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Raj Singh (left) and Mike Hilton (right), co-founders of Concur and now the CEO and chief product officer, respectively, at healthcare tech startup Accolade. (GeekWire Photo / Todd Bishop)

Raj Singh and Mike Hilton are best-known for Concur — the travel and expense management company they co-founded with Steve Singh in 1993 and led for the next 22 years before selling the company to enterprise technology giant SAP for $8.3 billion.

But in 2015 they left Concur and began searching for their next challenge. What they chose was a bit of a surprise: they joined Accolade, a Philadelphia-based healthcare tech startup, and announced plans to set up a second HQ for the company, in Seattle. The company, whose services and products help patients navigate the complex healthcare system, has grown to 70 employees in Seattle, out of 800 employees worldwide.

More than a year after joining Accolade, Singh and Hilton sat down with GeekWire editors John Cook and Todd Bishop this week to discuss their foray into the technology of healthcare, a notoriously difficult space to work in. Hilton said one reason for that difficulty is the giant players in the healthcare system, like pharmaceutical companies, health payer systems, and government regulators.

“It’s very difficult to affect change,” Hilton said. “You can either see that as a challenge or as an opportunity. I see tremendous opportunity.”

And despite the challenges to disrupting and improving the system, Singh said making those changes is essential given the current state of healthcare in the United States.

“We spend more on healthcare in this country than any other country in the world,” about $10,000 per person, Singh said. “In the developed world, countries that are getting better outcomes than we are in the United States are spending $4,000, $4,500, $5,000 per person.”

Concur Startupday 2015
Mike Hilton (center) and Raj Singh at GeekWire Startup Day 2015.

He also noted that healthcare currently makes up about 19 percent of the U.S.’s GDP, a number which has been rising steadily and dramatically for the past few years. That kind of growth isn’t sustainable for employers or other providers and needs to be controlled in some fashion, he said.

But the difficulty in addressing cost and other challenges in healthcare is the sheer complexity of the system. Most health systems are highly regional, not extending more than a few states in breadth. And there are many kinds of care consumers can have: Medicare for those over 65, Medicaid for those in low income brackets, employer provided health care, and care through the Department of Veteran Affairs.

“Every one of those systems is different, has a different set of problems, and has a different set of needs for the consumers,” Singh said.

In most of the tech world, “you’d think, ‘I build it once and I solve the problem for everybody.’ Here, that 65-year-old or that 70-year-old Medicare consumer is a hell of a lot different than the 25-year-old who’s working at Google. Their needs are different, their care coordination and management is different, and you have to think about your solutions in that kind of context,” he said.

Listen to the podcast above or download the MP3 here to listen to our full conversation with Singh and Hilton, including their experience jumping back into the startup ranks after decades at an established company. We also dive into how the Trump administration’s policy changes could have ramifications in tech, healthcare, and beyond.

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