our philosophy in a really basic way, it would be this: How do we take care of our doctors so they can take care of the older people we’re taking care of?

A big part of that has to do with designing a technology platform that is about making their time with a patient valuable and impactful and allowing them to work to the best of their license.

We’re just getting started, but that’s the ambition of technology.

Just taking a stab in the dark here, would this make room for telehealth services?

I expect that a good portion of our services will be delivered virtually. That is one of the great opportunities for us.

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While we believe that having a strong field game is important over time, we know that much of this care can be delivered really effectively virtually. In fact, it could be a great unlocker for people in rural communities who simply don’t have access to this kind of specialized help.

What is your #1 short-term goal? What is your #1 long-term goal?

Our short-term goal is to get our first network up and running and refine this model. This care model that we are pioneering is new and has not been done before. It has a lot of moving parts that will need to be tested. That is the most important thing we are doing.

Of all the things that have been talked about in the last three years created and funded, there has been a huge focus on the pediatric space and young adults. I just haven’t seen anything that specifically focuses on this type of specialized mental health care for seniors.

There are approximately 20 million people that we would classify as older people who have some type of cognitive challenge. Half of those people have dementia and the vast majority have Alzheimer’s. That is where we are starting because we believe that it is urgent and it is a great need.

Our system is not ready today and we have not reached the first 85 year old baby boomers and you have a 1 in 3 chance of having dementia once you turn 85.

We are going to learn a lot in the coming months about how to provide this highly specialized care. And I think we can be really influential with primary care providers and other potential partners and help them close that gap in care.

That is the long-term goal.

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