APPLY FOR THE ANTHEM SHOWCASE

APPLICATIONS HAVE NOW CLOSED - PLEASE DO NOT APPLY AS YOUR APPLICATION WILL NOT BE CONSIDERED

All applicants to The Anthem Showcase will be automatically entered into Anthem's Fast Track to Scale Accelerator application process and be assessed by the criteria for that program.

The Fast Track to Scale Accelerator looks for startups with the ability to both transform the health care system and impact whole health, a vision of the health care system that continuously supports and improves our overall health rather than only intervening when we are sick. Specifically, the Fast Track To Scale Accelerator 2021 Program will focus on solutions that address:

• Behavioral Health
• Population Health
• Chronic Condition Management
• Price Transparency
• Medication Adherence

Anthem is looking for solutions that address long-standing social injustice, racial inequality, and health disparities in America and deliver support and relief to all affected by the COVID-19 pandemic.

Company Name *

Company Website *

Brief Description of Company *

First Name *

Last Name *

Role on team

e-mail *

Phone Number

Form of Address

Street/PO Box

City

State

Zip code

Country *

Please select which focus areas your solution addresses. Focus Area 1 *

Focus Area 2

Focus Area 3

Approach: Describe your company’s approach and why it is effective in addressing the selected focus areas? *

Impact: How would your solution impact users’ ease of use, digital engagement, and personalization? How would your solution change the overall experience of patients, providers, payers, and other stakeholders? *

Competitors: Who are your top three competitors? What are your primary advantages relative to your competitors and how will you sustain these advantages? *

Development & Validation: Please explain how you have engaged with relevant stakeholders regarding your solution and how this has impacted your development. *

Data: What type of data does your solution require and where do you source or expect to source this data from? *

Policies: What policies and procedures do you have in place to ensure appropriate levels of privacy, encryption, security, and authentication? *

Privacy: Please describe your company’s privacy practices *

Operations & Security Control: With respect to your company’s IT, architecture and security infrastructure, please provide a high level summary of your operations and security controls. *

Regulatory Approvals: What regulatory approvals do you anticipate that your solution requires? *

Clinical evidence (if applicable) Have you participated in clinical studies to validate the effectiveness of your solution?

Goals: Why do you want your company to participate in this Program? How will this help your company achieve is goals? Please explain what success looks like?

Please attach a link to a non-confidential pitch deck describing the details of your technology or idea, elaborating on your product differentiation or competitive advantage, and explaining your potential fit with Anthem. *

Please provide a link to any additional materials relevant for us to review. Technical architectures, clinical publications, videos, etc. *

What is the legal structure of your team? *

Incorporated Entity

Team (not incorporated)

Limited Liability Company

Other

Team Members *

Diversity: Please outline how you promote diversity and inclusion within your company? Does your solution(s) include features that are conscious of diversity and inclusion? *

Structure: Additional notes about team structure

Have you received funding? If yes, please indicate source (angel investing, venture, capital, government or foundation grant, friends & family, venture & traditional debt, competitions or other), amount and date

Total 12 month Revenue *

Total Cumulative Revenue *

Are you currently or have you previously piloted your solution? If yes, please provide a breakdown of the pilot and the traction.

Partners: Who are your current partners? Do you partner with any health insurers? If yes, please outline the arrangement. *

How did you hear about the Challenge?

Do you agree to the Anthem Challenge T&Cs?

Yes

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Yes

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APPLY FOR THE ANTHEM SHOWCASE

Telehealth Online

8-10 September, 2020

Virtual Event | EDT Time Zone