Pluto Health, a tech-enabled health services company, announced its first-ever payer partners.
The Duke University spinout launched in 2020, with a plan to unify fragmented health data and close the loop on missing health services with the help of artificial intelligence. It is now working with Medicare, Medicaid, UnitedHealthcare, Aetna, Blue Cross Blue Shield, Ambetter and Cigna in select states. Pluto’s model prioritizes delivering care and mobilizing health services rather than monetizing patient data, executives say.
“Our name comes from the fact that we were told we were shooting for the moon,” Joy Bhosai, M.D., founder and CEO of Pluto, told Fierce Healthcare in an interview. “My biggest vision for Pluto has always been: build the next Dr. Alexa for healthcare.”
Pluto’s platform integrates medical records, labs and diagnostics to assess health needs and clinical trial eligibility. Its AI models develop personalized action plans that may include addressing missed vaccines, overdue labs, unfilled prescriptions and more. Pluto then acts to close those gaps, either through telemedicine, asynchronous support or in-home services. Pluto has about 40 providers on staff and operates in all 50 states. It can send phlebotomists and nurses into the home, with more technicians to be added soon, and also offers in-person visits in select regions.
Clinical trial participation is an ongoing challenge in the life sciences sector. While some models have aimed to strengthen recruitment and retention, Bhosai said, those one-off solutions are not really tied to the patient and have limited accessibility. Pluto isn’t only thinking of what trials a patient is eligible for but also looking at wraparound health services.
“We’re not thinking of them as a research subject,” Bhosai said. “It’s also important to make sure that they’re as healthy as they can be.”
When it comes to guardrails for its tech, Pluto asks patients for consent. They are not required to share what health facilities they use. They are always an active participant during Pluto’s information-gathering process. And the data scientists who build their algorithm are always paired with a practicing clinician to validate the model. “There’s none of this, ‘let's build it and validate it later.’ That speaks to our academic upbringing, if you will,” Bhosai said.
Payers pay a subscription fee for the Pluto platform. Additionally, Pluto charges on top of that depending on what services are requested. While its contracts are not yet at-risk, Pluto is open to value-based contracting in the future, Bhosai said.
Pluto follows patients no matter where they’re receiving their care. If they switch health plans, they may lose Pluto, Bhosai acknowledged, though the company tries to write into its contracts that members will be grandfathered in if they switch plans.
“Patients love the fact that they're able to coordinate their care,” Bhosai said. “Irrespective of a specific health system, patients move and patients change providers all the time.”