Ahmed Marmoush is the CEO of Handl Health, a technology platform transforming how health plans are evaluated, designed and managed. By unifying healthcare pricing, utilization, benefit and quality data into a single analytical and operational layer, Handl empowers employers, brokers and payers to build flexible, cost-effective health benefits that perform.
Why did you found the healthtech startup Handl Health?
I grew up in New Zealand in a family of pharmacists. A pharmacist by training, I never really wanted to be a pill counter. I was much more interested in the business of healthcare.
After starting my career in acute general hospitals in New Zealand, I moved into a quality improvement role. From there, I went to business school and moved into healthcare consulting for the next decade. It was during that time I worked alongside the former director general of the New Zealand Health System. He was accountable and responsible for not only funding New Zealand's healthcare system but also designing the exact healthcare insurance plan and the delivery model. That involved everything from how to contract on outcomes to creating innovative primary care models, recognizing the shift from episodic care to much more continuing care. Working with him is when I became interested in the role that administrators play in offering access to health care, and how you provide universal access at a price point that is digestible.
I came to the U.S. in 2019 with Ernst and Young to do something very similar, but realized very quickly that the lack of data transparency made it virtually impossible to truly understand healthcare value in America.
One of the foundational pillars of how you think through determining value is understanding the provider’s cost structure, the contracting nature of that as well as the outcomes they create. I am committed to this as my lifelong work. After healthcare pricing transparency legislation passed, I moved on from EY with my colleague Ria Shah, and we created Handl Health to understand the value of healthcare price transparency to the American enterprise and consumer.
Why is now the right time for transforming the American healthcare system?
Healthcare costs are growing at an alarming pace. Last year, we saw double-digit premium increases; this year, we’re expecting something very similar.
When you look across the board of all the contracts that are held out there with providers, you can see this huge variation in cost without necessarily a correlation to quality. At Handl, we’re bending that cost curve by optimizing for a few things: We're looking to optimize for what employers pay in terms of unit cost, and then we look to optimize for how employees utilize healthcare services.
Right now, employer healthcare costs are around $17,000 annually per employee. Add employee premiums to that total. That’s a lot of money spent on healthcare. These employers routinely ask me what they are really getting for that large figure – and that’s not even considering the additional copays and pharmacy costs that employees also pay.
That’s exactly why you’re starting to really see demand for a structural change in how our health insurance is offered, certainly on the employer-funded side. Nearly 75 percent of employers are self funded, but many lack the technology needed to evaluate the performance of their plans. Also consider that more than $2,000 is wasted, per employee, on poor network design, outdated plan structures and opaque pricing.
We have also seen a shift away from the traditional insurance model. Providers are really starting to get creative around different types of designs: that could include reference-based pricing, a cash-pay model, using an HRA, etc. There's really only two ways to solve the cost problem, though: You change the unit price, or you change the utilization problem.
Is there demand for non-traditional health insurance plans?
One of the biggest pain points we heard from our broker partners was, “Hey, what you are providing to us is fantastic, and I can go out there and wow a prospect or a client on all the things that we could do, but I am hamstrung in my ability to actually do that. The other side of the ecosystem is not only archaic in terms of its technology, but also doesn't necessarily have the know-how to activate and manage these types of plans.”
This demand led us to extend our platform with a focus on the activation of customized employer health plans. For these alternative health plans, we provide the exact same type of analytics suite to the TPAs and carriers, but we connect that to a member experience. So we have a member navigation tool, which is used by care advocates that can also integrate very nicely into existing member portals.
Finally, one of the most obvious things that one would argue you should do, but didn't actually appear to exist when we started Handl, was the ability to actually reconcile and monitor your plan. That means repricing claims as they come through: Are you paying according to the network’s contracts? Is your plan design driving the type of cost containment that you intended?
Handl is rooted in technological advancement, but there has to be a personal touch in what you do. How do you see the increasing use of AI impacting the industry?
Historically, the insurance broker ecosystem has been very much a service-based industry. And when you actually start to look at and unpack the workflows that exist and how brokerages operate, there's so much opportunity for the use of AI to fundamentally reshape the operating model.
AI is already making a huge impact on the industry. LLMs launching consumer health portals are applying pressure on health plans that are not equipped to deal with the technology. That’s why AI-enabled consumer care navigation is a native element of our platform.
Internally, we also see AI as a resource that enables every team to execute faster by ensuring that data, tools and processes accelerate work. It’s an idea-iteration machine. It’s coding support. It’s a document analyzer. One thing it is not? A replacement for the smart, innovative team at the heart of Handl Health.
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