It’s no secret that the lack of shared resources and communication between health providers and payers presents a major challenge to the delivery of quality healthcare. Nashville-based startup XSOLIS (pronounced similarly to “excellence”) uses machine learning to support the administrative side of healthcare — something known to keep medical providers and support staff away from the parts of their jobs patients actually pay to receive.
The SaaS platform provides predictive analytics derived from cognitive learning to determine medical necessity and revenue risk for patients in real time. This information helps caregivers deliver what CEO and co-founder Joan Butters calls “unbiased, efficient care determinations and streamlined utilization management processes.”
“Through the application of tech and analytics, XSOLIS manages the financial side so clinicians can get back to the appropriate care necessary to the patient,” says Butters.
XSOLIS identifies gaps and improves efficiency via utilization management, or the assessments made before and during provision of care in order to measure its necessity, appropriateness, and management of cost. By providing records to both payer and provider in a digital form, rather than handwritten documents, processes become more transparent and move more quickly as a result.
Using data and analytics to strengthen efficiencies is something many tech companies can claim to do. However, Butters says that XSOLIS’ early entrance into an area that had so few operators in existence caused some initial uncertainty from others.
“You can imagine the pushback and skepticism we initially had from the hospital market, but although there was skepticism, there was a huge acknowledgement that this was a better way to do things,” she says. “The application of AI in the healthcare space, particularly in hospitals, was unheard of. Manual identification of what’s supposed to happen has been tried and true for 30+ years. We kind of shattered what was a very manual process that’s been around for a very long time.”
A veteran IT and operations healthcare executive with more than 20 years experience in working with hospitals, pharmacies, payers and physicians, Butters started XSOLIS after serving as VP and general manager of strategy and emerging solutions for Optum, and says XSOLIS is in prime-position to lead by offering real solutions to the various entities that make up this multi-trillion-dollar sector.
“I’m gonna brag just a little bit. If you’ve been anywhere near the news, you heard about Amazon and Google getting into healthcare,” Butters told Hypepotamus. “This little company that started with five employees since 2013, we’ve been doing this for six years. That’s what’s fun: those organizations don’t know we exist, but in some ways, we’ve paved the way for them to do what we do.”
Butters says that she has chosen to keep XSOLIS bootstrapped even as it evolves and begins acquiring other companies and personnel aligned with the company’s stated goal of delivering “strategically and swiftly” on uniting payers, providers and patients.
In mid-November, XSOLIS announced its acquisition of MEDarchon, another Nashville-based healthcare startup which focuses specifically on delivery of care, in contrast to XSOLIS’ specific focus on operations. Calling the company “Salesforce on steroids,” Butters says XSOLIS will continue to work toward having health providers spend less time on administrative tasks and more time on what they’re trained to do.
“That’s what’s really exciting to us as an organization,” says Butters. “We’re freeing up resources for them to get back to the bedside.”