Kip Theno: Helloagain everybody and welcome back to The Road to Care podcast hosted by SamaCare. And today our special guest is my friend Jim Breidenstein, healthcareexecutive and dare I say, a maverick. JB currently serves as the CEO and ChiefCommercial Officer of Adhere+ (www.adhereplus.com) a telehealth platform,clinically proven to significantly improve care plan and medication adherence.
Before joining Adhere+, Jim has a deep history of innovation in medical device technologies and therapeutics. Jim previously served as theGlobal Vice President of Pear Therapeutics, where he stood up commercial operations for the [00:01:00] commercialization of the first and only prescription digital therapeutic.
JB was a commercial executive at Kyphon, Inc. The first minimally invasive spinal surgery company from conception to its acquisition.Jim introduced the first and only med device to the world of psychiatry at Neuronetics, where he led and scaled the organization to an ultimate IPO. Jimthen joined Cardiovascular Systems Inc where he led the world's first coronary orbital atherectomy product offering, adding 1.6 billion in shareholder value.As an executive leader in the startup med device and digital health space for over 25 years, Jim has added nearly $8 billion in shareholder value, developingan expertise in commercializing transformational digital health products.
JB my brother, how are you today, man?
Jim Breidenstein:Hey, I'm doing awesome. And, I like Maverick. I like that.
Kip Theno: Well, ifthat's your new call sign, we'll have jackets made. Gladly. I'm not gonna be goose though. All right.
Jim Breidenstein: Allright. Sounds good.
Kip Theno: Hey, [00:02:00] JB, I've known you for a long time, but the audience deserves a look, at your journey in the healthcare from novel devices to now digital health tech.
How'd you get here?
Jim Breidenstein: Yeah, it's a little bit of good fortune and a little bit of luck, and I've been really blessed to find myself at cutting edge technologies for a couple of decades now, and just addicted to the startup world. As you know, we've had many discussions on this and started the journey in medical device and then moved along the paradigm, ultimately ending up in the new emerging field of digital healthcare. And I know that's abig topic and covers a lot of ground, but I find myself taking new, innovative, not only technologies, or not only products, but taking emerging classes of medicine and trying like a son of a gun to make them mainstream.
And luckily today with great folks like you, I've been fortunate enough to do that a couple of times.
Kip Theno: Well,you've led these commercial organizations kind of from inception to some kindof a finish, and not all of them [00:03:00]survive.
Right, of course.
Kip Theno: But I'dlove for you to talk about leading a commercial sales team as an example and something new that hasn't been done before and change clinical behavior. What are your thoughts on leadership in general today versus when maybe you and I started?
Jim Breidenstein: Well, I think the core fundamentals of leadership always remains the same at least for me.
And it's always about the people. And if we take care of the people, the people will take care of the business and we'll all live happily ever after. But, you know, in terms of leadership one of the core fundamentals is communication. And I feel that one of the things I learned along the journeyis having the right expectations is one thing, but having those expectations communicated in the right way to the people so they understand where we're heading.
It's so critically important, and whether it's in my own personal journeys or the many, many companies that I've consulted with over they ears, that communication element cannot be underscored enough. It has to happen, and repetition is good. Sometimes [00:04:00]communication to the 10th degree just helps people stay on track and.
You know, communication is key, but what also is key is an incentive modality and an incentive program. Again, just can't underscore it enough. I mean, it's one of those pivotal things where we have to put as much time into that as we do about the corporate philosophy and corporate strategy.How do we incentivize our great, amazing people to get the most out of them and give back to the company as much as they possibly can?
Is. You know, right at the top of the list. So a lot of the things Kip yeah, have changed over time, but I'll tell you at the core, they're many are exactly what the way they used to be.
Kip Theno: Yeah. And Jim, I mean, you've created such unbelievable followership in the organizations and I've had the pleasure of working with you at companies in the past, and that typically when you're focused on that personal professional development, which you've had a fierce dedication to, I'm a testament to that.
You're a mentor of mine. I think it goes a long way and. Change is not easy. Right. That's why you need that followership from the folks kind [00:05:00] of going into the foxhole with you, andI've heard you talk about tearing down the four walls. That's a big change, right? In thinking about healthcare shifts in healthcare W did you mean by that?
When you always talked about tearing down the four walls?
Jim Breidenstein: Well you remember, back in the day when physicians started to consider these.Sites of service called Office-based Labs or OBLs, right? They started to think about doing surgical procedures outside the walls of the hospitals.
We, you and I, collectively and many others, we migrated a lotof our business to those facilities and to those centers. So I've seen that happen before and I've seen how, what a dramatic and positive change that's made for the patients and for the payers, for that matter. Not to mention the providers, but as I sit today and I think about how can we.
Deploy digital healthcare to help us take the process in the slow bureau process [00:06:00] that exists within the four dirty walls of the hospital, if you will. And get that out intothe mainstream and use different technology and modalities to expedite healthcare, to expedite access and keep patients and care teams and payers allaligned.
So when I say tearing down the walls of a hospital or a practice, really what that means, KIPP, is how do we use technology to make.Healthcare more efficient and more effective because the face-to-face interaction is great, right? You need that for certain things, but there's waythat we can bolster healthcare and outcomes, quite frankly, if we're able touse tech outside the four walls of the hospital.
Kip Theno: Yeah, andI remember we were in a meeting once, Jim, and you said, you know, it's just that, there's a brick and mortar piece of that, which is changing dynamics and thinking and processes and training. Then there's the other side, right?There's habituation, there's apathy, and that's a whole different, you know,when [00:07:00] we launched the coronary atherectomy device, sure, that would've been the first one in 20 years versus acompetitor.
They didn't have another science that had been proven to dothat, and it wasn't an easy sledding, was it Jim?
Jim Breidenstein: No, it certainly was not. And you know, change is tough in its own right. Not to mention change in a conservative industry like healthcare. One of the great things about the ability to embark and change in healthcare is that the good products will always win and the products that bolster clinical outcomes will always win. It might take a little while as you and I both know, but eventually the world of healthcare catches up I see the implementation of these digital solutions now that you and I are both so aware of, really beginning to take hold and make a difference and, embed themselves into the clinical workflow.
And heck, we should talk a little bit about that 'cause you know, that's always a journey in its own right because the providers are sobusy and the care teams are so busy. But again, utilizing this [00:08:00] automation, tools and techniques will ultimately make it more efficient at the practice level for sure.
I.
Kip Theno: Yeah. And you and I, you more than me, I will say, grew up in, in the world of medical devices, right. And kind of the golden age. I mean, I remember the first drug-eluting stents. We had the first coronary atherectomy device. You had the first minimally invasive surgical device. We both migrated, we've kind of jumped thatchasm into this wonderful world of, of digital healthcare.
And I remember 15, maybe 20 years ago, JB where RPM remote patient monitoring and cardiology kinda limped along for a while, and now you can't really go into a cardiologist's office without having some kind of remote patient monitoring opportunity with them. And you just talked about kind of changing workflows.
Kip Theno: And before we get into here, I'd love to hear your, you know, when you went over toDigital Health and you made that as a conscious decision, I think it was with PearTherapeutics first. Why did you make that decision and what did you see in that opportunity?
Jim Breidenstein: Yeah, it was a wonderful opportunity.
Completely game changing, a completely new emerging class of medicine, [00:09:00] right? I mean, there's nothing better than helping change the way that patients are treated or the way that physicians practice medicine, but boy, what a. What a just amazing leap here. Whoever thought we'd be using our cell phones for a therapeutic response in some very, very critically ill patients, in that case, patients suffering from opioid addiction.
But what was really interesting was, you know, Kip, if you think about. Some of the problems of healthcare, right? Access, scale, not enough providers, far too many patients. The chronicity of the diseases is starting at an earlier and earlier age. Not to mention the baby boomers are aging out, putting tremendous stress and pressure on the healthcare system, and not to mention just exploding healthcare cost.
So when I started to make my journey into digital, those principles really shined through to me. The conversations were kind of like, why would we not use digital solutions [00:10:00]to help us solve the problems of scale, of access, of affordability, of connectivity, right? And as we think about how digital healthcare is done to date, it's very easy to see.
It's the wave of the future, there's no doubt about it.Currently with Adhere+ where I'm currently stationed as the CEO as you mentioned. And thanks for that. There's governmental legislature support driving a remote, therapeutic monitoring, and again, it's driving it because ofthe lessons that were learned a little bit earlier on.
So it's been a bit of an evolution starting with remote patient monitoring like you've mentioned. Primarily using a physiological device. Think of blood pressure cuff, right? Like think your mom and dad sitting around the kitchen table, putting a blood pressure cuff on, sending a signal into the doc's office.
That was great. It was our first entree into the field of remote monitoring, but in its own ride, it was, you know, it was clergy and wonky, like who maintained the [00:11:00]device and who took care of it, and who owned it, who fixed it, who paid forit, all of those kinds of things, which you can imagine with Gen one.
But most importantly, it was very narrow. It was very narrow in terms of, if we think about large fields of patients like substance use disorder, chronic obesity, pain management, which is a, a huge market, as you know, they weren't typically using physiological devices or parameters to measure and monitor their patients, right?
You wouldn't typically check a blood pressure every day or a pulse ox. A few years into ROM, CMS got together, reviewed the information, reviewed the data, and said, I think in 2019, let's take a look at this and open this up. And that became the birth of remote therapeutic monitoring. So coming out of COVID, which again, a lot of bad things happened in COVID, but itdid help some areas of medicine.
And this is one of them. We had a plethora of data now emerging. Validating the [00:12:00] use ofelectronic intervention, driving clinical outcomes. It's actually undeniable atthis point. Right? So that was the entree that allowed remote therapeutic monitoring to really explode. So in 2021 CPT codes were birthed.
As a permanent level. In 22, they became, I'm sorry, temporary.In 22, they became permanent 2023. They were expanded and already in 2024, as quite frankly as most recently as last week, the AMA has approved additional legislature making it even more expensive and easier for broader specialties, not only to utilize it.
But also get fairly compensated for their time to work, their energy and their effort. And with the new legislature taking effect in 2026, you can see that's really the official beginning of where we're heading.
Okay. And where we're heading is remote monitoring. Is absolutely, positively my [00:13:00] opinion, of course, here to stay. And what's exciting about it, as you know, and as I'vebeen telling you all along about it, here, we're positioned ourselves inproviding these services already in four separate distinct vertical markets, paying obesity, substance use disorder.
And mental health, which I'm a big fan of, and I really look forward to helping, you know, hundreds of thousands of patients with the program. The history is so important to say where we are, but most importantly, quite frankly, where we're going.
Kip Theno: Well, it's not, I mean, JB your perspective is, is amazing on this.
It's not, it is here to stay, but what's nice about encouraging about it is. We're seeing kind of a doubling down effect that from a value-based model, now there are more resources, less regulations, more money going into this because they're seeing, hey, if you. Do this with RTM or RPM you are gonna get less hospitalizations as an example.
Patients are more in tune to their own healthcare and that's, that's one thing, but I wanna go back to here. Plus you're the CEO there [00:14:00] now and congrats on that brother. Well deserved. What was the genesis of that? You guys must have saw a gap and hadsome science in the background and some tech or dev in the background that said we can, we can fill this gap.
Kip Theno: What was the genesis of it and where are you guys going next?
Jim Breidenstein: It's, it's a really great question. And we were founded by a physician and a businessman, and they got together and they said they both had some tragic loss in their own family, unfortunately. And the underlying premise was, I.
There's a sense of loneliness. There's a sense of void. There's blind spots in these in patient care. So how do we drive and deliver a connectivity between the patients in need that are suffering along their journey in the care teams that want to provide? The best possible care that they possibly can.
However, it's a great story. However, [00:15:00]in today's healthcare environment and in the insurance world and environment that we live in, you can't possibly see your patients every day like you can with remote therapeutic monitoring, right? So they got together and they said, how do we increase proactive patient engagement?
It's really, that was the genesis. How do we keep the care team connected to the patient and the patient more connected to the care team when they're not sitting in front of them. I give you a story real quick. If I'm in the chronic pain space, I'm a patient suffering from chronic pain, maybe I'm on schedule two narcotics, opioids, or not, it doesn't matter, but by nature, you're typically seeing your provider once every 28 days.
You and I both know, and if you're in healthcare for more than five minutes, you know this, the bad stuff happens when you're not sitting in front of your provider, your doctor, right? So if you think about using [00:16:00] remote therapeutic monitoring to zoom in every day for just a minute, take a quick Polaroid of how that patient's doing by asking a couple of questions.
How's your pain level? Did you have any issues? Are you having any side effects? Is your incision itching or oozing or red? You're taking aPolaroid, a snapshot, and that snapshot woven together over 30 days, or 30months or even longer, tells a beautiful, complete clinical picture of how you're doing that information.
Which goes into the second part of this. That information allows the care team to intervene in your care as needed. If there's an issue that emerges, like an adverse event, we may be able to intervene and catch it before it turns into a serious adverse event. And we all know any type of event is a very, very costly event.
So it's a very well-rounded story [00:17:00]where. Now that we have technology to reach the patients every day, right?That's awesome. We have the tech to do that now, but no one would do it untilCMS has looked at the information, validated the efficacy, and most importantly, created a reimbursement mechanism that pays and compensates accordingly and fairly.
So now you have tech, which is great. And now you have a reimbursement mechanism and it, here is the software program in the middle that allows all of this to happen. And at the end of the day, it yields two really,r eally important things. Number one, it yields better clinical outcomes, no doubt about it, and more engaged a patient is.
The better the clinical outcomes. That's point number one. But point number two is if we have better outcomes, also undeniable better clinical outcomes equals a better total cost of healthcare. So you can [00:18:00] see why CMS and Medicare is particularly excited about this because not only better outcomes drives down the total cost of healthcare.
Kip Theno: Absolutely100% JB and I'd love to hear from it here, plus what. What are from your tech stack, your solution, what disease states or disciplines, I guess, patients right, would benefit from this? Who is your target audience right now? Or target market?
Jim Breidenstein: Yeah, sure. Well, we think about the nature I.
Of the program. It's for chronic diseases in particular and treatment plan adherence and medication management. So the way that we've developed a platform is agnostic, if you will. What goes in the platform is really disease state specific. The main verticals, if you will, or the main segments that we're targeting out of the gates here.
As you can imagine, the chronic pain space. Due to the opioid epidemic and era, we've [00:19:00] also in the world of mental health because we feel connectivity and patient engagement isso incredibly important, not to mention helping with this very complex medication regimen. We're also in the world of substance use disorder for manyof the same reasons, of course, as I've already mentioned, and also very activein the world of chronic obesity medical.
Weight loss management or bariatric surgical application as well. So those are the four opening markets. But again, as I mentioned, the platform is agnostic to the content. We can put any content that we want in there. Which we will over time. But, you know, being a young, small company that's growing like wildfire and, you know, going from California to New Yorkto Florida and having, really great success right out of the gates here and outta the gates, meaning the last 18 months.
But we're trying to maintain those four very, very large markets. [00:20:00]
Kip Theno: You followed my journey at SamaCare great interest. And one of our hurdles, the AMA came out with a study a few years ago and it was one of the genesis of SamaCare -- 46% of patients don't get on the right therapy or miss their date of service, and these are your medical benefit, your J-code, your injections or your infusions, lifesaving rare disease drugs, right? That's what we're trying to solve here at SamaCare because the prior authorization process is so bogged down, so complex, the inflection point is getting worse for clinics.
So I see synergy between us and what you guys are doing in that oncology, rheumatology, neurology space. Do you guys have plans to expand, what's the proof of concept side looking at, for you?
Jim Breidenstein: Yeah, we are already in two large facilities in the world of Rheumatology, fibromyalgia, lupus, rheumatoid arthritis.
And the reason, as you mentioned is, it's a kind of an untapped unknown [00:21:00] market and it's a lot of patients in need for additional therapies and not only do we feel we've seen inour clinical work, which, you know, we don't talk much about this, but we have10 published papers, eight of them, funded by the NIH or NIMH.
And what we really studied was, how do we drive utilization byway of a mobile app to drive clinical outcomes? And we studied things like painlevels, depression and anxiety, and, the areas that you mentioned are ofmassive importance to us, and again, I think you'll see just rapid expansionand adoption of the platform in those fields.
Kip Theno: Well, I'llvice versa. JB I'll be keeping a close eye on you and here. Plus, I think, youknow, one common theme here, a common thread is, and we've seen this throughoutour journey in devices as an example, it's probably no different on the pharmaside. And now we're in this digital health world, which is exploding.
There is that inertia versus momentum phenomenon to where anidea can [00:22:00] actually.
Kip Theno: Be successful long term and create a new sustainable market what needs to happen for this to be mainstream, to be main staple out there?
Jim Breidenstein: Yeah. This will play out over time.
I will have to say it's playing out much, much faster than we anticipated, which is a good thing. But, it comes going too fast. Comes with some lumps and bumps too, but I'll take it. It's wonderful. But the number one thing, Kip, in my opinion, is. Because of the improvement in clinical outcomes of the modality that will drive us to mainstream.
And what's really great about this is we see it at all legs ofthe stool, if you will. We see it from, as you can imagine, from the patient perspective, the outcomes are fantastic. We see it from the provider perspective because now the provider is getting hundreds of data points per month per patient.
Where typically they would get one. On that, approximately [00:23:00] five to seven minute long appointment that they have once a month. So that's really important for the providers. And then also from a payer perspective. And by the way, this is covered nationally underMedicare state, by state, by Medicaid.
But most of the commercials are also paying because the concept of driving down the total cost of healthcare in being a better solution is so evident. But part B to your question, Kip, is really the punchline here for our company. Since we get hundreds of electronic patient reported outcome datapoints directly from the patient, if you will, every single month for every single patient, we have a massive gathering of data analytics.
Will yield us the ability to change the way that patients are treated. And, you know, big data is so important and so valuable, quite frankly, right? So when you ask the question, you know, where will this go?What will it [00:24:00] take to make it mainstream? Well, by gathering these millions and millions and millions of datapoints, we will be able to clearly show by way of data.
If we do X, we get better outcomes. If we do y we get worse outcomes. Our data analytics platform will drive those decisions in the future.And we just happen to be gathering all that data by way of something called remote therapeutic monitoring. Like that's what gets me most excited about the company.
Kip Theno: Yeah. And Jim, of course, I'm rooting for you and I being on the tip of the sword as you and I have in RPM and RTM, I mean, it's gonna work. It's like AI, it's here to stay, like you said, I had a thought in the pre-show with you that we have been in kind of reactive medicine for a long time, right?
If someone has a heart attack, we go in and fix it. You know, that example, they need a surgical procedure.We're there to do that. When does this become the paradigm of first line medicine?
Jim Breidenstein: That's a good question. It is kind of first [00:25:00]line medicine Kipp it's, it's a way to get data to drive all different modalities and programs and treatment plans.
I mean, if we think again about the technology in its own right, it's to drive treatment plan adherence, right in medication management.So regardless if it's a pill or a protein, an injectable, a GLP one, you know, the ozempics of the world. A pharmaceutical agent or development, um, ketamine, oc Ibin, the modality of measuring and monitoring to see the clinical effect and outcomes that should start day one.
Think of a very clear, relevant example. Unfortunately, someone's in pain. They end up going to see a pain management physician, and they have to put 'em on schedule two narcotics. We'd wanna start utilizing that right away to measure the effectiveness and ability of the drug.
So I, I think in many ways it's there from that perspective Anyway.
Kip Theno: Wow. Yeah, no, I [00:26:00] agree with you. I mean, I think it should be first line and I think we'd see some massive, changes in healthcare in general. Nobody better to lead this charge than you JB And by the way, the check's in the mail love having on the podcast.
I do have a final question for you before we get to that for our listeners out there.
Kip Theno: How do clinics, patients, our advocates groups, how do they get a hold of you, Jim?
Jim Breidenstein: Yeah, there we have, an emerging website, at adhereplus.com, and that's all spelled out at here, plus.com. That's the best way. And you go right in there to the info tab and that'll connect you right to us.
And we send you right into our amazing, marketing team led byJeff Wynn, who's been an industry leader for about 20 years now. And we're happy to recently add Jeff to the team so he will be awaiting any information that comes in.
Kip Theno: JB thanks.This is super informative and, and always a pleasure to talk to you.
I've got an Easter egg question for you, brother. When Dominic left the Buffalo Sabres, went to my coveted Red Wings and won a bunch of Stanley Cups. Are you still [00:27:00] a Sabres fan? And why
Jim Breidenstein: Go Bills?
Kip Theno: That answers my question, go ahead.
Jim Breidenstein: the Sabres are great. Always a wonderful, wonderful night out with the family and the wife. But we're rooting hard for the bills. We're gonna make the playoffs and, you know, ultimately win the Super Bowl here with the bills. And, you know, we're gonna give the savers a little more time to catch up.
How's that for an answer?
Kip Theno: I willtake that as a non-answer, but we will help get Adhere+ across the line, JB and my good friend, thank you for joining The Road to Care podcast. We'll see you soon, brother.
Jim Breidenstein: Always my friend. Take care.
Kip Theno: ThanksJim.
Thank you for joining the Road to Care podcast, hosted bySamaCare, the leader in prior authorization technology and services, wherethrough a script to therapy operating system, we enable connectivity withclinics, payers, and manufacturers focused on optimizing patient care. Tune innext time as together we can make things right.
Enjoy the music written, produced, and recorded by Jamestown.
Podcast produced by JFACTOR, visit https://www.jfactor.com/
Together, we can make healthcare right. Here are some of the outstanding healthcare organizations and associations championing patient health mentioned in this episode:
Kip Theno: Helloagain everybody and welcome back to The Road to Care podcast hosted by SamaCare. And today our special guest is my friend Jim Breidenstein, healthcareexecutive and dare I say, a maverick. JB currently serves as the CEO and ChiefCommercial Officer of Adhere+ (www.adhereplus.com) a telehealth platform,clinically proven to significantly improve care plan and medication adherence.
Before joining Adhere+, Jim has a deep history of innovation in medical device technologies and therapeutics. Jim previously served as theGlobal Vice President of Pear Therapeutics, where he stood up commercial operations for the [00:01:00] commercialization of the first and only prescription digital therapeutic.
JB was a commercial executive at Kyphon, Inc. The first minimally invasive spinal surgery company from conception to its acquisition.Jim introduced the first and only med device to the world of psychiatry at Neuronetics, where he led and scaled the organization to an ultimate IPO. Jimthen joined Cardiovascular Systems Inc where he led the world's first coronary orbital atherectomy product offering, adding 1.6 billion in shareholder value.As an executive leader in the startup med device and digital health space for over 25 years, Jim has added nearly $8 billion in shareholder value, developingan expertise in commercializing transformational digital health products.
JB my brother, how are you today, man?
Jim Breidenstein:Hey, I'm doing awesome. And, I like Maverick. I like that.
Kip Theno: Well, ifthat's your new call sign, we'll have jackets made. Gladly. I'm not gonna be goose though. All right.
Jim Breidenstein: Allright. Sounds good.
Kip Theno: Hey, [00:02:00] JB, I've known you for a long time, but the audience deserves a look, at your journey in the healthcare from novel devices to now digital health tech.
How'd you get here?
Jim Breidenstein: Yeah, it's a little bit of good fortune and a little bit of luck, and I've been really blessed to find myself at cutting edge technologies for a couple of decades now, and just addicted to the startup world. As you know, we've had many discussions on this and started the journey in medical device and then moved along the paradigm, ultimately ending up in the new emerging field of digital healthcare. And I know that's abig topic and covers a lot of ground, but I find myself taking new, innovative, not only technologies, or not only products, but taking emerging classes of medicine and trying like a son of a gun to make them mainstream.
And luckily today with great folks like you, I've been fortunate enough to do that a couple of times.
Kip Theno: Well,you've led these commercial organizations kind of from inception to some kindof a finish, and not all of them [00:03:00]survive.
Right, of course.
Kip Theno: But I'dlove for you to talk about leading a commercial sales team as an example and something new that hasn't been done before and change clinical behavior. What are your thoughts on leadership in general today versus when maybe you and I started?
Jim Breidenstein: Well, I think the core fundamentals of leadership always remains the same at least for me.
And it's always about the people. And if we take care of the people, the people will take care of the business and we'll all live happily ever after. But, you know, in terms of leadership one of the core fundamentals is communication. And I feel that one of the things I learned along the journeyis having the right expectations is one thing, but having those expectations communicated in the right way to the people so they understand where we're heading.
It's so critically important, and whether it's in my own personal journeys or the many, many companies that I've consulted with over they ears, that communication element cannot be underscored enough. It has to happen, and repetition is good. Sometimes [00:04:00]communication to the 10th degree just helps people stay on track and.
You know, communication is key, but what also is key is an incentive modality and an incentive program. Again, just can't underscore it enough. I mean, it's one of those pivotal things where we have to put as much time into that as we do about the corporate philosophy and corporate strategy.How do we incentivize our great, amazing people to get the most out of them and give back to the company as much as they possibly can?
Is. You know, right at the top of the list. So a lot of the things Kip yeah, have changed over time, but I'll tell you at the core, they're many are exactly what the way they used to be.
Kip Theno: Yeah. And Jim, I mean, you've created such unbelievable followership in the organizations and I've had the pleasure of working with you at companies in the past, and that typically when you're focused on that personal professional development, which you've had a fierce dedication to, I'm a testament to that.
You're a mentor of mine. I think it goes a long way and. Change is not easy. Right. That's why you need that followership from the folks kind [00:05:00] of going into the foxhole with you, andI've heard you talk about tearing down the four walls. That's a big change, right? In thinking about healthcare shifts in healthcare W did you mean by that?
When you always talked about tearing down the four walls?
Jim Breidenstein: Well you remember, back in the day when physicians started to consider these.Sites of service called Office-based Labs or OBLs, right? They started to think about doing surgical procedures outside the walls of the hospitals.
We, you and I, collectively and many others, we migrated a lotof our business to those facilities and to those centers. So I've seen that happen before and I've seen how, what a dramatic and positive change that's made for the patients and for the payers, for that matter. Not to mention the providers, but as I sit today and I think about how can we.
Deploy digital healthcare to help us take the process in the slow bureau process [00:06:00] that exists within the four dirty walls of the hospital, if you will. And get that out intothe mainstream and use different technology and modalities to expedite healthcare, to expedite access and keep patients and care teams and payers allaligned.
So when I say tearing down the walls of a hospital or a practice, really what that means, KIPP, is how do we use technology to make.Healthcare more efficient and more effective because the face-to-face interaction is great, right? You need that for certain things, but there's waythat we can bolster healthcare and outcomes, quite frankly, if we're able touse tech outside the four walls of the hospital.
Kip Theno: Yeah, andI remember we were in a meeting once, Jim, and you said, you know, it's just that, there's a brick and mortar piece of that, which is changing dynamics and thinking and processes and training. Then there's the other side, right?There's habituation, there's apathy, and that's a whole different, you know,when [00:07:00] we launched the coronary atherectomy device, sure, that would've been the first one in 20 years versus acompetitor.
They didn't have another science that had been proven to dothat, and it wasn't an easy sledding, was it Jim?
Jim Breidenstein: No, it certainly was not. And you know, change is tough in its own right. Not to mention change in a conservative industry like healthcare. One of the great things about the ability to embark and change in healthcare is that the good products will always win and the products that bolster clinical outcomes will always win. It might take a little while as you and I both know, but eventually the world of healthcare catches up I see the implementation of these digital solutions now that you and I are both so aware of, really beginning to take hold and make a difference and, embed themselves into the clinical workflow.
And heck, we should talk a little bit about that 'cause you know, that's always a journey in its own right because the providers are sobusy and the care teams are so busy. But again, utilizing this [00:08:00] automation, tools and techniques will ultimately make it more efficient at the practice level for sure.
I.
Kip Theno: Yeah. And you and I, you more than me, I will say, grew up in, in the world of medical devices, right. And kind of the golden age. I mean, I remember the first drug-eluting stents. We had the first coronary atherectomy device. You had the first minimally invasive surgical device. We both migrated, we've kind of jumped thatchasm into this wonderful world of, of digital healthcare.
And I remember 15, maybe 20 years ago, JB where RPM remote patient monitoring and cardiology kinda limped along for a while, and now you can't really go into a cardiologist's office without having some kind of remote patient monitoring opportunity with them. And you just talked about kind of changing workflows.
Kip Theno: And before we get into here, I'd love to hear your, you know, when you went over toDigital Health and you made that as a conscious decision, I think it was with PearTherapeutics first. Why did you make that decision and what did you see in that opportunity?
Jim Breidenstein: Yeah, it was a wonderful opportunity.
Completely game changing, a completely new emerging class of medicine, [00:09:00] right? I mean, there's nothing better than helping change the way that patients are treated or the way that physicians practice medicine, but boy, what a. What a just amazing leap here. Whoever thought we'd be using our cell phones for a therapeutic response in some very, very critically ill patients, in that case, patients suffering from opioid addiction.
But what was really interesting was, you know, Kip, if you think about. Some of the problems of healthcare, right? Access, scale, not enough providers, far too many patients. The chronicity of the diseases is starting at an earlier and earlier age. Not to mention the baby boomers are aging out, putting tremendous stress and pressure on the healthcare system, and not to mention just exploding healthcare cost.
So when I started to make my journey into digital, those principles really shined through to me. The conversations were kind of like, why would we not use digital solutions [00:10:00]to help us solve the problems of scale, of access, of affordability, of connectivity, right? And as we think about how digital healthcare is done to date, it's very easy to see.
It's the wave of the future, there's no doubt about it.Currently with Adhere+ where I'm currently stationed as the CEO as you mentioned. And thanks for that. There's governmental legislature support driving a remote, therapeutic monitoring, and again, it's driving it because ofthe lessons that were learned a little bit earlier on.
So it's been a bit of an evolution starting with remote patient monitoring like you've mentioned. Primarily using a physiological device. Think of blood pressure cuff, right? Like think your mom and dad sitting around the kitchen table, putting a blood pressure cuff on, sending a signal into the doc's office.
That was great. It was our first entree into the field of remote monitoring, but in its own ride, it was, you know, it was clergy and wonky, like who maintained the [00:11:00]device and who took care of it, and who owned it, who fixed it, who paid forit, all of those kinds of things, which you can imagine with Gen one.
But most importantly, it was very narrow. It was very narrow in terms of, if we think about large fields of patients like substance use disorder, chronic obesity, pain management, which is a, a huge market, as you know, they weren't typically using physiological devices or parameters to measure and monitor their patients, right?
You wouldn't typically check a blood pressure every day or a pulse ox. A few years into ROM, CMS got together, reviewed the information, reviewed the data, and said, I think in 2019, let's take a look at this and open this up. And that became the birth of remote therapeutic monitoring. So coming out of COVID, which again, a lot of bad things happened in COVID, but itdid help some areas of medicine.
And this is one of them. We had a plethora of data now emerging. Validating the [00:12:00] use ofelectronic intervention, driving clinical outcomes. It's actually undeniable atthis point. Right? So that was the entree that allowed remote therapeutic monitoring to really explode. So in 2021 CPT codes were birthed.
As a permanent level. In 22, they became, I'm sorry, temporary.In 22, they became permanent 2023. They were expanded and already in 2024, as quite frankly as most recently as last week, the AMA has approved additional legislature making it even more expensive and easier for broader specialties, not only to utilize it.
But also get fairly compensated for their time to work, their energy and their effort. And with the new legislature taking effect in 2026, you can see that's really the official beginning of where we're heading.
Okay. And where we're heading is remote monitoring. Is absolutely, positively my [00:13:00] opinion, of course, here to stay. And what's exciting about it, as you know, and as I'vebeen telling you all along about it, here, we're positioned ourselves inproviding these services already in four separate distinct vertical markets, paying obesity, substance use disorder.
And mental health, which I'm a big fan of, and I really look forward to helping, you know, hundreds of thousands of patients with the program. The history is so important to say where we are, but most importantly, quite frankly, where we're going.
Kip Theno: Well, it's not, I mean, JB your perspective is, is amazing on this.
It's not, it is here to stay, but what's nice about encouraging about it is. We're seeing kind of a doubling down effect that from a value-based model, now there are more resources, less regulations, more money going into this because they're seeing, hey, if you. Do this with RTM or RPM you are gonna get less hospitalizations as an example.
Patients are more in tune to their own healthcare and that's, that's one thing, but I wanna go back to here. Plus you're the CEO there [00:14:00] now and congrats on that brother. Well deserved. What was the genesis of that? You guys must have saw a gap and hadsome science in the background and some tech or dev in the background that said we can, we can fill this gap.
Kip Theno: What was the genesis of it and where are you guys going next?
Jim Breidenstein: It's, it's a really great question. And we were founded by a physician and a businessman, and they got together and they said they both had some tragic loss in their own family, unfortunately. And the underlying premise was, I.
There's a sense of loneliness. There's a sense of void. There's blind spots in these in patient care. So how do we drive and deliver a connectivity between the patients in need that are suffering along their journey in the care teams that want to provide? The best possible care that they possibly can.
However, it's a great story. However, [00:15:00]in today's healthcare environment and in the insurance world and environment that we live in, you can't possibly see your patients every day like you can with remote therapeutic monitoring, right? So they got together and they said, how do we increase proactive patient engagement?
It's really, that was the genesis. How do we keep the care team connected to the patient and the patient more connected to the care team when they're not sitting in front of them. I give you a story real quick. If I'm in the chronic pain space, I'm a patient suffering from chronic pain, maybe I'm on schedule two narcotics, opioids, or not, it doesn't matter, but by nature, you're typically seeing your provider once every 28 days.
You and I both know, and if you're in healthcare for more than five minutes, you know this, the bad stuff happens when you're not sitting in front of your provider, your doctor, right? So if you think about using [00:16:00] remote therapeutic monitoring to zoom in every day for just a minute, take a quick Polaroid of how that patient's doing by asking a couple of questions.
How's your pain level? Did you have any issues? Are you having any side effects? Is your incision itching or oozing or red? You're taking aPolaroid, a snapshot, and that snapshot woven together over 30 days, or 30months or even longer, tells a beautiful, complete clinical picture of how you're doing that information.
Which goes into the second part of this. That information allows the care team to intervene in your care as needed. If there's an issue that emerges, like an adverse event, we may be able to intervene and catch it before it turns into a serious adverse event. And we all know any type of event is a very, very costly event.
So it's a very well-rounded story [00:17:00]where. Now that we have technology to reach the patients every day, right?That's awesome. We have the tech to do that now, but no one would do it untilCMS has looked at the information, validated the efficacy, and most importantly, created a reimbursement mechanism that pays and compensates accordingly and fairly.
So now you have tech, which is great. And now you have a reimbursement mechanism and it, here is the software program in the middle that allows all of this to happen. And at the end of the day, it yields two really,r eally important things. Number one, it yields better clinical outcomes, no doubt about it, and more engaged a patient is.
The better the clinical outcomes. That's point number one. But point number two is if we have better outcomes, also undeniable better clinical outcomes equals a better total cost of healthcare. So you can [00:18:00] see why CMS and Medicare is particularly excited about this because not only better outcomes drives down the total cost of healthcare.
Kip Theno: Absolutely100% JB and I'd love to hear from it here, plus what. What are from your tech stack, your solution, what disease states or disciplines, I guess, patients right, would benefit from this? Who is your target audience right now? Or target market?
Jim Breidenstein: Yeah, sure. Well, we think about the nature I.
Of the program. It's for chronic diseases in particular and treatment plan adherence and medication management. So the way that we've developed a platform is agnostic, if you will. What goes in the platform is really disease state specific. The main verticals, if you will, or the main segments that we're targeting out of the gates here.
As you can imagine, the chronic pain space. Due to the opioid epidemic and era, we've [00:19:00] also in the world of mental health because we feel connectivity and patient engagement isso incredibly important, not to mention helping with this very complex medication regimen. We're also in the world of substance use disorder for manyof the same reasons, of course, as I've already mentioned, and also very activein the world of chronic obesity medical.
Weight loss management or bariatric surgical application as well. So those are the four opening markets. But again, as I mentioned, the platform is agnostic to the content. We can put any content that we want in there. Which we will over time. But, you know, being a young, small company that's growing like wildfire and, you know, going from California to New Yorkto Florida and having, really great success right out of the gates here and outta the gates, meaning the last 18 months.
But we're trying to maintain those four very, very large markets. [00:20:00]
Kip Theno: You followed my journey at SamaCare great interest. And one of our hurdles, the AMA came out with a study a few years ago and it was one of the genesis of SamaCare -- 46% of patients don't get on the right therapy or miss their date of service, and these are your medical benefit, your J-code, your injections or your infusions, lifesaving rare disease drugs, right? That's what we're trying to solve here at SamaCare because the prior authorization process is so bogged down, so complex, the inflection point is getting worse for clinics.
So I see synergy between us and what you guys are doing in that oncology, rheumatology, neurology space. Do you guys have plans to expand, what's the proof of concept side looking at, for you?
Jim Breidenstein: Yeah, we are already in two large facilities in the world of Rheumatology, fibromyalgia, lupus, rheumatoid arthritis.
And the reason, as you mentioned is, it's a kind of an untapped unknown [00:21:00] market and it's a lot of patients in need for additional therapies and not only do we feel we've seen inour clinical work, which, you know, we don't talk much about this, but we have10 published papers, eight of them, funded by the NIH or NIMH.
And what we really studied was, how do we drive utilization byway of a mobile app to drive clinical outcomes? And we studied things like painlevels, depression and anxiety, and, the areas that you mentioned are ofmassive importance to us, and again, I think you'll see just rapid expansionand adoption of the platform in those fields.
Kip Theno: Well, I'llvice versa. JB I'll be keeping a close eye on you and here. Plus, I think, youknow, one common theme here, a common thread is, and we've seen this throughoutour journey in devices as an example, it's probably no different on the pharmaside. And now we're in this digital health world, which is exploding.
There is that inertia versus momentum phenomenon to where anidea can [00:22:00] actually.
Kip Theno: Be successful long term and create a new sustainable market what needs to happen for this to be mainstream, to be main staple out there?
Jim Breidenstein: Yeah. This will play out over time.
I will have to say it's playing out much, much faster than we anticipated, which is a good thing. But, it comes going too fast. Comes with some lumps and bumps too, but I'll take it. It's wonderful. But the number one thing, Kip, in my opinion, is. Because of the improvement in clinical outcomes of the modality that will drive us to mainstream.
And what's really great about this is we see it at all legs ofthe stool, if you will. We see it from, as you can imagine, from the patient perspective, the outcomes are fantastic. We see it from the provider perspective because now the provider is getting hundreds of data points per month per patient.
Where typically they would get one. On that, approximately [00:23:00] five to seven minute long appointment that they have once a month. So that's really important for the providers. And then also from a payer perspective. And by the way, this is covered nationally underMedicare state, by state, by Medicaid.
But most of the commercials are also paying because the concept of driving down the total cost of healthcare in being a better solution is so evident. But part B to your question, Kip, is really the punchline here for our company. Since we get hundreds of electronic patient reported outcome datapoints directly from the patient, if you will, every single month for every single patient, we have a massive gathering of data analytics.
Will yield us the ability to change the way that patients are treated. And, you know, big data is so important and so valuable, quite frankly, right? So when you ask the question, you know, where will this go?What will it [00:24:00] take to make it mainstream? Well, by gathering these millions and millions and millions of datapoints, we will be able to clearly show by way of data.
If we do X, we get better outcomes. If we do y we get worse outcomes. Our data analytics platform will drive those decisions in the future.And we just happen to be gathering all that data by way of something called remote therapeutic monitoring. Like that's what gets me most excited about the company.
Kip Theno: Yeah. And Jim, of course, I'm rooting for you and I being on the tip of the sword as you and I have in RPM and RTM, I mean, it's gonna work. It's like AI, it's here to stay, like you said, I had a thought in the pre-show with you that we have been in kind of reactive medicine for a long time, right?
If someone has a heart attack, we go in and fix it. You know, that example, they need a surgical procedure.We're there to do that. When does this become the paradigm of first line medicine?
Jim Breidenstein: That's a good question. It is kind of first [00:25:00]line medicine Kipp it's, it's a way to get data to drive all different modalities and programs and treatment plans.
I mean, if we think again about the technology in its own right, it's to drive treatment plan adherence, right in medication management.So regardless if it's a pill or a protein, an injectable, a GLP one, you know, the ozempics of the world. A pharmaceutical agent or development, um, ketamine, oc Ibin, the modality of measuring and monitoring to see the clinical effect and outcomes that should start day one.
Think of a very clear, relevant example. Unfortunately, someone's in pain. They end up going to see a pain management physician, and they have to put 'em on schedule two narcotics. We'd wanna start utilizing that right away to measure the effectiveness and ability of the drug.
So I, I think in many ways it's there from that perspective Anyway.
Kip Theno: Wow. Yeah, no, I [00:26:00] agree with you. I mean, I think it should be first line and I think we'd see some massive, changes in healthcare in general. Nobody better to lead this charge than you JB And by the way, the check's in the mail love having on the podcast.
I do have a final question for you before we get to that for our listeners out there.
Kip Theno: How do clinics, patients, our advocates groups, how do they get a hold of you, Jim?
Jim Breidenstein: Yeah, there we have, an emerging website, at adhereplus.com, and that's all spelled out at here, plus.com. That's the best way. And you go right in there to the info tab and that'll connect you right to us.
And we send you right into our amazing, marketing team led byJeff Wynn, who's been an industry leader for about 20 years now. And we're happy to recently add Jeff to the team so he will be awaiting any information that comes in.
Kip Theno: JB thanks.This is super informative and, and always a pleasure to talk to you.
I've got an Easter egg question for you, brother. When Dominic left the Buffalo Sabres, went to my coveted Red Wings and won a bunch of Stanley Cups. Are you still [00:27:00] a Sabres fan? And why
Jim Breidenstein: Go Bills?
Kip Theno: That answers my question, go ahead.
Jim Breidenstein: the Sabres are great. Always a wonderful, wonderful night out with the family and the wife. But we're rooting hard for the bills. We're gonna make the playoffs and, you know, ultimately win the Super Bowl here with the bills. And, you know, we're gonna give the savers a little more time to catch up.
How's that for an answer?
Kip Theno: I willtake that as a non-answer, but we will help get Adhere+ across the line, JB and my good friend, thank you for joining The Road to Care podcast. We'll see you soon, brother.
Jim Breidenstein: Always my friend. Take care.
Kip Theno: ThanksJim.
Thank you for joining the Road to Care podcast, hosted bySamaCare, the leader in prior authorization technology and services, wherethrough a script to therapy operating system, we enable connectivity withclinics, payers, and manufacturers focused on optimizing patient care. Tune innext time as together we can make things right.
Enjoy the music written, produced, and recorded by Jamestown.
Podcast produced by JFACTOR, visit https://www.jfactor.com/
Together, we can make healthcare right. Here are some of the outstanding healthcare organizations and associations championing patient health mentioned in this episode:
Kip Theno: Helloagain everybody and welcome back to The Road to Care podcast hosted by SamaCare. And today our special guest is my friend Jim Breidenstein, healthcareexecutive and dare I say, a maverick. JB currently serves as the CEO and ChiefCommercial Officer of Adhere+ (www.adhereplus.com) a telehealth platform,clinically proven to significantly improve care plan and medication adherence.
Before joining Adhere+, Jim has a deep history of innovation in medical device technologies and therapeutics. Jim previously served as theGlobal Vice President of Pear Therapeutics, where he stood up commercial operations for the [00:01:00] commercialization of the first and only prescription digital therapeutic.
JB was a commercial executive at Kyphon, Inc. The first minimally invasive spinal surgery company from conception to its acquisition.Jim introduced the first and only med device to the world of psychiatry at Neuronetics, where he led and scaled the organization to an ultimate IPO. Jimthen joined Cardiovascular Systems Inc where he led the world's first coronary orbital atherectomy product offering, adding 1.6 billion in shareholder value.As an executive leader in the startup med device and digital health space for over 25 years, Jim has added nearly $8 billion in shareholder value, developingan expertise in commercializing transformational digital health products.
JB my brother, how are you today, man?
Jim Breidenstein:Hey, I'm doing awesome. And, I like Maverick. I like that.
Kip Theno: Well, ifthat's your new call sign, we'll have jackets made. Gladly. I'm not gonna be goose though. All right.
Jim Breidenstein: Allright. Sounds good.
Kip Theno: Hey, [00:02:00] JB, I've known you for a long time, but the audience deserves a look, at your journey in the healthcare from novel devices to now digital health tech.
How'd you get here?
Jim Breidenstein: Yeah, it's a little bit of good fortune and a little bit of luck, and I've been really blessed to find myself at cutting edge technologies for a couple of decades now, and just addicted to the startup world. As you know, we've had many discussions on this and started the journey in medical device and then moved along the paradigm, ultimately ending up in the new emerging field of digital healthcare. And I know that's abig topic and covers a lot of ground, but I find myself taking new, innovative, not only technologies, or not only products, but taking emerging classes of medicine and trying like a son of a gun to make them mainstream.
And luckily today with great folks like you, I've been fortunate enough to do that a couple of times.
Kip Theno: Well,you've led these commercial organizations kind of from inception to some kindof a finish, and not all of them [00:03:00]survive.
Right, of course.
Kip Theno: But I'dlove for you to talk about leading a commercial sales team as an example and something new that hasn't been done before and change clinical behavior. What are your thoughts on leadership in general today versus when maybe you and I started?
Jim Breidenstein: Well, I think the core fundamentals of leadership always remains the same at least for me.
And it's always about the people. And if we take care of the people, the people will take care of the business and we'll all live happily ever after. But, you know, in terms of leadership one of the core fundamentals is communication. And I feel that one of the things I learned along the journeyis having the right expectations is one thing, but having those expectations communicated in the right way to the people so they understand where we're heading.
It's so critically important, and whether it's in my own personal journeys or the many, many companies that I've consulted with over they ears, that communication element cannot be underscored enough. It has to happen, and repetition is good. Sometimes [00:04:00]communication to the 10th degree just helps people stay on track and.
You know, communication is key, but what also is key is an incentive modality and an incentive program. Again, just can't underscore it enough. I mean, it's one of those pivotal things where we have to put as much time into that as we do about the corporate philosophy and corporate strategy.How do we incentivize our great, amazing people to get the most out of them and give back to the company as much as they possibly can?
Is. You know, right at the top of the list. So a lot of the things Kip yeah, have changed over time, but I'll tell you at the core, they're many are exactly what the way they used to be.
Kip Theno: Yeah. And Jim, I mean, you've created such unbelievable followership in the organizations and I've had the pleasure of working with you at companies in the past, and that typically when you're focused on that personal professional development, which you've had a fierce dedication to, I'm a testament to that.
You're a mentor of mine. I think it goes a long way and. Change is not easy. Right. That's why you need that followership from the folks kind [00:05:00] of going into the foxhole with you, andI've heard you talk about tearing down the four walls. That's a big change, right? In thinking about healthcare shifts in healthcare W did you mean by that?
When you always talked about tearing down the four walls?
Jim Breidenstein: Well you remember, back in the day when physicians started to consider these.Sites of service called Office-based Labs or OBLs, right? They started to think about doing surgical procedures outside the walls of the hospitals.
We, you and I, collectively and many others, we migrated a lotof our business to those facilities and to those centers. So I've seen that happen before and I've seen how, what a dramatic and positive change that's made for the patients and for the payers, for that matter. Not to mention the providers, but as I sit today and I think about how can we.
Deploy digital healthcare to help us take the process in the slow bureau process [00:06:00] that exists within the four dirty walls of the hospital, if you will. And get that out intothe mainstream and use different technology and modalities to expedite healthcare, to expedite access and keep patients and care teams and payers allaligned.
So when I say tearing down the walls of a hospital or a practice, really what that means, KIPP, is how do we use technology to make.Healthcare more efficient and more effective because the face-to-face interaction is great, right? You need that for certain things, but there's waythat we can bolster healthcare and outcomes, quite frankly, if we're able touse tech outside the four walls of the hospital.
Kip Theno: Yeah, andI remember we were in a meeting once, Jim, and you said, you know, it's just that, there's a brick and mortar piece of that, which is changing dynamics and thinking and processes and training. Then there's the other side, right?There's habituation, there's apathy, and that's a whole different, you know,when [00:07:00] we launched the coronary atherectomy device, sure, that would've been the first one in 20 years versus acompetitor.
They didn't have another science that had been proven to dothat, and it wasn't an easy sledding, was it Jim?
Jim Breidenstein: No, it certainly was not. And you know, change is tough in its own right. Not to mention change in a conservative industry like healthcare. One of the great things about the ability to embark and change in healthcare is that the good products will always win and the products that bolster clinical outcomes will always win. It might take a little while as you and I both know, but eventually the world of healthcare catches up I see the implementation of these digital solutions now that you and I are both so aware of, really beginning to take hold and make a difference and, embed themselves into the clinical workflow.
And heck, we should talk a little bit about that 'cause you know, that's always a journey in its own right because the providers are sobusy and the care teams are so busy. But again, utilizing this [00:08:00] automation, tools and techniques will ultimately make it more efficient at the practice level for sure.
I.
Kip Theno: Yeah. And you and I, you more than me, I will say, grew up in, in the world of medical devices, right. And kind of the golden age. I mean, I remember the first drug-eluting stents. We had the first coronary atherectomy device. You had the first minimally invasive surgical device. We both migrated, we've kind of jumped thatchasm into this wonderful world of, of digital healthcare.
And I remember 15, maybe 20 years ago, JB where RPM remote patient monitoring and cardiology kinda limped along for a while, and now you can't really go into a cardiologist's office without having some kind of remote patient monitoring opportunity with them. And you just talked about kind of changing workflows.
Kip Theno: And before we get into here, I'd love to hear your, you know, when you went over toDigital Health and you made that as a conscious decision, I think it was with PearTherapeutics first. Why did you make that decision and what did you see in that opportunity?
Jim Breidenstein: Yeah, it was a wonderful opportunity.
Completely game changing, a completely new emerging class of medicine, [00:09:00] right? I mean, there's nothing better than helping change the way that patients are treated or the way that physicians practice medicine, but boy, what a. What a just amazing leap here. Whoever thought we'd be using our cell phones for a therapeutic response in some very, very critically ill patients, in that case, patients suffering from opioid addiction.
But what was really interesting was, you know, Kip, if you think about. Some of the problems of healthcare, right? Access, scale, not enough providers, far too many patients. The chronicity of the diseases is starting at an earlier and earlier age. Not to mention the baby boomers are aging out, putting tremendous stress and pressure on the healthcare system, and not to mention just exploding healthcare cost.
So when I started to make my journey into digital, those principles really shined through to me. The conversations were kind of like, why would we not use digital solutions [00:10:00]to help us solve the problems of scale, of access, of affordability, of connectivity, right? And as we think about how digital healthcare is done to date, it's very easy to see.
It's the wave of the future, there's no doubt about it.Currently with Adhere+ where I'm currently stationed as the CEO as you mentioned. And thanks for that. There's governmental legislature support driving a remote, therapeutic monitoring, and again, it's driving it because ofthe lessons that were learned a little bit earlier on.
So it's been a bit of an evolution starting with remote patient monitoring like you've mentioned. Primarily using a physiological device. Think of blood pressure cuff, right? Like think your mom and dad sitting around the kitchen table, putting a blood pressure cuff on, sending a signal into the doc's office.
That was great. It was our first entree into the field of remote monitoring, but in its own ride, it was, you know, it was clergy and wonky, like who maintained the [00:11:00]device and who took care of it, and who owned it, who fixed it, who paid forit, all of those kinds of things, which you can imagine with Gen one.
But most importantly, it was very narrow. It was very narrow in terms of, if we think about large fields of patients like substance use disorder, chronic obesity, pain management, which is a, a huge market, as you know, they weren't typically using physiological devices or parameters to measure and monitor their patients, right?
You wouldn't typically check a blood pressure every day or a pulse ox. A few years into ROM, CMS got together, reviewed the information, reviewed the data, and said, I think in 2019, let's take a look at this and open this up. And that became the birth of remote therapeutic monitoring. So coming out of COVID, which again, a lot of bad things happened in COVID, but itdid help some areas of medicine.
And this is one of them. We had a plethora of data now emerging. Validating the [00:12:00] use ofelectronic intervention, driving clinical outcomes. It's actually undeniable atthis point. Right? So that was the entree that allowed remote therapeutic monitoring to really explode. So in 2021 CPT codes were birthed.
As a permanent level. In 22, they became, I'm sorry, temporary.In 22, they became permanent 2023. They were expanded and already in 2024, as quite frankly as most recently as last week, the AMA has approved additional legislature making it even more expensive and easier for broader specialties, not only to utilize it.
But also get fairly compensated for their time to work, their energy and their effort. And with the new legislature taking effect in 2026, you can see that's really the official beginning of where we're heading.
Okay. And where we're heading is remote monitoring. Is absolutely, positively my [00:13:00] opinion, of course, here to stay. And what's exciting about it, as you know, and as I'vebeen telling you all along about it, here, we're positioned ourselves inproviding these services already in four separate distinct vertical markets, paying obesity, substance use disorder.
And mental health, which I'm a big fan of, and I really look forward to helping, you know, hundreds of thousands of patients with the program. The history is so important to say where we are, but most importantly, quite frankly, where we're going.
Kip Theno: Well, it's not, I mean, JB your perspective is, is amazing on this.
It's not, it is here to stay, but what's nice about encouraging about it is. We're seeing kind of a doubling down effect that from a value-based model, now there are more resources, less regulations, more money going into this because they're seeing, hey, if you. Do this with RTM or RPM you are gonna get less hospitalizations as an example.
Patients are more in tune to their own healthcare and that's, that's one thing, but I wanna go back to here. Plus you're the CEO there [00:14:00] now and congrats on that brother. Well deserved. What was the genesis of that? You guys must have saw a gap and hadsome science in the background and some tech or dev in the background that said we can, we can fill this gap.
Kip Theno: What was the genesis of it and where are you guys going next?
Jim Breidenstein: It's, it's a really great question. And we were founded by a physician and a businessman, and they got together and they said they both had some tragic loss in their own family, unfortunately. And the underlying premise was, I.
There's a sense of loneliness. There's a sense of void. There's blind spots in these in patient care. So how do we drive and deliver a connectivity between the patients in need that are suffering along their journey in the care teams that want to provide? The best possible care that they possibly can.
However, it's a great story. However, [00:15:00]in today's healthcare environment and in the insurance world and environment that we live in, you can't possibly see your patients every day like you can with remote therapeutic monitoring, right? So they got together and they said, how do we increase proactive patient engagement?
It's really, that was the genesis. How do we keep the care team connected to the patient and the patient more connected to the care team when they're not sitting in front of them. I give you a story real quick. If I'm in the chronic pain space, I'm a patient suffering from chronic pain, maybe I'm on schedule two narcotics, opioids, or not, it doesn't matter, but by nature, you're typically seeing your provider once every 28 days.
You and I both know, and if you're in healthcare for more than five minutes, you know this, the bad stuff happens when you're not sitting in front of your provider, your doctor, right? So if you think about using [00:16:00] remote therapeutic monitoring to zoom in every day for just a minute, take a quick Polaroid of how that patient's doing by asking a couple of questions.
How's your pain level? Did you have any issues? Are you having any side effects? Is your incision itching or oozing or red? You're taking aPolaroid, a snapshot, and that snapshot woven together over 30 days, or 30months or even longer, tells a beautiful, complete clinical picture of how you're doing that information.
Which goes into the second part of this. That information allows the care team to intervene in your care as needed. If there's an issue that emerges, like an adverse event, we may be able to intervene and catch it before it turns into a serious adverse event. And we all know any type of event is a very, very costly event.
So it's a very well-rounded story [00:17:00]where. Now that we have technology to reach the patients every day, right?That's awesome. We have the tech to do that now, but no one would do it untilCMS has looked at the information, validated the efficacy, and most importantly, created a reimbursement mechanism that pays and compensates accordingly and fairly.
So now you have tech, which is great. And now you have a reimbursement mechanism and it, here is the software program in the middle that allows all of this to happen. And at the end of the day, it yields two really,r eally important things. Number one, it yields better clinical outcomes, no doubt about it, and more engaged a patient is.
The better the clinical outcomes. That's point number one. But point number two is if we have better outcomes, also undeniable better clinical outcomes equals a better total cost of healthcare. So you can [00:18:00] see why CMS and Medicare is particularly excited about this because not only better outcomes drives down the total cost of healthcare.
Kip Theno: Absolutely100% JB and I'd love to hear from it here, plus what. What are from your tech stack, your solution, what disease states or disciplines, I guess, patients right, would benefit from this? Who is your target audience right now? Or target market?
Jim Breidenstein: Yeah, sure. Well, we think about the nature I.
Of the program. It's for chronic diseases in particular and treatment plan adherence and medication management. So the way that we've developed a platform is agnostic, if you will. What goes in the platform is really disease state specific. The main verticals, if you will, or the main segments that we're targeting out of the gates here.
As you can imagine, the chronic pain space. Due to the opioid epidemic and era, we've [00:19:00] also in the world of mental health because we feel connectivity and patient engagement isso incredibly important, not to mention helping with this very complex medication regimen. We're also in the world of substance use disorder for manyof the same reasons, of course, as I've already mentioned, and also very activein the world of chronic obesity medical.
Weight loss management or bariatric surgical application as well. So those are the four opening markets. But again, as I mentioned, the platform is agnostic to the content. We can put any content that we want in there. Which we will over time. But, you know, being a young, small company that's growing like wildfire and, you know, going from California to New Yorkto Florida and having, really great success right out of the gates here and outta the gates, meaning the last 18 months.
But we're trying to maintain those four very, very large markets. [00:20:00]
Kip Theno: You followed my journey at SamaCare great interest. And one of our hurdles, the AMA came out with a study a few years ago and it was one of the genesis of SamaCare -- 46% of patients don't get on the right therapy or miss their date of service, and these are your medical benefit, your J-code, your injections or your infusions, lifesaving rare disease drugs, right? That's what we're trying to solve here at SamaCare because the prior authorization process is so bogged down, so complex, the inflection point is getting worse for clinics.
So I see synergy between us and what you guys are doing in that oncology, rheumatology, neurology space. Do you guys have plans to expand, what's the proof of concept side looking at, for you?
Jim Breidenstein: Yeah, we are already in two large facilities in the world of Rheumatology, fibromyalgia, lupus, rheumatoid arthritis.
And the reason, as you mentioned is, it's a kind of an untapped unknown [00:21:00] market and it's a lot of patients in need for additional therapies and not only do we feel we've seen inour clinical work, which, you know, we don't talk much about this, but we have10 published papers, eight of them, funded by the NIH or NIMH.
And what we really studied was, how do we drive utilization byway of a mobile app to drive clinical outcomes? And we studied things like painlevels, depression and anxiety, and, the areas that you mentioned are ofmassive importance to us, and again, I think you'll see just rapid expansionand adoption of the platform in those fields.
Kip Theno: Well, I'llvice versa. JB I'll be keeping a close eye on you and here. Plus, I think, youknow, one common theme here, a common thread is, and we've seen this throughoutour journey in devices as an example, it's probably no different on the pharmaside. And now we're in this digital health world, which is exploding.
There is that inertia versus momentum phenomenon to where anidea can [00:22:00] actually.
Kip Theno: Be successful long term and create a new sustainable market what needs to happen for this to be mainstream, to be main staple out there?
Jim Breidenstein: Yeah. This will play out over time.
I will have to say it's playing out much, much faster than we anticipated, which is a good thing. But, it comes going too fast. Comes with some lumps and bumps too, but I'll take it. It's wonderful. But the number one thing, Kip, in my opinion, is. Because of the improvement in clinical outcomes of the modality that will drive us to mainstream.
And what's really great about this is we see it at all legs ofthe stool, if you will. We see it from, as you can imagine, from the patient perspective, the outcomes are fantastic. We see it from the provider perspective because now the provider is getting hundreds of data points per month per patient.
Where typically they would get one. On that, approximately [00:23:00] five to seven minute long appointment that they have once a month. So that's really important for the providers. And then also from a payer perspective. And by the way, this is covered nationally underMedicare state, by state, by Medicaid.
But most of the commercials are also paying because the concept of driving down the total cost of healthcare in being a better solution is so evident. But part B to your question, Kip, is really the punchline here for our company. Since we get hundreds of electronic patient reported outcome datapoints directly from the patient, if you will, every single month for every single patient, we have a massive gathering of data analytics.
Will yield us the ability to change the way that patients are treated. And, you know, big data is so important and so valuable, quite frankly, right? So when you ask the question, you know, where will this go?What will it [00:24:00] take to make it mainstream? Well, by gathering these millions and millions and millions of datapoints, we will be able to clearly show by way of data.
If we do X, we get better outcomes. If we do y we get worse outcomes. Our data analytics platform will drive those decisions in the future.And we just happen to be gathering all that data by way of something called remote therapeutic monitoring. Like that's what gets me most excited about the company.
Kip Theno: Yeah. And Jim, of course, I'm rooting for you and I being on the tip of the sword as you and I have in RPM and RTM, I mean, it's gonna work. It's like AI, it's here to stay, like you said, I had a thought in the pre-show with you that we have been in kind of reactive medicine for a long time, right?
If someone has a heart attack, we go in and fix it. You know, that example, they need a surgical procedure.We're there to do that. When does this become the paradigm of first line medicine?
Jim Breidenstein: That's a good question. It is kind of first [00:25:00]line medicine Kipp it's, it's a way to get data to drive all different modalities and programs and treatment plans.
I mean, if we think again about the technology in its own right, it's to drive treatment plan adherence, right in medication management.So regardless if it's a pill or a protein, an injectable, a GLP one, you know, the ozempics of the world. A pharmaceutical agent or development, um, ketamine, oc Ibin, the modality of measuring and monitoring to see the clinical effect and outcomes that should start day one.
Think of a very clear, relevant example. Unfortunately, someone's in pain. They end up going to see a pain management physician, and they have to put 'em on schedule two narcotics. We'd wanna start utilizing that right away to measure the effectiveness and ability of the drug.
So I, I think in many ways it's there from that perspective Anyway.
Kip Theno: Wow. Yeah, no, I [00:26:00] agree with you. I mean, I think it should be first line and I think we'd see some massive, changes in healthcare in general. Nobody better to lead this charge than you JB And by the way, the check's in the mail love having on the podcast.
I do have a final question for you before we get to that for our listeners out there.
Kip Theno: How do clinics, patients, our advocates groups, how do they get a hold of you, Jim?
Jim Breidenstein: Yeah, there we have, an emerging website, at adhereplus.com, and that's all spelled out at here, plus.com. That's the best way. And you go right in there to the info tab and that'll connect you right to us.
And we send you right into our amazing, marketing team led byJeff Wynn, who's been an industry leader for about 20 years now. And we're happy to recently add Jeff to the team so he will be awaiting any information that comes in.
Kip Theno: JB thanks.This is super informative and, and always a pleasure to talk to you.
I've got an Easter egg question for you, brother. When Dominic left the Buffalo Sabres, went to my coveted Red Wings and won a bunch of Stanley Cups. Are you still [00:27:00] a Sabres fan? And why
Jim Breidenstein: Go Bills?
Kip Theno: That answers my question, go ahead.
Jim Breidenstein: the Sabres are great. Always a wonderful, wonderful night out with the family and the wife. But we're rooting hard for the bills. We're gonna make the playoffs and, you know, ultimately win the Super Bowl here with the bills. And, you know, we're gonna give the savers a little more time to catch up.
How's that for an answer?
Kip Theno: I willtake that as a non-answer, but we will help get Adhere+ across the line, JB and my good friend, thank you for joining The Road to Care podcast. We'll see you soon, brother.
Jim Breidenstein: Always my friend. Take care.
Kip Theno: ThanksJim.
Thank you for joining the Road to Care podcast, hosted bySamaCare, the leader in prior authorization technology and services, wherethrough a script to therapy operating system, we enable connectivity withclinics, payers, and manufacturers focused on optimizing patient care. Tune innext time as together we can make things right.
Enjoy the music written, produced, and recorded by Jamestown.
Podcast produced by JFACTOR, visit https://www.jfactor.com/
Together, we can make healthcare right. Here are some of the outstanding healthcare organizations and associations championing patient health mentioned in this episode:
Kip Theno: Helloagain everybody and welcome back to The Road to Care podcast hosted by SamaCare. And today our special guest is my friend Jim Breidenstein, healthcareexecutive and dare I say, a maverick. JB currently serves as the CEO and ChiefCommercial Officer of Adhere+ (www.adhereplus.com) a telehealth platform,clinically proven to significantly improve care plan and medication adherence.
Before joining Adhere+, Jim has a deep history of innovation in medical device technologies and therapeutics. Jim previously served as theGlobal Vice President of Pear Therapeutics, where he stood up commercial operations for the [00:01:00] commercialization of the first and only prescription digital therapeutic.
JB was a commercial executive at Kyphon, Inc. The first minimally invasive spinal surgery company from conception to its acquisition.Jim introduced the first and only med device to the world of psychiatry at Neuronetics, where he led and scaled the organization to an ultimate IPO. Jimthen joined Cardiovascular Systems Inc where he led the world's first coronary orbital atherectomy product offering, adding 1.6 billion in shareholder value.As an executive leader in the startup med device and digital health space for over 25 years, Jim has added nearly $8 billion in shareholder value, developingan expertise in commercializing transformational digital health products.
JB my brother, how are you today, man?
Jim Breidenstein:Hey, I'm doing awesome. And, I like Maverick. I like that.
Kip Theno: Well, ifthat's your new call sign, we'll have jackets made. Gladly. I'm not gonna be goose though. All right.
Jim Breidenstein: Allright. Sounds good.
Kip Theno: Hey, [00:02:00] JB, I've known you for a long time, but the audience deserves a look, at your journey in the healthcare from novel devices to now digital health tech.
How'd you get here?
Jim Breidenstein: Yeah, it's a little bit of good fortune and a little bit of luck, and I've been really blessed to find myself at cutting edge technologies for a couple of decades now, and just addicted to the startup world. As you know, we've had many discussions on this and started the journey in medical device and then moved along the paradigm, ultimately ending up in the new emerging field of digital healthcare. And I know that's abig topic and covers a lot of ground, but I find myself taking new, innovative, not only technologies, or not only products, but taking emerging classes of medicine and trying like a son of a gun to make them mainstream.
And luckily today with great folks like you, I've been fortunate enough to do that a couple of times.
Kip Theno: Well,you've led these commercial organizations kind of from inception to some kindof a finish, and not all of them [00:03:00]survive.
Right, of course.
Kip Theno: But I'dlove for you to talk about leading a commercial sales team as an example and something new that hasn't been done before and change clinical behavior. What are your thoughts on leadership in general today versus when maybe you and I started?
Jim Breidenstein: Well, I think the core fundamentals of leadership always remains the same at least for me.
And it's always about the people. And if we take care of the people, the people will take care of the business and we'll all live happily ever after. But, you know, in terms of leadership one of the core fundamentals is communication. And I feel that one of the things I learned along the journeyis having the right expectations is one thing, but having those expectations communicated in the right way to the people so they understand where we're heading.
It's so critically important, and whether it's in my own personal journeys or the many, many companies that I've consulted with over they ears, that communication element cannot be underscored enough. It has to happen, and repetition is good. Sometimes [00:04:00]communication to the 10th degree just helps people stay on track and.
You know, communication is key, but what also is key is an incentive modality and an incentive program. Again, just can't underscore it enough. I mean, it's one of those pivotal things where we have to put as much time into that as we do about the corporate philosophy and corporate strategy.How do we incentivize our great, amazing people to get the most out of them and give back to the company as much as they possibly can?
Is. You know, right at the top of the list. So a lot of the things Kip yeah, have changed over time, but I'll tell you at the core, they're many are exactly what the way they used to be.
Kip Theno: Yeah. And Jim, I mean, you've created such unbelievable followership in the organizations and I've had the pleasure of working with you at companies in the past, and that typically when you're focused on that personal professional development, which you've had a fierce dedication to, I'm a testament to that.
You're a mentor of mine. I think it goes a long way and. Change is not easy. Right. That's why you need that followership from the folks kind [00:05:00] of going into the foxhole with you, andI've heard you talk about tearing down the four walls. That's a big change, right? In thinking about healthcare shifts in healthcare W did you mean by that?
When you always talked about tearing down the four walls?
Jim Breidenstein: Well you remember, back in the day when physicians started to consider these.Sites of service called Office-based Labs or OBLs, right? They started to think about doing surgical procedures outside the walls of the hospitals.
We, you and I, collectively and many others, we migrated a lotof our business to those facilities and to those centers. So I've seen that happen before and I've seen how, what a dramatic and positive change that's made for the patients and for the payers, for that matter. Not to mention the providers, but as I sit today and I think about how can we.
Deploy digital healthcare to help us take the process in the slow bureau process [00:06:00] that exists within the four dirty walls of the hospital, if you will. And get that out intothe mainstream and use different technology and modalities to expedite healthcare, to expedite access and keep patients and care teams and payers allaligned.
So when I say tearing down the walls of a hospital or a practice, really what that means, KIPP, is how do we use technology to make.Healthcare more efficient and more effective because the face-to-face interaction is great, right? You need that for certain things, but there's waythat we can bolster healthcare and outcomes, quite frankly, if we're able touse tech outside the four walls of the hospital.
Kip Theno: Yeah, andI remember we were in a meeting once, Jim, and you said, you know, it's just that, there's a brick and mortar piece of that, which is changing dynamics and thinking and processes and training. Then there's the other side, right?There's habituation, there's apathy, and that's a whole different, you know,when [00:07:00] we launched the coronary atherectomy device, sure, that would've been the first one in 20 years versus acompetitor.
They didn't have another science that had been proven to dothat, and it wasn't an easy sledding, was it Jim?
Jim Breidenstein: No, it certainly was not. And you know, change is tough in its own right. Not to mention change in a conservative industry like healthcare. One of the great things about the ability to embark and change in healthcare is that the good products will always win and the products that bolster clinical outcomes will always win. It might take a little while as you and I both know, but eventually the world of healthcare catches up I see the implementation of these digital solutions now that you and I are both so aware of, really beginning to take hold and make a difference and, embed themselves into the clinical workflow.
And heck, we should talk a little bit about that 'cause you know, that's always a journey in its own right because the providers are sobusy and the care teams are so busy. But again, utilizing this [00:08:00] automation, tools and techniques will ultimately make it more efficient at the practice level for sure.
I.
Kip Theno: Yeah. And you and I, you more than me, I will say, grew up in, in the world of medical devices, right. And kind of the golden age. I mean, I remember the first drug-eluting stents. We had the first coronary atherectomy device. You had the first minimally invasive surgical device. We both migrated, we've kind of jumped thatchasm into this wonderful world of, of digital healthcare.
And I remember 15, maybe 20 years ago, JB where RPM remote patient monitoring and cardiology kinda limped along for a while, and now you can't really go into a cardiologist's office without having some kind of remote patient monitoring opportunity with them. And you just talked about kind of changing workflows.
Kip Theno: And before we get into here, I'd love to hear your, you know, when you went over toDigital Health and you made that as a conscious decision, I think it was with PearTherapeutics first. Why did you make that decision and what did you see in that opportunity?
Jim Breidenstein: Yeah, it was a wonderful opportunity.
Completely game changing, a completely new emerging class of medicine, [00:09:00] right? I mean, there's nothing better than helping change the way that patients are treated or the way that physicians practice medicine, but boy, what a. What a just amazing leap here. Whoever thought we'd be using our cell phones for a therapeutic response in some very, very critically ill patients, in that case, patients suffering from opioid addiction.
But what was really interesting was, you know, Kip, if you think about. Some of the problems of healthcare, right? Access, scale, not enough providers, far too many patients. The chronicity of the diseases is starting at an earlier and earlier age. Not to mention the baby boomers are aging out, putting tremendous stress and pressure on the healthcare system, and not to mention just exploding healthcare cost.
So when I started to make my journey into digital, those principles really shined through to me. The conversations were kind of like, why would we not use digital solutions [00:10:00]to help us solve the problems of scale, of access, of affordability, of connectivity, right? And as we think about how digital healthcare is done to date, it's very easy to see.
It's the wave of the future, there's no doubt about it.Currently with Adhere+ where I'm currently stationed as the CEO as you mentioned. And thanks for that. There's governmental legislature support driving a remote, therapeutic monitoring, and again, it's driving it because ofthe lessons that were learned a little bit earlier on.
So it's been a bit of an evolution starting with remote patient monitoring like you've mentioned. Primarily using a physiological device. Think of blood pressure cuff, right? Like think your mom and dad sitting around the kitchen table, putting a blood pressure cuff on, sending a signal into the doc's office.
That was great. It was our first entree into the field of remote monitoring, but in its own ride, it was, you know, it was clergy and wonky, like who maintained the [00:11:00]device and who took care of it, and who owned it, who fixed it, who paid forit, all of those kinds of things, which you can imagine with Gen one.
But most importantly, it was very narrow. It was very narrow in terms of, if we think about large fields of patients like substance use disorder, chronic obesity, pain management, which is a, a huge market, as you know, they weren't typically using physiological devices or parameters to measure and monitor their patients, right?
You wouldn't typically check a blood pressure every day or a pulse ox. A few years into ROM, CMS got together, reviewed the information, reviewed the data, and said, I think in 2019, let's take a look at this and open this up. And that became the birth of remote therapeutic monitoring. So coming out of COVID, which again, a lot of bad things happened in COVID, but itdid help some areas of medicine.
And this is one of them. We had a plethora of data now emerging. Validating the [00:12:00] use ofelectronic intervention, driving clinical outcomes. It's actually undeniable atthis point. Right? So that was the entree that allowed remote therapeutic monitoring to really explode. So in 2021 CPT codes were birthed.
As a permanent level. In 22, they became, I'm sorry, temporary.In 22, they became permanent 2023. They were expanded and already in 2024, as quite frankly as most recently as last week, the AMA has approved additional legislature making it even more expensive and easier for broader specialties, not only to utilize it.
But also get fairly compensated for their time to work, their energy and their effort. And with the new legislature taking effect in 2026, you can see that's really the official beginning of where we're heading.
Okay. And where we're heading is remote monitoring. Is absolutely, positively my [00:13:00] opinion, of course, here to stay. And what's exciting about it, as you know, and as I'vebeen telling you all along about it, here, we're positioned ourselves inproviding these services already in four separate distinct vertical markets, paying obesity, substance use disorder.
And mental health, which I'm a big fan of, and I really look forward to helping, you know, hundreds of thousands of patients with the program. The history is so important to say where we are, but most importantly, quite frankly, where we're going.
Kip Theno: Well, it's not, I mean, JB your perspective is, is amazing on this.
It's not, it is here to stay, but what's nice about encouraging about it is. We're seeing kind of a doubling down effect that from a value-based model, now there are more resources, less regulations, more money going into this because they're seeing, hey, if you. Do this with RTM or RPM you are gonna get less hospitalizations as an example.
Patients are more in tune to their own healthcare and that's, that's one thing, but I wanna go back to here. Plus you're the CEO there [00:14:00] now and congrats on that brother. Well deserved. What was the genesis of that? You guys must have saw a gap and hadsome science in the background and some tech or dev in the background that said we can, we can fill this gap.
Kip Theno: What was the genesis of it and where are you guys going next?
Jim Breidenstein: It's, it's a really great question. And we were founded by a physician and a businessman, and they got together and they said they both had some tragic loss in their own family, unfortunately. And the underlying premise was, I.
There's a sense of loneliness. There's a sense of void. There's blind spots in these in patient care. So how do we drive and deliver a connectivity between the patients in need that are suffering along their journey in the care teams that want to provide? The best possible care that they possibly can.
However, it's a great story. However, [00:15:00]in today's healthcare environment and in the insurance world and environment that we live in, you can't possibly see your patients every day like you can with remote therapeutic monitoring, right? So they got together and they said, how do we increase proactive patient engagement?
It's really, that was the genesis. How do we keep the care team connected to the patient and the patient more connected to the care team when they're not sitting in front of them. I give you a story real quick. If I'm in the chronic pain space, I'm a patient suffering from chronic pain, maybe I'm on schedule two narcotics, opioids, or not, it doesn't matter, but by nature, you're typically seeing your provider once every 28 days.
You and I both know, and if you're in healthcare for more than five minutes, you know this, the bad stuff happens when you're not sitting in front of your provider, your doctor, right? So if you think about using [00:16:00] remote therapeutic monitoring to zoom in every day for just a minute, take a quick Polaroid of how that patient's doing by asking a couple of questions.
How's your pain level? Did you have any issues? Are you having any side effects? Is your incision itching or oozing or red? You're taking aPolaroid, a snapshot, and that snapshot woven together over 30 days, or 30months or even longer, tells a beautiful, complete clinical picture of how you're doing that information.
Which goes into the second part of this. That information allows the care team to intervene in your care as needed. If there's an issue that emerges, like an adverse event, we may be able to intervene and catch it before it turns into a serious adverse event. And we all know any type of event is a very, very costly event.
So it's a very well-rounded story [00:17:00]where. Now that we have technology to reach the patients every day, right?That's awesome. We have the tech to do that now, but no one would do it untilCMS has looked at the information, validated the efficacy, and most importantly, created a reimbursement mechanism that pays and compensates accordingly and fairly.
So now you have tech, which is great. And now you have a reimbursement mechanism and it, here is the software program in the middle that allows all of this to happen. And at the end of the day, it yields two really,r eally important things. Number one, it yields better clinical outcomes, no doubt about it, and more engaged a patient is.
The better the clinical outcomes. That's point number one. But point number two is if we have better outcomes, also undeniable better clinical outcomes equals a better total cost of healthcare. So you can [00:18:00] see why CMS and Medicare is particularly excited about this because not only better outcomes drives down the total cost of healthcare.
Kip Theno: Absolutely100% JB and I'd love to hear from it here, plus what. What are from your tech stack, your solution, what disease states or disciplines, I guess, patients right, would benefit from this? Who is your target audience right now? Or target market?
Jim Breidenstein: Yeah, sure. Well, we think about the nature I.
Of the program. It's for chronic diseases in particular and treatment plan adherence and medication management. So the way that we've developed a platform is agnostic, if you will. What goes in the platform is really disease state specific. The main verticals, if you will, or the main segments that we're targeting out of the gates here.
As you can imagine, the chronic pain space. Due to the opioid epidemic and era, we've [00:19:00] also in the world of mental health because we feel connectivity and patient engagement isso incredibly important, not to mention helping with this very complex medication regimen. We're also in the world of substance use disorder for manyof the same reasons, of course, as I've already mentioned, and also very activein the world of chronic obesity medical.
Weight loss management or bariatric surgical application as well. So those are the four opening markets. But again, as I mentioned, the platform is agnostic to the content. We can put any content that we want in there. Which we will over time. But, you know, being a young, small company that's growing like wildfire and, you know, going from California to New Yorkto Florida and having, really great success right out of the gates here and outta the gates, meaning the last 18 months.
But we're trying to maintain those four very, very large markets. [00:20:00]
Kip Theno: You followed my journey at SamaCare great interest. And one of our hurdles, the AMA came out with a study a few years ago and it was one of the genesis of SamaCare -- 46% of patients don't get on the right therapy or miss their date of service, and these are your medical benefit, your J-code, your injections or your infusions, lifesaving rare disease drugs, right? That's what we're trying to solve here at SamaCare because the prior authorization process is so bogged down, so complex, the inflection point is getting worse for clinics.
So I see synergy between us and what you guys are doing in that oncology, rheumatology, neurology space. Do you guys have plans to expand, what's the proof of concept side looking at, for you?
Jim Breidenstein: Yeah, we are already in two large facilities in the world of Rheumatology, fibromyalgia, lupus, rheumatoid arthritis.
And the reason, as you mentioned is, it's a kind of an untapped unknown [00:21:00] market and it's a lot of patients in need for additional therapies and not only do we feel we've seen inour clinical work, which, you know, we don't talk much about this, but we have10 published papers, eight of them, funded by the NIH or NIMH.
And what we really studied was, how do we drive utilization byway of a mobile app to drive clinical outcomes? And we studied things like painlevels, depression and anxiety, and, the areas that you mentioned are ofmassive importance to us, and again, I think you'll see just rapid expansionand adoption of the platform in those fields.
Kip Theno: Well, I'llvice versa. JB I'll be keeping a close eye on you and here. Plus, I think, youknow, one common theme here, a common thread is, and we've seen this throughoutour journey in devices as an example, it's probably no different on the pharmaside. And now we're in this digital health world, which is exploding.
There is that inertia versus momentum phenomenon to where anidea can [00:22:00] actually.
Kip Theno: Be successful long term and create a new sustainable market what needs to happen for this to be mainstream, to be main staple out there?
Jim Breidenstein: Yeah. This will play out over time.
I will have to say it's playing out much, much faster than we anticipated, which is a good thing. But, it comes going too fast. Comes with some lumps and bumps too, but I'll take it. It's wonderful. But the number one thing, Kip, in my opinion, is. Because of the improvement in clinical outcomes of the modality that will drive us to mainstream.
And what's really great about this is we see it at all legs ofthe stool, if you will. We see it from, as you can imagine, from the patient perspective, the outcomes are fantastic. We see it from the provider perspective because now the provider is getting hundreds of data points per month per patient.
Where typically they would get one. On that, approximately [00:23:00] five to seven minute long appointment that they have once a month. So that's really important for the providers. And then also from a payer perspective. And by the way, this is covered nationally underMedicare state, by state, by Medicaid.
But most of the commercials are also paying because the concept of driving down the total cost of healthcare in being a better solution is so evident. But part B to your question, Kip, is really the punchline here for our company. Since we get hundreds of electronic patient reported outcome datapoints directly from the patient, if you will, every single month for every single patient, we have a massive gathering of data analytics.
Will yield us the ability to change the way that patients are treated. And, you know, big data is so important and so valuable, quite frankly, right? So when you ask the question, you know, where will this go?What will it [00:24:00] take to make it mainstream? Well, by gathering these millions and millions and millions of datapoints, we will be able to clearly show by way of data.
If we do X, we get better outcomes. If we do y we get worse outcomes. Our data analytics platform will drive those decisions in the future.And we just happen to be gathering all that data by way of something called remote therapeutic monitoring. Like that's what gets me most excited about the company.
Kip Theno: Yeah. And Jim, of course, I'm rooting for you and I being on the tip of the sword as you and I have in RPM and RTM, I mean, it's gonna work. It's like AI, it's here to stay, like you said, I had a thought in the pre-show with you that we have been in kind of reactive medicine for a long time, right?
If someone has a heart attack, we go in and fix it. You know, that example, they need a surgical procedure.We're there to do that. When does this become the paradigm of first line medicine?
Jim Breidenstein: That's a good question. It is kind of first [00:25:00]line medicine Kipp it's, it's a way to get data to drive all different modalities and programs and treatment plans.
I mean, if we think again about the technology in its own right, it's to drive treatment plan adherence, right in medication management.So regardless if it's a pill or a protein, an injectable, a GLP one, you know, the ozempics of the world. A pharmaceutical agent or development, um, ketamine, oc Ibin, the modality of measuring and monitoring to see the clinical effect and outcomes that should start day one.
Think of a very clear, relevant example. Unfortunately, someone's in pain. They end up going to see a pain management physician, and they have to put 'em on schedule two narcotics. We'd wanna start utilizing that right away to measure the effectiveness and ability of the drug.
So I, I think in many ways it's there from that perspective Anyway.
Kip Theno: Wow. Yeah, no, I [00:26:00] agree with you. I mean, I think it should be first line and I think we'd see some massive, changes in healthcare in general. Nobody better to lead this charge than you JB And by the way, the check's in the mail love having on the podcast.
I do have a final question for you before we get to that for our listeners out there.
Kip Theno: How do clinics, patients, our advocates groups, how do they get a hold of you, Jim?
Jim Breidenstein: Yeah, there we have, an emerging website, at adhereplus.com, and that's all spelled out at here, plus.com. That's the best way. And you go right in there to the info tab and that'll connect you right to us.
And we send you right into our amazing, marketing team led byJeff Wynn, who's been an industry leader for about 20 years now. And we're happy to recently add Jeff to the team so he will be awaiting any information that comes in.
Kip Theno: JB thanks.This is super informative and, and always a pleasure to talk to you.
I've got an Easter egg question for you, brother. When Dominic left the Buffalo Sabres, went to my coveted Red Wings and won a bunch of Stanley Cups. Are you still [00:27:00] a Sabres fan? And why
Jim Breidenstein: Go Bills?
Kip Theno: That answers my question, go ahead.
Jim Breidenstein: the Sabres are great. Always a wonderful, wonderful night out with the family and the wife. But we're rooting hard for the bills. We're gonna make the playoffs and, you know, ultimately win the Super Bowl here with the bills. And, you know, we're gonna give the savers a little more time to catch up.
How's that for an answer?
Kip Theno: I willtake that as a non-answer, but we will help get Adhere+ across the line, JB and my good friend, thank you for joining The Road to Care podcast. We'll see you soon, brother.
Jim Breidenstein: Always my friend. Take care.
Kip Theno: ThanksJim.
Thank you for joining the Road to Care podcast, hosted bySamaCare, the leader in prior authorization technology and services, wherethrough a script to therapy operating system, we enable connectivity withclinics, payers, and manufacturers focused on optimizing patient care. Tune innext time as together we can make things right.
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