About Elina Onitskansky
Elina Onitskansky is a healthcare executive dedicated to enhancing access, affordability, and equity in healthcare. Prior to founding Ilant, Elina was the Chief Growth Officer at Health at Home, SVP & Head of Strategy at Molina Healthcare, and an Associate Partner at Co-head of the Commercial Service Line at McKinsey.
About Ilant Health
Ilant is a value-based obesity and cardiometabolic health company focused on providing high-quality care for members and managing total cost of care for care for employers and health plans. Ilant is focused on de-averaging care, using a combination of proprietary analytics, purpose-built technology, and a comprehensive care (obesity medicine, mental health, dietitians, and peer navigators) to deliver the right care to the right member with the right support, optimizing clinical outcomes and financial value.
Medical Travel & Digital Health News (MTDHN): Can you share your background with our readers?
Elina Onitskansky (EO): I’ve been in the healthcare industry for several decades, mainly focusing on healthcare payers.
I was an associate partner in McKinsey’s Healthcare Systems and Services practice and co-led their commercial service line, focusing on building products for employers and developing strategies around value-based care and insurance design.
Early on, there was focus on wellness initiatives, where I learned that simple solutions like providing Fitbits were not enough to address complex issues like obesity.
Later, I became the head of strategy at Molina Healthcare, working with Medicaid and Medicare populations and addressing the needs of socioeconomically disadvantaged individuals.
MTDHN: How did you get started with your company?
EO: Obesity issomething that affected me personally, but I didn’t want to start a company just for the sake of it.
I spent six months talking to industry experts, validating my hypothesis from my own journey and experience and the research I did around. Those conversations revealed a significant gap in understanding obesity, obesity treatments – and the impact on cost.
Some of the smartest people I knew had little knowledge about how obesity was affecting a range of other disease states or how treatments might impact cost (this was before the full focus on GLP1s!). This convinced me of the opportunity.
MTDHN: Can you describe the model?
EO: Our model focuses on value-based care, aiming to get the right people on the right treatment with the right support.
We use analytics to identify who would benefit from obesity treatment, given that obesity is often under-coded in medical data. We built a proprietary model called the Ilant Rapid Returns to identify candidates and their potential impact.
We match individuals to appropriate treatments using a clinical decision support algorithm that considers phenotypes and, in the future, biomarkers – we call this the Ilant Metabolism Matters, and it helps us be evidence-based, consistent, and equitable in who is on what treatment (including which individuals are supported on GLPs). We provide robust support through a clinical team that includes obesity medicine specialists, registered dietitians and mental health clinicians.
We also use peer navigators with lived experience to offer empathetic support and technology to track and engage individuals.
MTDHN: Do you have to be referred by your employer? What does it cost?
EO: Yes, we partner with employers and health plans, including Medicare and Medicaid.
This approach enables us to support health equity. We offer different levels of support, from group sessions to one-on-one interactions, making our model viable for various employers and government plans.
We only get paid when people are engaged with our program and we take on financial risk, ensuring we only profit when outcomes are achieved.
MTDHN: What are the outcomes?
EO: We focus on improving health and well-being, not just weight loss.
We measure physical health markers like A1C and blood pressure, mental health improvements using validated screeners like PHQ and GAD and overall quality of life.
Our goal is to address the root causes of obesity and its related conditions, ensuring a comprehensive approach to treatment.
MTDHN: What do you tell employers about covering GLP-1 drugs?
EO: We believe in using the right treatment for the right person, which includes GLP-1 drugs for some individuals – but not for many others. Our focus is on managing GLP-1 use to optimize clinical and financial value.
It is essential to have a range of treatment options, from behavioral therapy to bariatric surgery and match them appropriately to each person. Misalignment between treatment and the individual can lead to suboptimal outcomes, including affecting not just financial costs but also safety.
MTDHN: How many individuals are now enrolled in the program?
EO: We’re currently serving hundreds and will soon be serving thousands.
MTDHN: Are you bringing on health plans and Medicare Advantage?
EO: Yes, although employers moved first.
We are now in discussions with Medicare Advantage plans. We believe addressing obesity can significantly impact longevity and healthcare costs in the Medicare segment.
MTDHN: Is obesity a disease that needs to be managed like a chronic disease?
EO: Yes, we consider obesity a chronic disease that requires lifelong management – but the approach to that management may vary over time.
Obesity is causal or comorbid with over 200 conditions. Effective treatment involves a sustained approach, not a one-time solution. Diet culture has created unrealistic expectations about quick fixes, but we focus on long-term sustainable outcomes.
MTDHN: Are you looking to take in more investment? What is your business vision?
EO: We plan to take in more investment to scale our operations and serve more employers and health plans.
Our model is designed to be financially sustainable, ensuring we are good partners to our members and customers. We use early capital to build out our analytics and technology, but our pricing model ensures sustainability as we scale.