The American health care system is not prepared to care for the growing aging population and the mental health challenges that come with that, according to Kris Engskov.
That’s why he started Rippl Care.
As its CEO and co-founder, Engskov leads a fledgling company that seeks to combine highly specialized care, technology and home-based services to address the mental health of seniors in a way that keeps them at home longer and out of long-term care facilities.
Rippl Care emerged out of stealth mode last week with $32 million in seed funding. The round was led by two venture capital firms: Chicago-based ARCH Venture Partners and Cambridge, Massachusetts-based General Catalyst. Engskov and his fellow founders had teased the release of more information about the company in the week leading up to the investment announcement
BHB first reported on Engskov’s venture in March as he sought to build out the company’s leadership team. He co-founded Rippl with Inca Dieterich, who has been an associate at ARCH Venture Partners since 2020. She is also vice president and partner of strategy and innovation.
A former Clinton White House administrator and former long-time Starbucks Corp. (Nasdaq: SBUX) executive, Engskov left as president of Bellevue, Washington-based senior living company Aegis Living in September 2021 to start a then-unnamed startup.
The following Q&A has been edited for length, clarity and style.
BHB:What is Rippl Care? What does Rippl Care do?
Engskov: It is a tech-enabled, highly specialized people network that helps keep people at home and out of the ER that have a range of mental health conditions starting with dementia.
What does it do? I’ll try to answer this in the context of what we think the differentiators are. This doesn’t exist today, what we’re trying to provide. It doesn’t exist primarily because fee-for-service health care doesn’t pay for it. And that’s why we’re trying to approach it in a value-based way.
We may not start value-based, but that’s the ambition because we want to be paid for outcomes and for doing it less expensively which I’m confident we can do.
First, we want to provide 24/7 crisis behavioral support to patients and families.
Second, we want to provide navigation and care coordination and that’s the big one that’s not paid for by fee-for-service Medicare. How do you help people through the journey? Because it is a long one.
Also, specialized medical management. Most of these folks have multiple chronic conditions. And oftentimes, those are not looked at holistically.
Lastly, we want to provide psychotherapy both to the patient that has the capacity and also to the family because we know that the tipping point, typically, for long-term care is the caregiver is not the patient.
Longer term, we’re going to add remote patient monitoring.
It sounds like your team was very successful in fundraising. You’re calling this a seed round, right?
Yes, it’s a seed round. I acknowledge that it’s a large seed round.
We incubated the company within Arch Ventures.
While I understand that the initial condition that you’re seeking to address is dementia and other cognitive needs, why would we classify Rippl Care as a behavioral health company?
I think that we’ve been much more consistent in saying mental health because that’s a broader category and represents more broadly what we are trying to do.
We’re starting with dementia and neurocognitive but we fully expect that we will want to help people with depression and anxiety. Seniors experience these mental health conditions, defined broadly, in a very different way than most other groups.
We expect that we’re going to have a broad impact on mental health conditions in this category.
So the services you provide are not just limited to folks with dementia or other neurocognitive issues? Say a senior is really struggling with the transitions in their life and are exhibiting depressive symptoms. Would Ripple Care help that patient even though they don’t have dementia?
Absolutely. Dementia is just a starting point for us because we think there is such an urgent need. We expect that the psych services we’ll offer will be applicable to a broad range of conditions. That’s the reason to have the specialized team that we’re building.
Do Rippl Care have providers going into homes yet?
No, we have not started service yet. We expect that we will begin service sometime later this fall. But we built a team, we are hiring clinicians — primarily advanced nurse practitioners, licensed social workers and community health workers.
We expect to serve our first patient later this year.
Does your team have goals for early hiring rounds in terms of the in-home workforce?
I hesitate to speculate because we’re going to take the amount of time it requires to learn how the model works best. We have been inspired by a lot of the collaborative care models that exist out there and there have been several that CMMI has piloted over the last few years that have shown really impressive results.
But this model is different in terms of how it uses technology, how it deploys people (both virtual and on the ground), and the like.
In terms of the broad categories, what types of technology is Rippl Care using?
We’re so early on. I can’t give you a lot of specifics.
But what I can say is that we fully expect to build our own proprietary platform to do the work that we’re going to do, which is really intended to realize our mantra about clinician obsession. If I had to describe our philosophy in a really basic way it is this: How do we take care of our clinicians so they can go take care of the seniors we are looking after?
A big chunk of that has got to be about designing a tech platform that is about making their time with a patient valuable and impactful and allowing them to work at the top of their license.
We’re just getting started, but that’s the ambition for the technology.
Just taking a stab in the dark here — would this leave space for telehealth services?
I expect that a good deal of our services will be provided virtually. That’s one of the great opportunities for us.
While we believe that having a strong ground game is important over time, we do know that a lot of this care can be delivered really effectively virtually. In fact, it could be a very big unlock for people in rural communities that just have zero access to this kind of specialized help.
What is your No. 1 short-term goal? What is your No. 1 long-term goal?
Our short-term goal is to get our first network up and running and to hone this model. This care model we are pioneering is new and hasn’t been done before. It has a lot of moving parts that are going to need to be tested. That’s the most important thing we’re doing.
Of all of the things that have been talked about in the last three years created and funded, there’s been a huge focus on the pediatric space and young adults. I just haven’t seen anything that specifically focused on this kind of specialized mental health care for seniors.
There are roughly 20 million people out there that we would classify as seniors that have some kind of cognitive challenge. Half of those folks have dementia and the great majority of them have Alzheimer’s. That’s where we’re starting because we think it’s urgent and it’s such a need.
Our system is not ready today and we haven’t gotten to the first 85-year-old baby boomers and you have a 1-in-3 chance of having dementia once you turn 85.
We are just going to learn a lot over the next few months about how to deliver this highly specialized care. And I think that we can be really influential with primary care providers and other potential partners and help them bridge that gap in care.
That’s the long-term goal.