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Our mission at Alto is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it.

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Alto / Blog

People and healthcare providers deserve more from today's healthcare system. See how Alto is building a new kind of pharmacy aimed at improving the pharmacy experience for everyone. Learn more!

Building a Better Pharmacy | Alto Pharmacy

After three months of listening, learning, and living, I am excited to share a bit about what I learned on my journey to join Alto as Chief People Officer. The accomplishments of this team are already extraordinary -- and we’re about to embark on scaling to even greater heights. 

My journey to becoming an Altoid* started in November 2019 when I came onboard with the short-term scope of helping the team get traction on their 90-day goals, hire several leadership key positions, and develop the 2020 People Operating Plan and budget. The experience and the energy of how much we accomplished in a short period were surreal, and  I observed a People team truly committed to delivering an amazing experience to our 400+ Alto employees and contractors. It gave me a clear perspective of the direction I wanted to take my career.

I knew I would select my next opportunity based upon three criteria: the team, the product, and the impact the organization has on society. I appreciate that I have been blessed with opportunities to be a part of some of the world’s top workplaces and brands, including Accenture, Google and Dropbox, and finding my next role would take some awesome soul searching. 

People and healthcare providers deserve more from today’s healthcare system. At Alto, we're building a new kind of pharmacy to cure one of our healthcare system's most startling ills: over 50% of prescriptions are never picked up. Because staying on track with doctor's orders requires more than just delivering pills, we're managing everything from insurance logistics to pricing, late-night questions to supply chain, and anything else that could stand in the way of effective treatment.

Given the importance of this mission, it shouldn’t surprise you that the team at Alto is special. It is a group of pharmacists, fulfillment operators, patient care specialists and partnership managers that are experienced, committed to our mission, and go above and beyond every day for our patients and provider partners. The product suite includes an intuitive platform built in partnership with our patient care and frontline teams using empathy and rigor. 

The impact we’ve had and will continue to have is substantial: our patients fill their prescriptions 30 - 50% more often than with the national chains (“adherence” to those in health care). We’ve helped patients save more than $23M on their medications through automatics savings searches and other programs. And these numbers reflect the impact of just the six markets we’ve launched in (two of which launched just this past month). Imagine what we’ll see as we expand across the US. 

The leadership team is committed to expanding the culture in a meaningful way, and I’ve found the culture to be one built on curiosity and collaboration. Before I arrived, the leadership team aligned on a leadership framework based upon Conscious Leadership. Its’ 15 commitments are by no means new or innovative, but I can honestly say this team’s whole-hearted embrace of open and honest dialogue about where we are and are not fulfilling the commitments is refreshing. This commitment will help us become better both as individual leaders and as a company and serve to further differentiate us as a workplace committed to open and constructive conversation.

For those embarking on a similar journey to find your next opportunity, I share the following:

Take time to reflect -- identify what you love.

Recognize that no opportunity is likely to check all your boxes, even in this HOT HOT market.

Take every meeting. This meant I didn’t have much time off between gigs but I learned a lot.

Seek opportunities to really work with your future team. Not everyone or every company will be open to this kind of interim opportunity but ask for more than just interviews

Ask to attend a regular leadership meeting.

Ask to take a real problem the leadership team is facing and work through it in real life with a member of the leadership team.

We’ve aligned on the five key tenants for the People Team at Alto. They are our north star and will help guide us on this journey.

Our first priority on the People team will be our People: We will have lots of goals and metrics but will always ask: “Is this doing the right thing by our people? Are we improving the quality of the experience they’re having at Alto?” Our team will be available when you need us, and you’ll have an advocate and sounding board any time you need one.

Look across our people’s end-to-end journey to deliver amazing experiences: HR too often stays stuck in our silos of recruiting, employee relations, compensation, benefits or performance management. We will differentiate our workplace and teams by threading the needle through each of those traditional processes to identify the impactful parts of the journey. Our goal is to amplify the joyful moments and support Altoids through difficult ones.

Connect disparate, siloed systems (recruiting, core HR, payroll): To help create a cohesive overall experience for employees and foster collaboration, we will connect disparate siloed systems. We will improve adoption and engagement of these tools and help Altoids learn and grow using world-class technologies to deliver people services and optimize their experience. Finally, connected systems will mean comprehensive data to support visualizations and better decision making by leaders.

Grow smart with efficient processes and automation: We can do a lot of what we want to deliver awesome experiences by adding lots of people, but that wouldn’t be using Alto dollars efficiently. We want to grow smart and scale using lessons learned by the many, many companies who’ve come before us. We’ll measure the efficiency of our processes, operations, and engagement with Altoids and candidates using a myriad of solutions from technology, vendor-partnerships and lean practices across our journeys.

Evolve our culture to one filled with curiosity, collaboration, inclusivity, creativity and workplace with intentional design, actions, and reinforcing behaviors: Delivering a workplace that is more diverse, inclusive and equitable requires thoughtful frameworks starting with attracting talent, defining behaviors creating an inclusive environment where all communities and people feel they belong, and rewarding and growing people equitably based upon their results and how they achieve them.

My hope in sharing these reflections is that some will learn from my experience and therefore do one or two better in the search for their next opportunity.

The future of work is about us all learning and growing faster than we did before. If any of this interests you, reach out, connect or apply online to one of our positions now (or in the future). To learn more take a look at our brand video and then apply today!

Alto Rebrand Sizzle Video

*We affectionately refer to Alto employees as “Altoids.”

People and healthcare providers deserve more from today's healthcare system. See how Alto is building a new kind of pharmacy aimed at improving the pharmacy experience for everyone.

Anna left her doctor’s office with a glimmer of hope. For months, Anna had been struggling with digestive issues and now her doctor had suggested they try a promising new medication. Finally, she thought, maybe this new medication could provide some relief and her life could return to normal. But when Anna arrived at her pharmacy, she was shocked to discover the medication would cost $400 per month! The pharmacist at the counter explained that if she couldn’t afford the copay, she would need to call her insurance or her doctor to “figure it out.” Frustrated and overwhelmed, Anna left the pharmacy empty-handed and with the distinct feeling that healthcare had been designed to work against her.

Unfortunately, Anna is not alone in encountering obstacles that prevent her from getting the medication she needs. From the moment we leave the doctor’s office, we are thrust into a maddening, depersonalized system that feels like a big black box. We are left to navigate it all on our own, especially when it comes to medication pricing. 1 in 3 Americans admit that they aren’t taking the medication they need because of cost. This is not only harmful to our long term health as patients, but also a devastating cost to our country. It is estimated that there are 125,000 avoidable deaths per year and nearly $300 billion in downstream medical costs due medication non-adherence. You may have heard stories of diabetic patients who, faced with climbing insulin costs, died from skipping doses or resorting to cheaper alternatives. For these patients and their families, getting the right medication is an issue of life or death. And for many like Anna, it’s, at the very least, very high stakes.

Today, medication pricing is set by multiple stakeholders in a process that is entirely hidden from patients and doctors:

Your employer contracts with a pharmacy benefits manager (or “PBM”, like Caremark, Express Scripts, etc.) whose job is to determine which medications should be covered or not under your insurance plan (even down to the exact dosage and brand that your doctor prescribes).

The PBM negotiates with the drug manufacturers to agree upon a specific price to charge the employer for a medication, the remaining copay for patients, and the PBM’s hefty cut for administering the service. It’s not hard to imagine how commercial incentives might color decisions on which medications are covered and how they are priced.

Drug manufacturers also offer copay assistance programs for select medications, with varying eligibility criteria, but these are marketed primarily through doctors, meaning patients often don’t know these assistance programs exist or if they qualify.

Today, none of this data is transparent or shared. These parties (doctors, drug manufacturers, PBMs) do not have the incentives nor the technology in place to coordinate with one another to act in the patient’s best interest. Drug manufacturers and pharmacies get paid by the medications dispensed, doctors get paid by the appointment/procedure, and PBMs get paid through taking a hefty cut of the negotiated medication price. These parties are naturally incentivized to pursue a path that delivers the highest financial return with the least amount of effort. Sitting in the center of this web, pharmacies are uniquely positioned to coordinate the best outcome for the patient. Traditional retail pharmacies, however, don’t have access to technology solutions that would easily bridge the gap between insurer, manufacturer and physician. It’s no wonder medication prices continue to climb and the process of getting medication remains so inefficient.

At Alto, we asked ourselves, “What if every patient could have a pharmacy expert on standby to help him/her navigate the complex world of medication pricing?”

We believe that pharmacy’s role is to make the process work around patients, rather than asking patients to learn how to work the system. So we built a modern pharmacy software platform that enables our Alto pharmacists, billing specialists and patient advocates to coordinate between doctors and insurance companies to ensure patients have clear choices and transparency on medication pricing.

Alto is the first pharmacy to proactively:

Show patients the price of a medication both with and without insurance, within minutes of receiving their prescription. These prices matter because sometimes the price without insurance is actually cheaper.

Match patients with savings and copay assistance programs offered through drug manufacturers. Often, patients and doctors don’t have time to manually keep track of these programs, so our service automatically searches for eligible programs.

Help patients and doctors navigate the complexities of insurance, whether by identifying an alternative medication that is more affordable under the patient’s plan or helping to petition insurance to cover the medication (a process called Prior Authorization). Compiling all the paperwork and medical history data required by these insurance processes takes up valuable time from doctors (estimated at 20 hours of work per week per doctor). Our technology automates this process so patients can quickly get access to the medications they need.

Here’s what all this means for a patient like Anna:

When Anna told her doctor about the expensive copay, her doctor sent the prescription to Alto. Anna’s doctor knew that Alto would help with the paperwork needed to petition insurance to cover a patient’s medication. Within a few hours, Anna received a notification from Alto that they’d worked with her doctor to start the process with her insurance. In the meantime, Alto had matched her with a program from the drug manufacturer that would reduce her copay so she could get started on her therapy right away. When her first Alto package was delivered that evening, Anna regained that early glimmer of hope, relieved to have the Alto team in her corner. Within days, Anna’s insurance approved the coverage, and Anna has been able to stay on the medication, better managing her symptoms (and her medication costs) for over a year now. Anna has been able to focus on her health and feel some semblance of her new “normal.”

Since Alto Pharmacy opened four years ago, we’ve had the privilege to help hundreds of thousands of patients and physicians. By harnessing the power of our pharmacy team and our technology, patients get access to the best medications, at the best possible prices, delivered to their home the same day. 

We are proud to be cracking open the black box surrounding medication pricing and giving Alto patients a new level of transparency and control in their health journey. And we are hopeful that with increased awareness and patient advocacy, systemic changes are on the way that will help make medications more accessible and affordable for everyone.

Monica Tran has led the Product and Design team at Alto for two years, helping build a suite of products for pharmacists, physicians and patients that allows Alto to break down barriers to medication access and transform the pharmacy experience. She recently transitioned into a leadership development and coaching role, helping to scale Alto’s organization, values and patient experience.

Breaking Open the Black Box of Medication Pricing

Choose when and how you are notified about prescriptions with our Prescriber Notifications feature.

Starting tomorrow, February 14th, AltoMD users have access to improved prescriber-based notification options in AltoMD. These new settings help users manage which patient prescriptions generate email notifications for pharmacy actions.

Control which patient prescriptions generate email alerts when there are pharmacy questions or actions;

Subscribe to updates by the patient or by the prescriber; and

Keep your email inbox clean and focused only on the patients you work with on a daily basis.

Occasionally, Alto will need additional information from a clinic to fill a patient’s prescriptions. For clinics using AltoMD, the Alto team can send brief messages via the portal rather than having to reach out via phone, voicemail or fax. These messages can be quickly responded to in between rooming patients or while handling other administration duties — no more waiting on hold or playing phone tag with the pharmacy!

Notifications allow AltoMD users to receive email alerts when there is a new message requiring the clinic’s attention. To help you limit which patient alerts you receive, AltoMD has offered the ability to subscribe to an individual patient (get alerted for all messages for that specific patient). Our new prescriber-based notifications allow an AltoMD user to subscribe to updates for all patients for a given prescriber (get alerted for all messages for all patients with scripts written by that prescriber).

AltoMD is designed to keep you off the phone, away from the fax machine, and focused on your patients. Our existing patient-based subscription functionality allowed users to get targeted notifications about patients, but required active management in the patient directory to keep up to date on all needed subscriptions. Opting into a prescriber’s notifications means it’s easier to get all updates on the patients you care about, with fewer steps.

Prescriber Notifications: Select which prescribers at your practice you would like to follow; by following or subscribing to a prescriber, the user will receive email alerts when there are pending pharmacy actions requiring attention.

Revamped Settings page: Your user profile and notifications settings are now at the top of the page; click into the “Notifications Settings” module to add (or remove) prescribers that you want to receive updates on.

Revamped Patient Directory filters: Filter the patient directory listing by notification status: all, following, not following; this filter will show all individual patients you have subscribed to, both individually and by prescriber.

AltoMD is a complimentary service that allows prescribers and clinic staff to track prescriptions, view medication histories and message directly with the Alto Pharmacy care team. By streamlining prior authorization workflows and coordinating with insurance companies, AltoMD helps clinical teams stay focused on patient care.

If you have any questions, feedback or ideas, please email providersuccess@alto.com or reach out to your Partnerships Manager.

More Choices and Control With New AltoMD Notifications

Mattieu Gamache-Asselin, CEO & Co-founder

Today, we are excited to announce a $250 million Series D funding round, bringing our total funding to over $350M. We are honored to welcome Softbank to our team of investors and thrilled that our existing investors — including Greenoaks, Jackson Square Ventures, OliveTree Capital, and Zola Global — have reinvested to accelerate our mission to bring the Alto experience to 100 million people by 2025.

Over the past four years, we’ve delivered over 1 million prescriptions directly to our patients’ doors, and created a service that makes our patients happier — our patient NPS is over 80 for the fourth year in a row — and healthier — our medication adherence rate is 77% compared to an industry average of 50%.

This has been possible because we’ve learned from experienced community pharmacists, we’ve reimagined and rebuilt the underlying infrastructure of pharmacy, and, most important of all, we’ve built an amazing and diverse team that truly lives out our values every day. Never in my wildest dreams did I imagine I’d get to work on such a meaningful mission with such a genuinely passionate and talented team. Whenever I have a tough day and need a boost of energy, I walk through our pharmacies and look around in awe at all the hard work, care and perseverance that goes into making this type of service possible for our patients — from our pharmacists and patient care champions to our couriers and product managers, all working together.

This new round of funding will enable us to take everything we’ve built and learned over the past four years and bring it to more people and more patient demographics. I’ve seen many companies scale too quickly, hire too fast, and in that process lose sight of the heart of the company’s values and mission. What is most important to me as Alto enters this next chapter is that we maintain the same empathy and human connection we’ve had since we were a small community pharmacy.

I want to thank our team for joining us on this mission, to thank our investors for believing in us, and most importantly, I want to thank our patients for reminding me every day of why we’re on this journey.

Healthcare is complicated, but managing your medications doesn’t have to be.

With holiday travel, family engagements, and end of year insurance submissions, December brings with it both excitement for the new year and a lot of housekeeping. Alto takes the hassle out of pharmacy by making pharmacy convenient and fast — no more standing in line or adding an extra stop to your evening commute. Get a question answered or schedule your next medication delivery with a few quick clicks online or over the phone with the assistance of our friendly Care team.

We’re always adding new features to both the mobile and desktop app experiences to save you valuable time, give you control over your medications, and provide transparency into what really goes into pharmacy. Cross “pharmacy” off of your year-end to-do list with the newest features in our app.

Download your FSA receipts: No need to keep a paper receipts folder or try to remember which medications you filled when. Alto keeps track of the details so you don’t have to. Your year-end FSA receipts are now available for easy download from both the desktop and mobile apps under “Payment Details.”

Set up a linked bank account: Alto’s commitment to transparency means more choices and more control. In addition to payment via credit or debit card, you can link a bank account to automatically save 1% off every order.

Manage your family’s medications: Eliminate extra trips to the pharmacy and confusion around refill cycles. Set up a family account to view and manage medications for you and your family members from a single account:

View medications for your whole family from one med list

Schedule medications for any family member in one delivery

Request refills and prescription renewals on behalf of your family members

To manage your family members’ medications, you’ll need to link them to your account. Contact our patient care team at 1 (800) 874–5881 to quickly get set up.

New to Alto? Here’s what you can expect from the full Alto app experience:

View all of your current and archived prescriptions along with detailed medication information

Access price information for each medication, including insurance, coupon, and cash pay prices so you always know your options

Schedule deliveries for the date and delivery window of your choice — delivery is always free!

Request refills and enroll in our auto-refill program

Securely message a pharmacist with questions, including in the evenings and on weekends

We want to know what you think about these new features! Email us at feedback@alto.com.

Take Control of Your Prescriptions With New Features in the Alto App

True visibility with AltoMD’s improved patient profile pages

Starting today, August 13th, prescribers and clinics using Alto’s AltoMD platform have access to a new feature set designed to help clinical partners understand the current status of any medication sent to Alto and exactly what will happen next. Track a medication as it moves through the full Alto workflow (now with more detail!), view patient contact logs, and drill down into medication histories.

AltoMD is designed to keep you off the phone, away from the fax machine and focused on your patients. Our previous patient profile pages answered some questions about medications but didn’t go far enough in helping clinic teams understand exactly where each prescription falls in the fulfillment process or how to help move things along. These improvements allow AltoMD users to:

See how and when Alto is contacting our shared patients;

Determine exactly where a prescription is in the Alto fulfillment workflow;

Quickly understand any blockers to getting the prescription filled; and

New Patient Contact Log: See when and how Alto is communicating with our shared patients, including text, email, phone calls and in-app messages.

Revamped Patient Medication List: Filter and sort by medication name, fills remaining and delivery status.

New Medication Detail View: View the current active prescription details, progress through the Alto fulfillment process, related inactive prescriptions and detailed medication history.

You can also message the Alto pharmacy team with patient specific questions and subscribe to updates from the patient profile page.

AltoMD is a complimentary service that allows prescribers and clinic staff to track prescriptions, view medication histories and message directly with the Alto Pharmacy care team. By streamlining prior authorization workflows and coordinating with insurance companies, AltoMD helps clinical teams stay off the phone, away from the fax machine and focused instead on patient care.

Track Every Prescription Through Every Step

Working at Alto isn’t just a job. For every team member, from product designers to pharmacists to patient care gurus, Alto is a means to a fulfilling career focused on making a difference in the lives of people who rely on prescription medicine to lead healthy, happy lives. In the process, we’re also changing an industry that has long gone unchecked.

Our mission is to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. That takes a dedicated team of mission-driven, value-minded people. Read on to figure out if Alto is the right career move for you.

At the highest level, Alto is a pharmacy. But we are not a traditional pharmacy. Instead of operating dozens of small-volume distribution sites across a metro area like chain pharmacies, we own and operate high-volume pharmacy fulfillment centers staffed by small, highly efficient teams supported by proprietary technology. We have one fulfillment center per metro area that we serve, including San Francisco, Los Angeles, and Orange County, and a centralized operations facility in Denver. Out of our fulfillment centers, we process and fill prescription orders and deliver directly to patients’ homes or offices by way of our free, same-day courier service.

On top of the convenience and accessibility of same-day delivery, Alto has three product pillars that allow us to deliver an exceptional experience to our users: the Alto Patient app, Alto MD, and Wunderbar. Learn more about our products and our industry-disrupting business model.

Alto is the world’s most patient-centric pharmacy. Our goal is not simply to distribute prescription medications but to improve patients’ health outcomes and their quality of life and to make those improvements accessible to everybody.

To get to that point, we need to understand what’s preventing patients from accessing all the benefits medicine has to offer. We believe it’s especially important to address the high-level problem of non-adherence, which is when patients don’t take the medication they’re prescribed. It also means learning how to scale our technology and processes to bring our products to more people in current and new markets. To achieve both of these things, we need to first scale our team. Learn more about Alto’s potential for growth and plans for the future, and how our team contributes to our success.

Loving what you do starts with doing something you believe in. It’s enriched by working alongside people who share your goals in an environment conducive to your work style and aspirations. At the foundation of Alto’s culture is our mission; our core values like acting empathically, thinking rigorously, making impact, staying humble, and putting patients first; the diverse backgrounds of our team members; and the supportive but highly autonomous way we get work done. Learn more about the Alto’s values and culture through the eyes of our CTO and co-founder, Jamie Karraker.

If Alto sounds like an environment you would thrive in, we would love to hear from you! We’re always on the lookout for great people to fill in our product, design, engineering, analytics, people, recruiting, finance, sales, business operations, logistics, pharmacy, and patient care teams. Check out our open positions to see if there is an opportunity that’s right for you!

Why Mission-Driven Software Engineers Hold the Key to Alto’s Continued Success

Alto is the world’s most people-centric pharmacy. Our goal is not simply to distribute medications but to improve health outcomes and quality of life. What’s more, we want to make those improvements accessible to everybody.

To get to that point, we need to understand what is preventing people from accessing all the benefits medicine has to offer. We believe it’s especially important to address non-adherence, which is when people don’t take medications as prescribed. Non-adherence is a national problem that causes 125,000 avoidable deaths per year (more than three times the number of car accident deaths) and $300 billion in avoidable medical costs (more than half the money spent on pharmacy as a whole).

It also means learning how to scale our technology and processes to bring our products to a bigger swath of the population. To achieve both of these things, we need to first scale our engineering team.

Because of our unique business model, Alto is positioned to pursue three exciting growth vectors:

New Therapeutic Specialties: In addition to our general pharmacy capabilities, we have developed specialized expertise and infrastructure for managing complex treatments like fertility, dermatology, HIV, psychiatry, and other therapies that come with sticky coordination issues and unique considerations. We have made it easier than ever for people to navigate these treatment areas, but there is more we can do. Our team has identified 26 additional treatment areas that could benefit from specialized technology and processes. Mastering those areas is high on our to-do list.

New Geographic Markets: By expanding into the top 50 U.S. cities, we could potentially serve 55% of the country’s population. If we expand to the top 100 cities, our coverage would increase to 70%.

New Clinical Partnerships: Alto facilitates coordination between our team, healthcare providers, insurance companies, and the people taking the medications. In the process, we improve workflows and health outcomes. That offers a powerful benefit to clinics, medical groups, and hospital systems. Because of that reputation, we currently have a waiting list of healthcare providers who want to partner with us. That’s more demand than we can keep up with, which isn’t such a terrible problem.

When Opportunity and Demand Exceed Capacity

Alto is in a fortunate position. It is rare among companies to have multiple compounding growth vectors and a reserve of would-be partners angling for our product. We are not demand constrained, we are operationally constrained, and even then, we continue to double our business every six to nine months — just not as quickly as our potential promises.

Scaling up as a means of reaching our potential is an exciting challenge we’re already tackling. In late 2018, we closed our Series C, giving us the fuel we need to build out our engineering team and develop the technology and processes that will make our continued growth possible. That work will entail fleshing out each of our existing product areas, scaling them, and identifying and solving even more deep-rooted industry issues through better technology and better processes.

Currently, Alto boasts a small but talented and agile engineering team staffed by individuals who honed their experience at some of the biggest names in tech like Facebook, Google, Uber, 23andMe, MIT, Stanford, and Berkeley. All of our engineers are relatively senior, so everyone has autonomy and ownership over their projects. It’s a collaborative, supportive, mission-driven environment, which is how we’ve been able to build so much in a relatively short period of time.

Up until now, we have been deliberate about keeping the team small, but we’ve reached an inflection point. In the next 18 months, we’re looking to increase the engineering team four-fold. With our new team in place, we will be in a great position to focus on our objectives: building and perfecting our operational efficiencies and product scalability.

We’re approaching the challenge of scalability from a few angles:

One is automation. We want to take the algorithms that are in our employees’ heads and put them into code, so they can focus more on caring for patients rather than logistics. We’ve done a bunch of automation work already, but there’s a lot left to do.

We’re also intent on designing tools to help our own team be more efficient with their time, which will mean better UX, better UI, more batching, and less context switching.

The third angle is self-service, and it’s the one we’re focused most intently on. Right now, there is significant human interaction between our team and consumers because we want to make sure consumers have the information they need to make optimal healthcare decisions. In our next phase of growth, we want to automate that process without losing any transparency or depriving a consumer of any agency, no matter their technological competence.

Essentially, we want to build the pharmacy version of TurboTax (without the part about lobbying to keep the system broken). With the right prompts and information, TurboTax walks users through the U.S. tax system, which is huge and complicated. In effect, the user becomes totally self-servicing. We want to do the same for the people who use Alto. That said, not everybody is proficient or comfortable with technology. In the spirit of accessibility and inclusivity, it will still be important that everyone who uses Alto also has the option to speak to a real, knowledgeable, and friendly person to get their questions answered and needs met. We have a responsibility as a healthcare provider to take care of all our patients, no matter how tech-savvy they might be, but for these patients we can still use technology to enable our team to get the patient the best possible option, quickly and easily.

Our engineering team is working toward products with even more expertise built in. In the process, we will also make our operations more efficient and more scalable, unblocking barriers to expansion in existing markets, new markets, and new verticals.

When we succeed at that alignment, we stand to change the nature of the industry. To get there, we will continue to grow our engineering team with right-fit, world-class talent that not only has the skillset to take Alto to the next level but also the values to keep us aligned and mission-driven in the process.

Learn more about Alto’s company values and mission-driven work culture.

To Alto’s CTO, an ethical, altruistic, supportive workplace is everything.

Every morning (ok, most mornings), I wake up motivated — eager, even — to get out of bed and go to work. But it’s not because I am some super-performing success-bot. This is not another blog post about a c-level executive’s otherworldly, highly-meticulous-yet-seemingly-effortless morning routine, and I have no prescriptive regimen for staying happy and mindful while still managing to “get it all done.” I only have one piece of advice, but it is one that has served me (and my mornings) well:

Work with people who share your passion and values.

At Alto, the company I co-founded in 2015, everyone, from me (the CTO) to product engineers to part-time prescription couriers, is dedicated to the same mission and vision. Every day, we strive to improve health outcomes by optimizing technology and processes to become the world’s most people-centric pharmacy. I am never not excited to work alongside the few hundred Alto employees that daily act in concert to support the success of our company and make a difference in the lives of people who use Alto.

Underlying this relentless drive toward mission and vision is a set of shared core values that defines our internal culture:

Patients come first — even before our bottom line and industry partners. We will always prioritize the wellbeing of the people who use Alto to manage their prescription medications.

Leave no person behind. It’s more important to be good for all than to be great for a select few.

Start with empathy. We strive deeply to understand the thoughts and feelings of everyone we interact with.

Focus on impact. We prioritize impact over activity and focus on the work that makes the biggest strides toward our goals.

Think rigorously. We’re open to changing our minds and never hesitate to question assumptions and first principles. There is nothing sacred about the status quo.

Be humble. Our work — however expert, technical, or specialized — is in service of our team, the people who use Alto, and the greater good. Everyone’s contributions count, and no one is too important to take out the trash, so to speak. And we are certainly not above other players in the industry whose mission to help patients aligns with our own.

For me and my teammates, it’s extremely fulfilling to contribute to this smart, caring, talented team working tirelessly to help so many people. Everyone’s role is different but invaluable, and our efforts have real meaning. I can say with confidence that working in this environment makes a huge difference in how I carry myself, because I know from previous professional experiences what the opposite looks and feels like.

When my co-founder Matt and I started Alto in 2015, we were both software engineers at Parse, a Facebook-owned company. Having spent years in Silicon Valley, we were already jaded by the tech ecosystem and were ready for a change. In thinking about what we wanted to pursue next in our lives, we noticed that other companies were not working on society’s most meaningful problems; they were focused on catering to the 1%. In contrast, we wanted to use our time and skills to build something that makes a tangible, positive impact on the daily lives of all people, especially those ignored by the tech industry.

And so, we found ourselves drawn to healthcare — a big, broken industry that affects most people negatively, especially the underprivileged. We did a lot of research to figure out what our wedge into healthcare would be, and pharmacy jumped out to us. Essentially, pharmacy is the healthcare industry’s consumer product, and consumer products just happens to be our area of expertise.

If you think about it, pharmacy is a product not unlike Facebook; almost everybody in the country uses at some point in their life. But evidence suggests it’s generally a bad one. The net promoter score of chain pharmacies is somewhere in the vicinity of -10. That’s shockingly bad. (For reference, American Airlines has a net promoter score of four.) Our research also found that more than 35% of all medications sent to pharmacies are never picked up as a result of some upstream issue.

It became clear to us that none of the pharmacy incumbents thought of themselves like a product, and especially not one that is consumer focused. None of them had the mindset to prioritize and optimize the user experience, which is the mindset Silicon Valley applies to photo-sharing apps and ad optimization tools and all sorts of other products we aren’t so passionate about. Instead, pharmacy incumbents focus on extracting value from the system and pushing the cost off onto patients. In that gap, we saw opportunity — and a moral imperative.

Today, Alto is making pharmacy convenient, accessible, and user-friendly. We make it easy for consumers to get information on their medications so that they can make informed healthcare decisions. To get there, we have built and continually work to improve a robust set of user-facing and internal tools to guide consumers through the complex and often barrier-laced process of prescription procurement, payer authorization, and medication fulfillment.

Because health outcomes are what we care about, we’re not pushing pills for profit. We are just as happy if a patient pursues an alternative therapy so long as it is in his or her best clinical interest. Our unique business and operational models make that possible.

In disrupting an industry that can be predatory to the most vulnerable among us, I am proud to say Alto attracts some of the most ethical, altruistic talent I have ever worked with. They make coming to work a pleasure and a privilege, and that makes all the difference, not just in my mornings but also my professional satisfaction and overall well-being. If any of that resonates with you, you might be just our type.

"Work With People Who Share Your Passion"

Above all, Alto Pharmacy strives to fulfill medicine’s true purpose — to improve quality of life — for everyone who needs it. In working toward that mission, we’re building technology to disrupt the healthcare industry, which has long deprioritized the patient experience. At Alto, we’re putting patients first with free, same-day medication delivery; always-there, cost-saving support from our dedicated pharmacists and care team; and a cheerful online interface where people can conveniently manage all their prescriptions. Here’s how we make it work.

At the highest level, Alto is a pharmacy. But we are not a traditional pharmacy. Instead of operating dozens of small-volume distribution sites across a metro area like chain pharmacies, we own and operate high-volume pharmacy fulfillment centers staffed by small, highly efficient teams supported by proprietary technology. We have one fulfillment center per metro area that we serve, including San Francisco, Los Angeles, and Orange County, and a headquarters in Denver, where we are centralizing and growing our care operations team. Out of our fulfillment centers, we process and fill prescription orders and hand deliver them directly to patients’ homes or offices. About seven million people fall within the delivery zone of our San Francisco fulfillment center alone. In Southern California, our delivery radius covers another 20 million people.

Our model is made possible thanks to three Alto products:

With the easy-to-use Alto Patient app, people can consult a friendly and knowledgeable Alto pharmacist, schedule deliveries, and otherwise manage and learn more about their medications. Through the Alto Patient app, our care team also works with people to find them ways to save on their prescription costs.

AltoMD is our physician-facing product that allows physicians to easily manage the pharmacy needs of their patients that use Alto. The beauty of AltoMD is that it simplifies the workflows of the medical practices that use it. The typical clinic spends an average of 20 hours of administrative time per physician, per week, just on pharmacy workflows. In relieving practices of many of these administrative tasks, Alto reduces the likelihood of human error and redirects physicians’ time and energies back to their patients. In turn, Alto helps ensure treatment adherence and a better overall healthcare experience, making it a win-win for physicians and patients alike.

Wunderbar is the internal technology our pharmacists and care teams use to manage their workflows. It also controls the robots that fill every prescription order. Wunderbar was built and continues to be improved in house, giving us a strong foundation to grow and scale.

My co-founder, Matt Gamache-Asselin, and I came up with the idea for Alto in 2015, when we were working as software engineers at Parse, a Facebook-owned company. By then, our years in Silicon Valley had left us jaded and disillusioned with a tech industry that had lost sight of what really matters. We watched companies pour their resources into addressing the not-so-meaningful problems of the 1% while the broader population went underserved by many of the technological innovations being developed. We wanted to use our time, energy, and experience in consumer products to build something with the potential to have tangible, positive impact on the lives of all people. That led us first to healthcare — a big, broken industry with a terrible reputation — and then, more specifically, to pharmacy.

Our research revealed that no pharmacy incumbents think of themselves as consumer product companies. Unlike the Facebooks of the world, which are constantly optimizing how people use their products, pharmacy incumbents deprioritize it. We saw that gap as an opportunity to use our technical expertise to bring a people-focused mindset to the industry.

Back then, neither Matt nor I had any pharmacy experience. So, we left our jobs and dove in headfirst. After raising some capital, we purchased and ran a mom-and-pop operation, A-G Pharmacy, that had been serving San Francisco’s Mission District for more than 50 years.

We learned by fire how pharmacies work (and don’t). Soon enough, it became clear to us that despite caring about their patients, the A-G team wasn’t able to give them the best possible experience because they didn’t have the right tools. They were using antiquated software that required clumsy, inefficient work-arounds like relying on analog typewriters to create prescription labels. Because they didn’t have a streamlined operation, patients didn’t receive a streamlined experience.

We further discovered that technology wasn’t connecting the right stakeholders across the industry either. Pharmacy transactions require coordination between the physicians choosing the medication, the insurance companies paying for the medication, the pharmacies filling the orders, and the patients ultimately using the medications. The industry standard has been to conduct that coordination by fax and phone. That makes coordination slow, disjointed, and prone to things falling through the cracks. Patients take the brunt of those issues.

It became clear to us that Alto’s software needed to deeply integrate with and connect the disparate systems that stakeholders use. We also wanted to give stakeholders tools to solve other workflow issues not being addressed by their existing systems. And so Alto’s suite of products came to be.

A single Alto fulfillment center can serve as many people as 400 chain pharmacy locations, and we do it with a much smaller team thanks to our proprietary technology. That saves our company resources that we reinvest in the Alto experience. By way of example, we’ve developed specialized expertise in managing the coordination of complex therapeutics like fertility treatment, psychiatry, dermatology, and HIV prevention and care. The efficiencies we’ve uncovered make lifesaving and life-improving treatments available to people who might otherwise not have access to them.

The result is a system of products and processes that have demonstrated utility for tens of thousands of people and counting. Alto isn’t just convenient; by keeping people well informed about their prescription medications, Alto helps them make the best possible healthcare decisions for themselves and their families. But we’re not stopping there. Alto is poised for growth, and in the coming months and years, we will be rapidly adding to our team to help us build the technology to continue to solve pharmacy’s deep operational issues at scale.

Learn more about our vision, growth trajectory, and the Alto engineering team that makes it all possible.

How Alto Pharmacy Is Using Tech to Put Patients First

AltoMD makes it easier for doctors and nurses to communicate and collaborate with a pharmacy. AltoMD is an online platform where providers can track the status of a prescription, patient, or prior authorization. Rather than relying on phone and fax and responding to endless voicemails, providers can message a pharmacist for an expedient response in between patient visits. AltoMD also eliminates a number of administrative hassles, such as processing prior authorizations and contacting insurance companies, and provides valuable insights like compliance reports to improve the efficacy of care.

Fewer Phone Calls, Faxes, and Messages with Pharmacy Requests

On March 19th, Alto launched a new feature on AltoMD called Pharmacy Requests, which is a one stop shop for a provider’s most pressing tasks, whether it’s a quick clarification, therapeutic substitution, or providing information for a prior authorization. Alto’s streamlined form eliminates excess messaging and overflowing inboxes, allowing you to focus on what’s most important — your patients.

Here we’ll take you through the before and after to illustrate what has changed on AltoMD. Historically, providers had to make sense of a confusing list of messages. It was hard to determine what was most important and where to spend one’s time.

As seen below, now, a provider is alerted to how many outstanding pharmacy requests require his or her attention. We’ve categorized them into three buckets:1) Prior Authorizations, 2) Clarifications, and 3) Therapeutic Substitutions. This makes it easy to see not only what but which patient’s medications require follow-up.

If you have any questions, feedback or ideas, please email providersuccess@alto.com or reach out to your Partnership Manager.

On International Women’s Day, we’d like to celebrate the women of Alto. Every day, they care for patients, fill prescriptions, build products, and drive growth.

By the numbers, 63% of our employees, 40% of the executive team, and 60% of people leaders on product and engineering are women. In comparison, 20% of tech jobs are held by women and only 11 percent of executive positions at Silicon Valley companies.

This amazing representation was made possible by the company mission and values. The founders recognized that improving the pharmacy experience for a diverse population of patients meant Alto had to be a diverse company, capable of understanding and empathizing with everyone we serve.

Recruiting this talented mix of people has been one of our greatest successes, and today, our team has a broad representation of age, gender, race, sexual orientation, and socio-economic status. Diversity and inclusion is never a solved problem. We still and always will have room to improve, and will continue working hard to ensure D&I are prioritized as we continue to grow.

Focus at Alto: Providing the best care to Alto’s patients

Why did you join Alto? I was originally drawn to Alto for the opportunity to work at a pharmacy that was questioning the status quo and because, quite frankly, I could not possibly fathom how a pharmacy could have so many positive Yelp! reviews and I needed to see it with my own eyes. I quickly learned that the “Patients Come First” mentality was not just for show — it is brought to life every day through our incredible team and serves as the North Star for every strategic decision we make as a company.

Background: CVS Health, Walgreens, Northeastern

Focus at Alto: Keeping patient and provider information secure

Why did you join Alto? As a parent and patient, I am constantly frustrated by how hard it is to interact with doctors and data, in the name of security and privacy. I believe that we can secure patient data, protect their privacy and still make care accessible and convenient. I joined Alto Pharmacy because their passion for patients aligned so well with this belief. Alto feels like the kind of place I can be impactful. Also, the day I interviewed, they had a holiday cookie exchange and I’m a sucker for homemade baked goods.

Background: Mango Health, HP, Fortify Software, MIT

Focus at Alto: Building products that simplify medication management and improve health outcomes

Why did you join Alto? I love working on complex problems and creating user-friendly products to improve people’s lives. Everyone is a patient at some point in their lives, and we can make the experience so much better! The team here rallies around that mission, and approaches each decision with openness, rigorous intellectual honesty, and the desire to improve patients’ lives.

Background: Tesla, Boku, Intuit, QuestBridge, Stanford

FRANCES SCHENDLE, General Manager of Fertility

Focus at Alto: Developing and growing Alto’s Fertility Services

Why did you join Alto? In all my years in healthcare, I have never heard of a pharmacy creating an awesome experience for patients and clinicians! I wanted to be a part of this team’s mission to make healthcare simpler and more affordable for patients. The fertility space is a particularly meaningful area for me, as it is growing quickly but is still such a confusing and expensive journey. I believe Alto’s technology and dedicated fertility team are making this a more positive experience, and I’m excited to share that with more women and families.

Focus at Alto: Building products that transform pharmacy operations

Why did you join Alto? The two most important factors for me in a career move are 1) a clear, compelling company mission and 2) a strong yet humble team. When I met the Alto team, I was thrilled to find not only these attributes, but so much more to love. The founders set out to solve a hard problem, bought a brick and mortar pharmacy to learn the ropes, developed empathy with doctors, pharmacists and patients, and then built products that solved some of their thorniest problems. This approach demonstrates a hard-to-find mix of drive, fearlessness, humility and talent that I saw in droves as I met the rest of the Alto team. As someone who believes healthcare has to be so much better, I’m thrilled to spend my day contributing to that mission, with a team that inspires me… and shares lots of laughs every day!

Background: Granular, Inkling, BrightRoll, Apple, MIT, Berkeley

Blog

Building a Better Pharmacy

Breaking Open the Black Box of Medication Pricing

More Choices and Control With New AltoMD Notifications

Bringing Alto to a Neighborhood Near You

Take Control of Your Prescriptions With New Features in the Alto App

Track Every Prescription Through Every Step

Help Us Shape the Future of Healthcare

Are You Right for Alto?

"Work With People Who Share Your Passion"

How Alto Pharmacy Is Using Tech to Put Patients First

AltoMD Saves Times and Adds Transparency

Women Leading the Way

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