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A Startup Wants To Help Safety Net Community Health Centers Expand Their Reach

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There are about 1,400 Federally Qualified Health Centers (FQHCs) in the U.S. providing care to Medicare, Medicaid and uninsured patients in underserved communities—a one-stop-shop safety net for health and wellness that charges a sliding scale. So it might not come as a surprise to learn they lack the resources to help everyone who needs their services. In fact, about 20 million or so low-income people don’t have access to a FQHC, according to Cesar Herrera, CEO and co-founder of Yuvo Health.

“They’re critical for low-income people, but there aren’t enough of them,” he says.

That’s why, about a year ago, Herrera and three co-founders launched their startup with a mission of giving FQHCs access to additional revenues and the wherewithal to expand their reach.

Value-Based Care

It all relates to the move by policy makers and health plans to value-based care and away from fee for service reimbursement systems. The approach aims to bring down the cost of care, in part, by ensuring people get the services they need early on, so they don’t wind up in the ER, either because they have nowhere else to go,  their conditions have worsened due to inadequate care or they have underlying mental health issues that should have been managed more effectively by primary care.

How to make sure people get the care they need before their conditions worsen? The answer is shared savings—that is, savings shared between doctor and health plan—and revamping the incentives for primary care doctors, since they’re the first line of defense making sure patients get the right care at the right time. Thus, under a value-based care system, primary care doctors earn more money for keeping track of the various services their patients need, making sure they receive appropriate care and reporting all that to health insurers.  Plus there are added  incentives attached to preventive services.

But making that happen requires a new set of operating requirements. That is, primary care doctors need a way to get access to and report relevant patient information. “A whole new machinery needs to be built to support that model,” says Herrera.

Three Barriers

What does this mean for FQHCs? To move into value-based care, they face several barriers. First, they need to build a new infrastructure and many don’t have the resources to do so. Plus, many of them aren’t large enough to compete. And they face regulatory limitations. Specifically, they’re prohibited from taking part in certain potentially lucrative models where there’s a downside risk.

Addressing those barriers is Yuvo Health’s mission. To that end, it has a global contracting system enabling FQHCs to join in aggregate, with Yuvo negotiating contracts on behalf of all participating health centers. So FQHCs that would have been too small to qualify for those contracts are now eligible, because the company negotiates for the collective.

Then there’s the matter of how costly it is to build the necessary reporting, data analytics and data aggregation infrastructure. The company’s managed services system has an administrative component that takes care of all reporting, as well as patient engagement and outreach, transition to care coordination and risk adjustment. “They’re all table stakes functions needed to operate a value-based care engine,” says Herrera. Because it’s centralized, the system can support multiple FQHCs.

As for downside risk, since Yuvo isn’t an FQHC, it isn’t governed by the same regulations. As a result, the company can take on the downside risk on behalf of its customers. That, in turn, unlocks more lucrative value-based care arrangements for participating FQHCs they otherwise wouldn’t be able to tap.

Also, the FQHCs don’t pay the company, so there’s no cost to them. Instead, Yuvo receives a percentage of the shared savings achieved in the back-end. If there are no savings, then the company doesn’t get paid. The upshot: FQHCs face little risk, while gaining access to additional revenue.

“Every new dollar that comes in the door is not padding investor wallets,” says Herera. “It goes directly into serving the community—everything from hiring more doctors to increasing hours of operation.”

Inspired by Personal Experience

Herrera spent his career in health care strategy and operations for Medicaid, Medicare and commercial companies. But he and his and his co-founders, who also have a background in managed care, got the idea for the startup from their own experiences as Medicaid or FQHC patients.  

As a child growing up in southeastern Michigan, for example, Herrara didn’t always have health insurance. But there was a FQHC. It wasn’t until many years later that he realized how much the organization had done for his family and his community. “It was an incredibly powerful realization that, if I had not access to this FQHC, I would not have had access to care, unless I went to the ER,” he says.

When Covid hit, Herrera and his co-founders decided it was time to take the plunge and launch their startup. They formed the company with not much more than an idea. Then in April, they closed on a round of about $1.3 million that allowed them to start building out the system. They just closed on their next round of $6 million. The initial market is in downstate New York, where they’ve signed contracts on behalf of their FQHC partners with various health plans. While Herrera says he can’t disclose specifics, the goal is to have contracts covering 25,000 Medicaid members by the end of this quarter .

After establishing a track record, Yuvo plans to move to the rest of New York, where there are different health plans to contend with, and then to other markets in Michigan, Ohio, Pennsylvania and New Jersey.

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Dune: Awakening is an open world survival MMO

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Dune: Awakening made its debut at The Game Awards as an open world survival massively multiplayer online game.

The game from Funcom and Nukklear looks beautiful, full of very detailed imagery of the desert planet Arrakis, also known as Dune. The game asked for beta signups, but we got no other information. Survival is the key word. Dune is a very deadly world, with sandworms and an unforgiving climate.

You can see places in the trailer like the city of Arakeen by day and night, as well as desert biomes and more. It’s not clear when it is coming. With luck, it will be close to the second Dune movie coming in late 2023.

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Rumors confirmed, Street Fighter 6 kicks off in June 2023

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Fighting Game fans are excited now that Capcom announced that Street Fighter 6 is coming to PS5, PS4, Xbox Series X/S and PC on June 2, 2023. The game was initially announced in February 2022, but that reveal did not include a specific release date beyond 2023.

The trailer at The Game Awards focused on new mini games and the international setting. In addition to the 18 previously announced fighter, the trailer also confirms that several new fighters — Dee Jay, Manon, Marisa and JP — that will join the game’s roster.

Notably, the June 2 release date for Street Fighter 6 may be a strategic choice for Capcom. June is the very beginning of Q3.

The last installment of the franchise — Street Fighter V — released nearly seven years ago so fans have been eager for another installment. A day before The Game Awards, the game’s June release date was leaked via the PlayStation Store.

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5 Things to Do Now to Propel Your Business in 2023

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Opinions expressed by Entrepreneur contributors are their own.

Entrepreneurship is a daily leap of faith. In times of economic uncertainty, that leap may feel like a dive off a cliff. We are in one of those times. It likely will take months to fully re-adjust to the forces that have pummeled the world’s economy, and to entrepreneurs, months can feel like years.

With the right playbook, entrepreneurs can survive and thrive in whatever economic scenario. Here are five things you can do to propel your business ahead now and through the difficulties of business cycles for years to come.

1. Learn the lessons of more challenging times

A rocky economy presents a unique opportunity to make tough decisions about the business plan. Everything is open to reexamination. How has the market changed? Are your customers facing challenges that create new opportunities for your solutions? How do new conditions change your assumptions, and what actions do you need to take in response?

Critically evaluate your product roadmap. Is this the time to pivot or become more aggressive with your current plans? Prioritize the highest margin features that are achievable in the next twelve months. Push out projects that don’t make that list, and re-assign resources accordingly. Re-assess pricing. Even as inflation tiptoes back from the highest levels in forty years, raw material and transportation costs remain way up. What will impact your customers if you adjust the pricing or add surcharges to offset these costs, at least temporarily?

It’s been a rough year for hiring. Many companies took the talent they could get. If there are employees or gig workers who would fare better in a different job, now is the time to let them go. Make tough-minded corrections that will pay off overall — corrections that might be avoidable in less challenging times.

Related: How to Turn Inflation and Recession into Your Largest Business Opportunity

2. Tighten your grip on cash

Venture capitalists are pulling back. In the third quarter, Crunchbase reported that funding for startups in U.S. and Canada fell 50% year-over-year. Valuations are down across the board. If you are fortunate enough to be a later-stage startup that benefited from VC largess in 2021, make your last raise last longer than intended.

Keep your dry powder dry, and put off going for another round until the markets even out. Reemphasize the basics for early-stage companies with less market validation and greater distance between now and a potential exit. Delay all capital expenditures. Leverage the hybrid work model if possible, to reduce rent and other office expenses. Continue with Zoom or Google Meet. Now is not the time to rack up travel costs. Re-negotiate fees and terms with service providers. Seek credit terms with key suppliers, in a word, bootstrap.

3. Talk to customers, in person. Now.

How have the business needs of your customers — whether paying or beta — changed over the last 18 months? Are there benefits to your solution that have more recognized value now? Nearly every business, for example, from corporates to startups, has been forced to re-learn the lessons of supply chain management. Startups that can help their customers make better business decisions based on artificial intelligence (AI), reduce costs by improving inventory management or protect against out-of-stock scenarios by identifying and building relationships with new, more local sources of supply will have an edge.

Related: Finding Validation in Serving Customers

4. Non-dilutive capital

According to PitchBook, venture capitalists are showing greater interest in portfolio companies “whose satellite, robotics and software tools can do double duty” in military and commercial markets. International conflicts are one reason, of course.

Another is that the defense and military security industries are generally viewed as recession-proof. Our firm routinely encourages portfolio companies to consider non-dilutive funding from the Small Business Administration — grants to support cutting-edge technologies range from $150,000 to more than $1 million.

Navigating the application process isn’t for the faint of heart. A startup must be realistic about the work involved, but in many states, there are resources to help. Besides the funding, severe responses to agency requests for proposals are reviewed and evaluated by technologists. At a minimum, this can be terrific feedback and a great source of industry contacts.

5. Blue-chip cultures attract blue-chip talent

Company culture can be an asset or a liability. An inclusive, rich culture helps key hires say yes. Finding stakeholders that believe what you believe and are aligned with your team’s values significantly improves the odds that they will stick with you in good times or bad.

After months of “great resignation” fever, the over-heated demand for talent may be cooling off. Maybe offers aren’t as fast or grand as they were a year ago. Maybe Twitter won’t be the only advanced technology business to let people go. Regardless, the search for great talent isn’t a faucet that a young company turns off and on. A startup might modulate the timing or the number of hires but stand at the ready to recruit and filter for culture fit.

Related: 3 Ways to Stay Competitive in the War for Talent

With the right mindset and intentional approach, an entrepreneur can make 2023 a year to strive and thrive. As Yogi Berra, my favorite baseball player of all time, said, “Swing at the strikes.” In business, like baseball, the right swing can turn even the most challenging pitch into a hit.

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