How Premise Health Scales Care Delivery for Millions of Members Nationwide

This week's panel was packed with insights from Beth (COO) and Meghan (VP of Product) from Premise Health.

Here are the main takeaways:

‍(1) Science over sales preferences.

‍When scaling to diverse employers, Premise Health decided not to allow unnecessary variability in care standards. While some employers wanted custom thresholds—like adjusting PHQ-2 scores for mental health follow-up—Premise prioritized evidence-based practices over individual preferences.

Megan explained, “We don’t modify evidence-based thresholds. Instead, we ask: what’s the problem you’re trying to solve, and what does the data tell us?” This allowed them to deliver consistent, high-quality care while maintaining flexibility in how results are achieved—like offering warm handoffs when behavioral health specialists were on-site or virtual referrals when they weren’t.

‍(2) Not all patients want tech to take over.

‍Premise Health thought self-check-in kiosks would be a hit, especially with their tech-savvy clients. But as Beth explained, “Even at our high-tech clients, people preferred a person who greets them warmly and facilitates a high-touch experience.”

While kiosks didn’t deliver as expected, they didn’t abandon the concept entirely. Instead, they kept the tech available for those who wanted it but prioritized the human connection most patients valued.

‍(3) Don’t say yes to everything.

‍Beth reflected, “We were too quick to say yes to client requests without fully understanding their objectives.” This created a patchwork of one-off solutions that added unnecessary complexity over time.

Now, they use a governance process to evaluate each request and align it with scalable, evidence-based goals. As Beth put it, “We’d rather focus on changes that deliver real value, rather than variability that doesn’t move the needle.”

‍(4) Start with the end in mind.

‍One of Premise Health’s early lessons in scaling was the importance of defining success before launching a new initiative. Megan shared, “We’ve launched products without setting up systems to measure success—whether for experience, efficiency, or effectiveness. And then we’re left asking, ‘Is this actually making a difference?’"

Now, Premise ensures every initiative starts with clear metrics and a detailed implementation plan. Megan explained, “We map out the process, the technology, and the resources needed, involving interdepartmental teams to ensure care delivery is possible at every level.”

(5) From many to one.

‍Premise transition to Epic consolidated six EMRs into one. Beth reflected, “If I had it to do all over again, I would be more intentional in how we review and approve ‘one-off solutions.’ We’ve had to untangle multiple custom revenue cycle processes, lab setups, and third-party integrations to get to where we are today.”

While some challenges stemmed from mergers and acquisitions, their rigorous governance process now ensures new solutions align with scalable, long-term goals.