A startup called Zarminali Health launched with $40 million in seed funding led by General Catalyst and with the ambitious goal of transforming pediatric care across the country. Danish Qureshi, CEO of the company, recently spoke with Healthcare innovation about why he set out to create a better pediatric care experience for both doctors and patients and how he plans to do it.
In a blog post on the company’s website, Qureshi explained how his personal experience gave him the idea for the company and why he named it after his daughter Zarmina:
“Last year, the need for a new approach to pediatric care became deeply personal for me when my daughter was diagnosed with an autoimmune disorder. My wife and I found ourselves navigating a fragmented pediatric healthcare system, desperately trying to get our daughter the care she needed to be able to thrive again in all aspects of her childhood. That experience highlighted to me the burden that falls squarely on the shoulders of families when their children’s health deviates even slightly from ‘routine care’ and was the driving force behind founding Zarminali.”
Innovation in the healthcare sector: could you start by talking a little about your career path in the healthcare field?
Qureshi: Zarminali is the third startup I am part of. The first time, 15 years ago, was in the outpatient wound center space. We built that company into the second-largest operator of outpatient wound centers in the country. We ended up selling it to the only larger group left in the space, in late 2015. Then, three of us co-founded what became LifeStance Health, which today is the largest provider of outpatient mental health services in the country. with a presence in 33 states and around 7,000 doctors, as well as a very important telemedicine component.
I firmly believe, particularly in healthcare, that being highly mission-driven is key. This idea about pediatrics had been floating around in my head for a few years, primarily informed by my own experience with my children receiving pediatric care.
What we saw was that attention was very divided by specialties. Although there was desire, there was really no capacity for coordination among all the specialists, not even with the primary care pediatrician. And ultimately, the burden of care coordination ended up falling on us as a family. And although I have 15 years of experience in healthcare, I found it extremely stressful, and still do to this day.
HCI: Did some of that fragmentation occur even within a health system, not just between different provider groups?
Qureshi: Many of those specialists we saw were in the same health system and the same EMR. However, as everything is set up, there is no incentive to boost care coordination among specialists. It was really surprising that even with specialists within the same health system there was really a lack of coordination. In my opinion, it is not a failure of physicians who lack the desire to coordinate or the desire to create a better experience for families and patients. The thing is that the system is not set up to facilitate this.
The quotes are too short. There is this constant drive of needing to see more and more patients, and it is one of the key factors that leads to physician burnout. They never really invest time in any of their cases.
So, let’s return to Zarminali’s concept of formation. This is where it became a very personal mission. And for anything you do, there has to be a core mission that you are trying to achieve. It cannot be a financial mission. It has to be that we are trying to improve a certain specialty or healthcare space and ultimately positively impact the lives of what will hopefully be millions of people. I can’t think of working in a more important aspect of healthcare than this.
HCI: It sounds like you’re trying to tackle something really big, though. Where do you start? Are you developing a model for a type of practice that you think will work fundamentally differently? What do you think about the payment mechanisms that will make that work?
Qureshi: You are absolutely right. It’s a big, complex topic to tackle, and it’s one of the first things I’m asked: How are you going to tackle something of this magnitude? Firstly, if you look at our team, they all have several years of operational experience in healthcare in high-growth groups or companies. They have addressed equally important issues in fields such as adult primary care or behavioral health.
The vast majority of today’s independent pediatric practices are small. They are underfunded due to the nature of their size and are unable to invest in areas such as technology or giving a modern look to the way care is delivered. But what they do have are dedicated doctors who believe in what they do and want to do it better for their patients.
What we’re looking to do is maintain the core of that and build a stellar national practice group around it that has all the things that they’ve dreamed of, but haven’t been able to invest in because of their size and scale.
Today, an outpatient practice group consists of five pediatricians with one to three locations, and they focus primarily on non-urgent issues. We will have primary care clinics, but we will also have urgent care co-located with many of the primary care locations. If you, as a family, wake up to a child who is sick, you cannot wait for an appointment a week later and go to an adult or general urgent care center that will not coordinate or share notes with your pediatrician. not working.
Additionally, we will have multi-specialty centers that will be located more centrally within the markets we enter. We want specialists housed within the same practice group, so they coordinate as teammates. Then we will also have a single, unified brand. Therefore, we will operate exclusively as Zarminali throughout the country, with a modern look, from our digital presence to the physical spaces or clinics we operate. The final piece is that everything will be technology-enabled to improve both the family and patient experience and the physician experience by reducing the burden of administrative tasks and helping to address the issue of burnout within the physician base. So that’s the different approach. It hadn’t been done before, and definitely not on a national scale. You may find pockets of it in cities here and there, but I truly believe that this is the future of what good healthcare should be, and something that is greatly needed among the pediatric population. So we are very excited to deliver it.
HCI: How many locations do you plan to open and on what kind of timeline?
Qureshi: Our current plan is to be among the top 30 states, representing 90% of the US population, over the course of the next 36 months. It is a very aggressive and rapid expansion plan. However, I really believe that if you want to have a material impact on families across the country, that national scale is important and will be a differentiator versus just being in a few states or a few cities.
HCI: Will it require working differently with payers or developing contracts with payers?
Qureshi: Here’s a statistic that always surprises me: half of the children in America are covered by Medicaid. So I think it’s inevitable, as you achieve scale across the country, the need to be able to engage with managed Medicaid programs in a unique way and provide excellent care to children who are covered by Medicaid.
However, we are very focused on taking a phased approach to this. During the first years of the company, we will mainly focus on commercial payment for the service. I think you have to build scale and demonstrate it in the traditional commercial space and then use the clinical quality outcomes that can be demonstrated to be able to have informed conversations with managed Medicaid about how we can provide the same quality and the same approach. care and participate in value-based care arrangements.
HCI: What is the selling point for pediatricians to come work for you?
Qureshi: For pediatricians, we are putting your experience before everything we think. It’s not because we can pay more than a hospital system or a competitor. The main problem facing pediatricians today is the lack of ability to coordinate with specialists. Asking any health system for referrals and expecting to receive a response simply doesn’t work. It is a central frustration. That’s why they want to work in a multi-specialty group where they have access to colleagues and can work in the same way they trained, which is during residency. Everyone trains in teams and collaborative environments, and then you enter the real world and suddenly everyone is isolated. That is, in itself, very attractive.
The second thing is to focus a lot on avoiding physician burnout, and that means reducing administrative work for them, setting reasonable patient volumes daily that are significantly better than what you would see elsewhere. And then ultimately creating a conducive environment that ensures that they can have a strong work-life balance. Those are main areas that we think about in terms of how we can build something unique and differentiated.
