Q&A with Nicky Kirby of Sprinter Health

Q: Nick, can you tell me more about Sprinter’s model and where it fits into the broader in-home care landscape?

Yes, I’ll actually start with the broader landscape because that helps explain where Sprinter fits in. The in-home care landscape has changed significantly over the last few years, with lots of innovation. It ranges from higher acuity care, like hospital-at-home models, to lower acuity care, like personal care services. Most in-home care models are focused on improving access to care, reducing hospital admissions, and lowering costs by decanting volume from high-cost facilities to the home.

The legacy side of in-home care typically focuses on post-acute care, where patients discharged from the hospital receive home health nursing services to help them recover and avoid readmission. There’s also an emerging hospital-at-home model, which has shown good outcomes at lower costs and helps hospitals free up bed capacity.

Then, there are more longitudinal, at-risk providers like Landmark and CareBridge, which focus on managing the most complex and costly patients by providing regular in-home visits.

Sprinter doesn’t exactly fit into any of these categories, but we work with many of these providers as an extension of their care teams. Our focus is more on preventive care—we engage unengaged members, close gaps in care, and connect them to the resources they need to stay healthy. We’re a little further upstream from the workflows you typically see in the home health space.

Q: You mentioned engaging unengaged members. How does Sprinter approach that, both from a care delivery and technology standpoint?

There are two core aspects of our model: care delivery and the technology platform. A lot of the populations we work with have gaps in care or haven’t had a primary care visit in a while. Our strategies depend on several factors, like the member’s geography and demographics.

On the care delivery side, we hire from the communities we serve. Our sprinters might go to the same church or shop at the same grocery store as the patients they’re visiting, which helps build trust.

On the tech side, we’ve built a platform that makes it easy for members to book appointments. They can do it through text, email, or embedded links without needing a login, and it takes about 45 seconds. We also have an in-house outbound call center with bilingual patient engagement specialists (PES) who can support multiple languages. All of this helps us meet members where they are, both in how we communicate with them and in their homes.

Q: You touched on health equity earlier. Can you explain how Sprinter approaches different markets and underserved communities, like your work in Michigan?

Sure, it’s very much tailored to each community. We work closely with health plan partners, and if they tell us a percentage of their population speaks a certain language, we can recruit sprinters who are bilingual. We also have a live translation service for hundreds of languages to ensure we can serve everyone.

Our outreach strategy is customized based on the community’s needs. We’re constantly running A/B tests on everything from the language we use in outreach to the timing of texts and emails.

In Michigan, we launched a program last year and hired around 10 sprinters across the state. This year, we found that over half of the patients we served were from communities of color, and about 20-30% of the visits had highly actionable clinical outcomes, like identifying uncontrolled A1C, diabetic retinopathy, or uncontrolled blood pressure. About half of the visits screened positive for social needs, like food, housing, or transportation insecurity. Our care navigation team follows up to connect these patients with local resources, such as non-emergency medical transportation or food banks. It’s a good example of how we address both clinical and social needs.

Q: How do you partner with health plans to scope programs and measure success?

We typically work closely with the quality teams at health plans, continuously evaluating what gaps in care their members have across different lines of business. We also build strategic relationships for future programs. For example, we’re not doing immunizations in the home today, but we’re working on partnership structures to support the commercial development and deployment of this product because it’s a big gap, especially for pediatric populations.

We collaborate with quality teams to identify core gaps in care and also work with medical directors and CMOs to design clinical workflows. Additionally, we engage with the risk side of health plans. Our approach is that if you focus on quality, risk follows, and Sprinter has positioned itself at the intersection of these two strategic priorities. 

Some key measures of success are the percentage of unengaged members we are able to reach in the home, the total number of care gaps we close, and patient experience - all of which we track, share, and review on a regular cadence with our partners.

Q: How is Sprinter preparing to scale, both on the technology side and with your clinical workforce?

On the technology side, scalability is critical. Our secret sauce is the matchmaking algorithm, which connects the right clinician to the patient’s specific need. For example, at any given point in time, we have patients who require Sprinter-only visits with individual service needs, and other patients who need a hybrid visit with a Sprinter in the home and a virtual NP at the same time - our system must know all Sprinter and NP availability in order to matchmake the right Sprinter and the right NP to the right patient at the right time.  It takes into account things like drive time, service requirements and time estimates of the appointment, and many other variables - running continuous simulations to determine the optimal allocation of resources.  

The system also continuously optimizes routing. For instance, if we know there are 30 members in Detroit who need diabetic eye exams tomorrow, the system matches the sprinters with the necessary device and optimizes their daily routes. This allows us to maximize the number of visits per day and drive down costs while ensuring efficient care delivery.

On the clinical side, training non-nursing clinicians is key to scaling. Sprinter University has been a major investment, where we fly folks out for training and then deploy them back into the field. It’s helping us build a new level of workforce, which is essential given the scarcity of nurses and nurse practitioners available for home care.

Q: You mentioned trying to drive down costs by maximizing the number of visits. Do you have a benchmark for the ideal number of visits per day?

Utilization is something we track closely, and we aim for >8 appointments per day per Sprinter on average. In dense areas, we’ve seen sprinters do up to 15 visits in a day. It really depends on the specific market—how rural or dense it is—and we aim to balance this to create a sustainable model.

Q: That wraps up all the questions! Thanks so much for your time.

You’re welcome! It was a pleasure.