Newfire Supports FOLX Health in Bringing Affirming Healthcare to the LGBTQIA+ Community

The LGBTQIA+ community has historically been underserved in healthcare, even in the most developed countries of the world. In the US, for example, 71% of queer and trans individuals have actively avoided seeking healthcare due to fear of discrimination. Among those who did request care, 42% reported experiencing mistreatment or abuse, and as many as 1 in 5 were refused care altogether. As shocking as these statistics are, they can be at least partially explained by the fact that most medical schools dedicate five hours or less to LGBTQIA+ health education across four years of medical school.

FOLX Health was one of the first digital health companies championing equality in healthcare access.

FOLX Health is a digital health platform tailored to meet the needs of the LGBTQIA+ community in the US. It provides a wide array of services that are often difficult to access, including gender-affirming hormone therapy, PrEP (HIV prevention) prescriptions, primary care, and sexual and mental health services. All of these services are delivered with discretion via a secure online platform by a team of LGBTQIA-expert clinicians with a diverse set of identities striving to bring affirming and joyful experiences to LGBTQIA+ healthcare.

On their mission to provide the right care to “everybody and every body,” FOLX Health sought a reliable partner to ensure their platform operates seamlessly while remaining competitive and compliant in a tightly regulated market. We worked with them to build software that gave their team full visibility and improved efficiency across all of the internal teams responsible for delivering care. We also upgraded the platform’s membership model, letting FOLX onboard more customers and set itself apart as a product that brings holistic care at accessible pricing to the LGBTQIA+ community. As our collaboration continues, the leadership at FOLX can focus on strategy and growth.

Member care at FOLX Health is entrusted to teams of expert clinicians, medical assistants, and support staff. FOLX’s clinicians hold consultations online (and in person where available), prescribe treatments, and monitor the health status of members. FOLX’s fulfillment experts ensure medications are delivered on time and that prescriptions are filled by members as needed.

These internal teams faced significant efficiency and visibility challenges that tied them up with manual administrative work and took time and focus away from their mission to deliver optimal care:

• Team members had to access multiple systems to complete core activities.
• Orders were hard to track, and it wasn’t always possible to confirm that prescriptions had been filled.
• Manual tasks ate up time for internal customers and the leadership team, who had to deal with operational issues instead of focusing on growth strategy.

As FOLX grew and expanded, we identified new areas needing focused attention and innovative solutions, which gave us the opportunity to deepen our long-term partnership. Here are some of the challenges we addressed or continue to address in this phase of the Operational Excellence program:

• LGBTQIA+ health regulations are often in flux and differ from state to state, creating lots of compliance overhead, which took time from FOLX’s core mission.
• The billing system fell short of addressing real member needs, offering a one-size-fits-all approach with access to all FOLX services at a high cost, effectively excluding potential new members. Additionally, the system’s inefficiencies, such as permitting access to services and treatments even after membership expiration, were straining FOLX’s resources.
• FOLX could not accept insurance, which made its care programs less affordable to its audience and less competitive in the market.
• The member experience side of the platform needed upgrades, such as a more comprehensive offer of health services, seamless delivery to a growing body of members, and nationwide availability in total compliance with HIPAA standards.

Our mission was to release FOLX from technical burdens and help them focus on what really matters: bringing holistic, accurate, timely, and affirming care to as many users as possible.

• 360 Member View: Enable full visibility of every FOLX member and their data for the internal team so that clinicians can deliver care with accuracy and less time wasted searching for information.
• Timely Care: Add transparency to the fulfillment process to give the team more control over treatments and prescriptions and to ensure medicines reach patients on time (including foreseeing delays and communicating them to members).
• From Busy Work to Added-Value Work: Reduce the burden of manual tasks for the internal team and help them focus on providing care.
• A Membership Model Fitting a Market Leader: Improve the membership system and update the billing model (including integrations with insurance providers).
• A Holistic Approach to Member Experience: Provide support as FOLX upgrades its member experience and expands services and membership.

Newfire has extensive experience in providing efficiency and accuracy to digital health operators, especially those serving underserved or marginalized communities in markets characterized by smaller audiences, unique needs, and tight regulations.

To meet FOLX’s needs, we deployed an Operations Engineering Scrum team to begin an operational excellence program focusing on process inefficiency. Our goal was to reduce time loss for internal teams and simplify their workflows as much as possible. We achieved this by implementing integrations and automations to reduce manual work and prevent FOLX’s clinical, fulfillment, and customer service experts from having to access multiple systems to complete their tasks.

On the integration side, a network of twenty new high-level integrations pulled together data gathering, ticketing, communications, membership status, billing, session attendance, insurance validity, prescription fulfillment, and even license verification insight (confirmation that a clinician is appropriately licensed in the member’s state). All of these integrations helped the FOLX membership team work faster and more accurately.

Automations were critical to process improvement, especially for FOLX’s engineering, member support, and fulfillment teams, as they reduced manual work in account reactivation, member information adjustments, prescription fulfillment processes, and billing. These automations enabled clinician and fulfillment teams to adjust treatment and membership data autonomously, without having to go to engineering, shaving steps of processes.

To facilitate smooth operations, our team overhauled the operational front-end software and migrated it to a more suitable React-based framework. The migration helped with streamlining processes and provided a cost-saving opportunity, as the new dashboard didn’t have to be built from scratch. This decision brought some added value to FOLX’s internal team as well, as they found that using the new interface provided a more intuitive and pleasant user experience.

Newfire also supported FOLX in updating the platform’s billing system. The old one-size-fits-all membership model was replaced with more dynamic billing that encompassed a low baseline membership and pay-as-you-go services like prescriptions or consults, as needed.

To further enable payments, we also started the ongoing process of integrating the FOLX platform with insurance providers to reduce out-of-pocket payments for members. As we make progress on this front, optimal care is finally coupled with an accessible membership model.

Data privacy and HIPAA compliance were critical in our work with FOLX Health. The core team dispatched to the project had extensive expertise in this area and helped apply specialized HIPAA training to incoming team members, ensuring the protection of sensitive health information. We strictly used anonymized data for testing and chose HIPAA-compliant tools like Zoom for communication. As our collaboration evolves, Newfire’s teams will continue to enhance data security and system reliability by simulating live scenarios with anonymized production data to ensure platform updates and new features are thoroughly performance tested.

• We created a one-stop shop for clinicians and the fulfillment team where they could access member data from a single interface for total visibility and update information as needed, including membership status, medical records, enrollment in services, treatments, and medications.
• The Operational Excellence program unlocked efficiency and accuracy gains across all departments. Examples include: Less time spent on account reactivation for engineering and member support. An end to manual medication tracking for the fulfillment team through integration with the FOLX pharmacy API. An anticipated 50% reduction of administrative work for clinicians thanks to automated refill submission and tracking. 
• Moving to a React-based front-end improved the delivery time of front-end features as existing components can be reused and allowed FOLX to provide a modern application to the clinicians that is easy to use and looks great.
• The revised membership model increased accessibility for members by aligning billing more closely with their needs. In addition, under the previous model, members who canceled their subscriptions would occasionally still receive medications, the cost of which was absorbed by FOLX. The new billing approach eliminated that problem, resulting in a 15% cost reduction for FOLX.

• Integration with major insurance providers further expanded FOLX’s reach, as members could now co-pay for their treatments through insurance, and made it more competitive in the market of LGBTQIA+ digital health. Furthermore, this allowed FOLX to onboard more B2B customers, companies that offer LGBTQIA+ health benefits for their employees. FOLX won two such customers immediately and has since onboarded dozens more.
• Complete compliance with existing and upcoming regulations on LGBTQIA+ health thanks to the team’s agility and Newfire’s extensive experience operating in healthcare.
• A comfortable and respectful working environment throughout the close collaboration, owing to careful and culture-oriented hiring from Newfire’s dedicated recruitment team.

• As Newfire’s Operations Engineering Team delivered results on time, with accuracy, and in dialogue with the leadership team at FOLX, we were trusted with building a second Scrum team to work on the user-facing platform and enhance the member experience. The Member Experience (MX) Team’s training and work process building was entrusted to Newfire’s original team, with first results currently coming in after an exceptionally fast ramp-up time.
• The extraordinary work we’ve done to ensure FOLX can serve an ever-growing number of members of the LGBTQIA+ community with accuracy earned us a Gold Globee® in the Annual 2022 Disruptor Company Awards, which recognize disruptive technologies and innovative solutions transforming consumer experiences across industries.

During our long-term collaboration with FOLX Health, our team members working on the project have often commented that they feel as much at home at FOLX as they do at Newfire. And that’s the essence of our approach to IT staff augmentation: clients can expect more than the highest level of expertise in digital health. They can count on full dedication to project goals and complete synergy with their extended team.

Are you looking for a team that can guarantee your digital health projects will find their way from ideation to fruition? Get in touch today, and let us accelerate your path to success.