Vincere Health Gets Paid to Pay People to Quit Smoking

The best thing anyone can do for their health and longevity is to never smoke cigarettes. The second best thing anyone can do to live a longer, healthier life is to quit smoking but, given the powerful addictive quality of nicotine, for most smokers quitting cigarettes is like climbing a mountain. The business model of Vincere Health, a startup launched in 2019 at the Harvard Innovation Lab, is to be the sherpa helping struggles smokers make it to the smoke-free summit they aspire to.

Vincere Health pays smokers to quit and stick with a behavior change program designed to replace smoking with healthier habits. The program includes a Bluetooth breath carbon monoxide monitor, which lets smokers see the quantity of poisonous gas in their lungs, and a personal coach participants can speak with remotely. Participants earn cash rewards for doing your breath tests and speaking with the coach. Vincere partners with local governments, Medicaid Managed Care programs and some employers who pay for the program and cover the incentives.

“Our target market is low income smokers, who happen to be some of the highest risk, highest cost utilizers of healthcare resources in the US,” said Vincere CEO Shalen De Silva. “Pregnant smokers are a key focus group. We also see that our smoking participants have 3-4x as much diabetes, COPD, heart disease risk and mental health comorbidities as the general population that does not smoke.”

Prior to Vincere, De Silva was an investment banker in London and Singapore who had founded a healthcare non-profit as a voluntary side hustle. “I saw a dire need for better solutions to help people in remote communities in Asia get access to care and have better tools for preventive health,” he said.

Co-founder Jake Keteyian, who is now president of Vincere, saw remarkably similar needs working on Medicaid projects as a healthcare consultant in Michigan, where he grew up. They teamed with Hadi Javeed, now Vincere CTO, “to build a company that solved the most pressing problem in healthcare – addressing the biggest preventive health risks that can curb the tsunami of chronic health disease burden among low income, vulnerable communities.”

Arguably the biggest obstacle facing Vincere was not developing their technology or even reaching clients, but figuring out how to get paid for their services. Few people pay for their care out of their own pocket, De Silva noted, and while it is easy for a hospital to get paid for treating lung cancer, it it is much harder for Vincere, or anyone else, to get paid for preventing lung cancer.

“Healthcare is very much about figuring out how to get third party payers to cover the cost of care,” De Silva said. “We make money by charging the Medicaid Managed Care org or state/local government that has a budget to support their members/constituents who need help with smoking. We put up to 100% of our fees at risk so that we only get paid if we are objectively proving to be successful.”

The Vincere approach is part technology and a lot of behavioral science. The crucial tech is the breath pen, which measures carbon monoxide (CO) in the smoker’s exhaled breath. “The breath pen allows people, often for the first time in their lives, to quantify the poisonous gas (CO) in their lungs as a result of smoking,” De Silva said. “This gives them a jolt, and over time seeing this number change and improve as their behavior changes can have motivating effect.”

Equally important is that the health coach assigned to work with the smoker also see the breath pen result reinforces participation. “If you want to incentivize a behavior, you need to be able to objectively measure it,” De Silva said. “The breath pen is vital for us to measure the behavior and also be accountable to our enterprise customers that our program is actually working and we are hitting the population health outcomes they are paying us for.”

Last but far from least are the financial incentives participants receive. De Silva learned the power of incentives while still an investment banker.

“Coming from the banking and finance industry, I know how powerful financial rewards and incentives can be in motivating and influencing behavior – sometimes to society’s detriment,” he said. “Banker bonuses have resulted in some dire consequences. I was always curious what would happen if this were flipped on its head – what if small, daily micro-rewards can be used to motivate and influence people for personal and societal good?”

That theory, known is behavioral psychology as contingency management, has been shown to be effective in encouraging positive health behaviors. “It was a relatively overlooked field and there was very little technology built to automate and scale the methods that researchers used to verify and reward the health behaviors of their study participants.” De Silva said.

Vincere Health has raised a total of $4.3 million from VCs and angels. Investors include American Family Insurance, SixThirty Ventures, Victress Capital, Flare Capital, Equity League, Trevor Fetter and others. The company has a staff of 13 and has multiplied revenue 3-4x each year since its founding, De Silva said. About 1,800 people participant in the Vincere Health. De Silva is optimistic the company will grow as healthcare payers place increasing focus on preventing smoking related illnesses that are very expensive to treat.

“We’ve launched a major pilot, with a rigorously designed study with a state quit line in the Northeast through our partnership with Optum,” he said. “The results so far have been great!”