Building the Bridge to Value-Based Specialty Care: An Interview with Dr. Najib Jai, Co-Founder and CEO of Conduce Health

Hanna: Tell me about your background before Conduce.

Najib: For me, it all starts in North Carolina, where I grew up. In my household, my mother embodied and instilled in my siblings and me the concept of “If you can do something for another person, you should,” Her example inspired me to become a clinician – specifically, I wanted to be a neurological surgeon. What better way to have an impact on others than through preserving the most magical organ – the essence of who we are as people, the brain.

For additional context on my upbringing, and how it informed my life and career, there are a few important points to share. First, is my heritage: my mom is a retired teacher who grew up in Haiti and my dad is from Morocco and owns a small store in a flea market. Second, is that while I was fortunate to not be pressured into medicine by my parents, I didn’t have much exposure to all the various careers and ways I could make a difference. Third, we moved around…a lot.

As a result of all of those moves, by the time I began my undergraduate studies at Duke University, I had attended six different schools and managed to never have a class in chemistry, calculus, or physics. As a pre-medical student, I would go on to take competitive versions of all of those classes, and as a lover of pragmaticism, I obtained a degree in chemistry. All of this meant that, despite enjoying the fun of Duke basketball (we won a national championship during my senior year) college was not a career exploration experience for me – my blinders were on as I worked towards the goal of neurosurgery.

The real paradigm-shifting experiences, which would eventually lead me down the path to co-founding Conduce, were a byproduct of my gap year between college and medical school. While my work as a research chemist had little influence over my long-term career choices, the exposure to the intersection of healthcare business, technology, and innovation that occurred serendipitously throughout that year was transformative. I knew my path to impact lay at that intersection and I saw clinical experience as an important part of that journey. For that reason I choose to attend the University of Chicago for both an MD and MBA degree to flesh out the specifics of my career.

Healthcare on the south side of Chicago is and continues to be challenged in many ways – several patients seeking or needing medical care live in historically neglected and under-resourced communities with low health literacy and high prevalence of chronic diseases. Clinically, and to no fault of the amazing healthcare workers I had the privilege of calling my colleagues, there were several experiences that felt like a revolving door where a patient would come in, be hospitalized, and a metaphorical band-aid was put on their gaping wound before discharging them back into the circumstances that brought them there in the first place.

Concurrent to these experiences, my MBA internships in the health tech investing and startup space introduced me to value-based care models. While imperfect in many ways, value-oriented care held the promise of being a real solution for the patients and communities represented on the south side of Chicago and across the United States.

It was the amalgam of my clinical experiences and belief in where healthcare was going that inspired the idea of one day building a value-based care company. In search of more learning and exposure, I was fortunate to join Oak Street Health where my primary focus was around specialty care costs and, most specifically, the integration of e-Consults into the care model. Leveraging e-Consults represented integrating elements of specialty care into at-risk primary care models, which conceptually would later inform my co-founding of Conduce Health.

After leaving Oak Street, I joined a couple of fellow doctorpreneurs at AlleyCorp as an Operator in Residence, tasked with starting a company. Over the span of several months, I went through the typical non-linear customer discovery and ideation process that all founders are accustomed to, which all coalesced into Conduce Health.

Hanna: What inspired you to start Conduce and what problem are you solving?

Najib: Taking a step back, value-based care has historically focused on primary care providers – the quarterbacks of many patients’ care. While primary care continues to play a critical role, the need for multi-specialty care is essential for many elderly adults with polychronic conditions. Unfortunately, specialty care is often a black box where quality is compromised, costs rise, and data is opaque. All of which contribute to poor patient outcomes and disconnected care. Conduce aims to make specialty care transparent and integrated, ensuring primary care teams can refer patients to specialists in a personalized, data-driven way.

Conduce’s two products, the Referral Engine and Smart Network, impact critical moments in a patient’s specialty care journey. Our Referral Engine supports primary care providers and teams to identify patients in need of specialty care and the optimal specialist, within existing referral patterns, for a given patient. Powered by machine learning predictive models and the use of Conduce’s proprietary patient phenotyping methodology, "Patient Signatures"— groupings based on chronic conditions, comorbidities, zip codes, and other relevant health factors – the Referral Engine enables personalized and timely care.

Directly solving the disconnection of primary and specialty care, our Smart Networks, in which we contract with optimal specialists, identified through Patient Signatures, create continuity in incentives, data sharing, and clinical co-management. The inevitable future of value-based care is marked by the inclusion of specialists and Conduce’s Smart Network product serves as the necessary infrastructure to do that successfully. To date, we’ve implemented this in Georgia and South Carolina, bridging the primary to specialty care divide.

Hanna: How does your technology improve care? What role does AI or data analytics play?

Najib: Instead of evaluating specialists solely on cost metrics, we analyze patient populations using claims data, Medicare data, and social determinants of health – e.g. the social deprivation index, reliance on public transit, and access to fresh food. These insights inform our Patient Signatures and reveal that a single specialist can perform in the top decile for one Signature (defined by lowering total cost of care and improving patient

outcomes), but in the bottom quartile for another – an intuitive result made actionable.

Our machine-learning model integrates this data into the Referral Engine to predict when a patient is likely to experience a major health event, such as worsening kidney disease or heart failure. In some cases, we can predict these issues 6 to 12 months in advance and recommend specialty interventions to prevent them.

Hanna: What are the biggest barriers to value-based care adoption?

Najib: One we think of often, and has informed our products, is provider behavior change. Physicians train under a fee-for-service model and transitioning to value-based care can require a shift in workflows, practice operations, and the use of novel technology. Rather than asking specialists to change everything, we identify those already delivering high-quality care for specific patient groups and optimize their impact. Analogously, the Referral Engine is designed to be workflow agnostic such that it can seamlessly integrate into primary care providers’ existing referral processes.

Hanna: What trends in healthcare are most exciting to you?

Najib: Amongst many potential applications, AI and machine learning tools allow for the processing of vast amounts of disparate data to create a personalized healthcare ecosystem – moving away from treatment plans designed for hypothetical and unreflective “average” patients and clinical presentations. The likely inevitable commoditization of AI tools ideally makes their use ubiquitous and improves access to their impact, which is particularly relevant for Medicare populations with polychronic conditions.

Hanna: What lessons have you learned as a founder?

Najib: Too many to list concisely, but two lessons really stand out.

First – a point that can never be overemphasized – at the earliest stages of a business, the team is critical, if not the most important aspect to optimize. Who you work with determines the company’s success, resilience, and how enjoyable an otherwise challenging experience can be.

Second – company building is nonlinear, but some form of forward movement is mandatory. Ups and downs are a perpetual occurrence and finding a way to truly generate progress, regardless of how small and in spite of those oscillations, is how a company eventually succeeds. Finding momentum and maintaining a steady hand, while preserving a strong belief in what we’re building has bolstered our work at Conduce Health tremendously.

Hanna: How do you deal with failure?

Najib: Failure is an experience I’ve incurred well before my journey as a founder on several occasions. With pride, I’d say it’s an area of expertise. I deal with each new failure by recalling the long-term result of failures that preceded it. Regardless of the domain – career, personal, athletic – I’ve learned from all of my failed experiences that they’re often prerequisites for a future breakthrough. This knowledge does not relieve the sting and avoidance of each experience, but it does provide the comforting solace needed to keep pushing forward.

Hanna: How do you see Conduce evolving long-term?

Najib: A hallmark of being a functional founder is maintaining a balanced focus on the present need for execution while investing in the future of the company. While it has been many years in the making and will likely require many more years to come, healthcare is moving towards global budgets and value-oriented care, requiring infrastructure to support it. Primary care models have seen value-based success and specialty care is still slowly evolving. Conduce is building an integrated ecosystem in which primary and specialty care work together seamlessly by focusing on the possibilities of today.

Our goal is not just to identify and contract top specialists but to personalize care at the patient level. Ultimately, we at Conduce believe value-based care is personalized care provided by the most optimal primary and specialty care teams for any patient. Technology, data insights, and a fully functioning, multi-stakeholder marketplace will be required to realize that vision and Conduce is positioned to play a critical role in that future of healthcare.

Learn more about Conduce Health here.