Many people have a story that reveals the distressing impact of senior neurocognitive disorders, such as Alzheimer’s disease and dementia, on their family or loved ones. For Holly, it was her grandmother’s diagnosis with Alzheimer’s disease, and the rippling implications the intense caregiving requirements had on her family. This is a growing generational problem we need to tackle head-on, as it is estimated that the number of Americans with Alzheimer’s disease will increase from 6 million today to nearly 13 million by 2050. Furthermore, approximately 1 in 7 people over the age of 60 have mild cognitive impairment, a brain condition that may be an early sign of Alzheimer's disease, yet 82% of Americans have either limited or no knowledge of the condition.1 These factors combined illustrate the immediate need to alleviate the burden on caregivers, like Holly’s family, by reimagining geriatric behavioral health delivery.
Foremost, in order to appropriately care for the growing population of seniors, mental health needs to be approached with the same sense of urgency and accessibility as physical health. One in four older adults experience some form of a mental health disorder2, but it’s estimated that two-thirds of them do not receive the treatment they need.3 Moreover, a staggering 20% of Americans who die by suicide are seniors.4 Primary care physicians often lack the time and expertise to treat these conditions, and there is a massive shortage of specialized geriatric psychiatrists and nurse practitioners.5 As a result, family caregivers often bear the burden of care for this population and are forced to navigate a confusing and complex healthcare system with little support. At General Catalyst, we see this as both a dire need and tremendous opportunity to drive positive change in the delivery of geriatric behavioral healthcare. For this reason, we are pleased to announce our Seed investment in Rippl Care, a tech-enabled behavioral health platform that allows seniors to stay at home and out of the ER by providing the right care, at the right place, and the right time. We are grateful to be partnering with our friends at ARCH, F-Prime and GV in this work.
Rippl Care is deploying mobile care ‘pods’ – staffed with psychiatric nurse practitioners, therapists and/or licensed social workers, and care coordinators – to provide 24/7 care both virtually and in the home. Specialized medication management and full integration with the patients’ PCP are core to the model. The company is starting with crisis care in dementia to fill an immediate gap in the market but plans to expand its services over time. Importantly, Rippl Care’s clinical model is grounded in previously piloted models6 that demonstrated significantly improved outcomes and ROI, including that patients enrolled in UCLA’s program had 40% reduced risk of entering a nursing home.7 In order to participate in the value created and align incentives, Rippl will enter value-based contracts with risk-bearing providers and managed care organizations. Rippl will launch its first market by the end of this year, with plans to be live in at least four markets by the end of 2023.
Under the leadership of Kris Engskov, CEO and Co-Founder of Rippl, and Inca Dieterich, PhD, Co-Founder and Head of Strategy, we are confident in the company’s ability to continue to attract world class talent and scale high quality services. Kris brings relevant experience as the former President of Aegis Living, a senior assisted living and memory care developer and operator. He previously spent 16 years at Starbucks in various executive roles, including EVP of Global Business Integration; EVP & President, US Retail; EVP & President, Global Channel Development; and SVP & President, EMEA.
The emphasis on workforce transformation is a key factor for Rippl and a component that makes Kris’ background from Starbucks so compelling. As previously mentioned, there are very few geriatric psychiatrists and NPs who specialize in elderly care. Rippl recognizes the importance of recruiting, training, and retaining high quality people into its organization. The company is drawing upon Teach for America’s mission-driven ‘calling’ movement to build a culture centered around its people. Furthermore, Rippl is looking ahead at building a pipeline of talent through collaborations with institutions and even launching its own ‘geri-psych university’ and internal ‘residency’ to train and upskill more clinicians into the field. Rippl is in advanced negotiations with Academic Medical Centers to partner in education content development for this next generation of caregivers.
For years, behavioral health has been viewed as an entrenched problem without clearly defined solutions. General Catalyst’s Health Assurance thesis aims to take on the most difficult issues plaguing the traditional healthcare ecosystem. We are collaborating with innovative partners to deliver distributed, data-driven and preventative care that forms the basis of a new 21st century model. Working with Rippl adds to our portfolio of investments that collectively allows us to address the broken, expensive and inequitable history of behavioral health treatment.
General Catalyst echoes Rippl’s “#DoneWaiting” urgency in the behavioral health space. In alignment with our Health Assurance thesis, this financing will provide the capital to scale Rippl’s clinical, technology and leadership teams to support the initial market launches. We are thrilled to join Rippl on this journey to improve geriatric behavioral health outcomes by welcoming the company to our Health Assurance network of portfolio companies.
1 Alzheimer's Association, 2022 Alzheimer’s Disease Facts and Figures.
2 Kaiser Family Foundation, “One in Four Older Adults Report Anxiety or Depression Amid the COVID-19 Pandemic,” October, 9, 2020.
3 Pan American Health Organization (PAHO), “Seniors and Mental Health."
4 Centers for Disease Control and Prevention, “Suicide Disparities Infographic,” 2020.
5 Only 3% of practicing psychiatrists specialize in geriatrics, according to Merz CC, Koh D, Sakai EY, et al. The Big Shortage: Geropsychologists Discuss Facilitators and Barriers to Working in the Field of Aging. Transl Issues Psychol Sci. 2017.
6 Indiana University Center for Aging Research’s Aging Brain Care Medical Home program; UCLA’s Alzheimer’s and Dementia Care program; and UCSF’s Care Ecosystem, which were all funded by the Center for Medicare & Medicaid Innovation Center.
7 Jennings LA, Laffan AM, Schlissel AC, et al. Health Care Utilization and Cost Outcomes of a Comprehensive Dementia Care Program for Medicare Beneficiaries. JAMA Intern Med. 2019