Is Aspire Health the next Health Care Giant

Bill Frist is a man driven by challenges.

In the 1980s, when Massachusetts General Hospital told him heart transplants couldn’t be done, the young surgeon left for Stanford, where he learned how to perform heart and lung transplants, a skill he would eventually bring back to Nashville to found the Vanderbilt Transplant Center.

When Tennesseans elected him to Congress in 1994, Frist became the shortest-sitting senator to rise to majority leader. He and his family are among the wealthiest people in the world, according to Forbes. And Modern Healthcare, the industry’s premier trade publication, has placed Frist among the 10 most powerful people in health care for five years in a row.

When it comes to health care, the bigger the climb, the more Frist is interested.

Frist’s most ambitious endeavor yet may be Aspire Health, a palliative care physician network for the sickest patients that launches this week in Nashville with the goal of expanding nationwide.

It places Frist, who serves as co-founder and chairman, firmly in the business seat of one of health care’s biggest challenges: improving care and lowering costs for patients with chronic illnesses.

“I spent 12 years in Washington trying to reform the system. If this works, millions of patients benefit,” Frist said in an exclusive interview with the Nashville Business Journal. “That’s why you have to be in business.”

The startup company, 18 months in the making, won’t disclose how much it has raised, but it is backed by venture capital heavyweights, including Clayton Associates, Mountain Group Capital and Nashville Capital Network. The business model calls for a mix of clinic and home care, and relies heavily on nurse practitioners working with specialized palliative care doctors.

“Nobody is doing it right today,” Frist said, explaining his interest in palliative care. “For patients, it’s an unsatisfying, chaotic time.”

According to the Centers for Disease Control and Prevention, chronic disease accounts for 75 percent of the nation’s health care spending. Looking at taxpayer-funded programs, that percentage goes up, to every 96 cents per Medicare dollar and 83 cents per Medicaid dollar.

While Aspire isn’t hospice or traditional end-of-life care, it does cater to patients with life-threatening conditions like advanced renal failure or cancer. By coordinating care — both spiritual and medical — around the patient, Frist believes Aspire can improve the quality of care for advanced illnesses, and as a by-product, lower costs for patients and the health care system.

“It’s a simple concept, but to build these things is hard,” Frist said. “The advantage of having someone like myself is that I understand policy and reimbursement mechanisms. … I know which buttons need to be pushed.”

One button he’s pushing is the insurance community. Medicare rates cover slightly more than half of the type of care Aspire delivers, so getting private insurers on board will be critical to the company’s ability to grow rapidly during the next six months. The company also is developing a proprietary data system that, by using health plans’ information, will identify vulnerable patients that may be most eligible for the program, feeding Aspire’s patient roster.

Frist’s co-founder at Aspire, and the company’s chief executive officer, is 30-year-old Brad Smith.

Smith, a Knoxville native and Harvard University graduate, is a familiar face in Nashville’s policy and venture capital circles. He was interim CEO of Launch Tennessee after a stint as chief of staff for Economic and Community Development Commissioner Bill Haggerty.

Smith is “competent, smart, hardworking. That combination is attractive,” Frist said. The two first met six years ago when Smith joined the team at TN SCORE, an education initiative that Frist was tapped to lead for the state.

Setting out to redefine palliative care, Frist and Smith went after one of the nation’s top palliative care doctors to be Aspire’s chief medical officer. That brought them to San Francisco, where they pitched the idea to Dr. Andrew Lasher, director of palliative medicine at California Pacific Medical Center, a large nonprofit teaching hospital affiliated with Sutter Health.

“I recruited the very best palliative care physician from the West Coast,” Frist said. “[Andrew’s] existence is built around taking care of these patients.”

At one point during his interview with the NBJ, Frist ducked out to take a phone call with CEOs from five of the country’s largest companies. When he returned, he asked rhetorically, “How do you build this beyond Tennessee? By talking to the folks I was just talking to.”

Frist is confident. But the mantra that guides him is more in-line with the Frist who practices yoga at 6 a.m. on Tuesdays and Thursdays: hope, health and healing.

“Aspire Health is a chance to do all three of those,” he said.

“I want other people to do it, but I don’t mind being first.”

Aspire Health

The team: Dr. Bill Frist, co-founder and chairman of the board; Brad Smith, co-founder and chief executive officer, previously served as CEO of Launch Tennessee and chief of staff for Economic and Community Development Commissioner Bill Haggerty; Dr. Andrew Lasher, chief medical officer, previously served as director of palliative medicine at California Pacific Medical Center, a large teaching hospital affiliated with Sutter Health; Dr. William Anderson, president, previously served as a division president at Iasis Healthcare, vice president of clinical integration at HealthSpring and assistant chief medical officer of Vanderbilt University Medical Center

The advisers: Gene Fleming, former CEO of Cogent Healthcare, a national hospitalist company; Mike Tudeen, former president and CEO of Inspiris, a care management company

The business: Aspire Health aims to form a national network of palliative care physician practices. The model is physician-led and centered around the patient, delivering care in the most appropriate setting, often times at home. By coordinating care through one team, Aspire believes it can improve the quality of life for patients with advanced illness and reduce costs for the health care system. Aspire has launched its first practice in partnership with the palliative care team at Alive Hospice, called Aspire Health Medical Partners of Middle Tennessee.

The investors: Clayton Associates, Mountain Group Capital, Nashville Capital Network, Bill Frist, Gene Fleming, Mike Tudeen and others.

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