Matthew Holt

Matthew Holt
Matthew Holt is the founder and publisher of The Health Care Blog and still writes regularly for the site. He is also the co-founder of the Health 2.0 Conference, as well as a Founding Principal of the associated consulting firm Health 2.0 Advisors.

Don’t like CB Insights’ numbers? Just wait…

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Last year I got in a modest Twitter spat with Anand Sanwal the CEO of investor analytics company CB Insights. Anand writes a very amusing newsletter, has built a wildly successful business tracking venture investing (at $20-50K a client) and has recently taken on $10m in VC himself to build out his business which was already profitable. The spat was because in August 2015 (5 months ago) CB insights said that “Digital Health” investments totalled $3.5 billion in 2014. You can go read the article Stephanie Baum concocted from the Tweetstream but my point was that when CB Insights, a generalist analyst company, said that the investment in digital SMAC health was $3.5bn in 2014 they were wrong because 4 specialists (Health 2.0, Mercom, Rock Health and Startup Health) all said it was over $4.5bn.

What’s a billion between friends? Not much, but what I left unsaid until now is that if they’re 25% off the average in one sector, where are they in the other sectors they cover? But other than a few amused readers of MedCity News no one much cared and the world moved on.

Then everyone stared putting out their Q4 2015 numbers. Amusingly, but probably only to me, both Rock Health & Startup Health put out their Q4 numbers 2 weeks before the quarter/year ended, and missed a bunch of late deals! But by the time the revised numbers came in everyone was again in that middle $4 billion range and there was general agreement that funding was about flat in 2015 compared to 2014–albeit at a high level compared to what the Cinderella sector had been recently.
Health 2.0’s numbers in our report were $4.8 billion for the year, as shown on the left. (You can see more on these and some other data in our Q4 report here. In case you don’t know I co-run Health 2.0 as my day job and yes I own THCB). OK. All so far so ho-hum.

Then as the other numbers started coming out I noticed something a little odd. CB insights came out with its numbers for 2015, but something was different.
You’ll recall that I had poo-poohed their 2014 number shown as $3.477 Bn in their blog post here and displayed in the chart below. These are 2014 numbers shown in a post about investment in 2015, published in August 2015. CB Insights chart with 2014 $$ in Aug 15 And that was the number I’d started the original spat about. But when I looked at the post they released in January 2016, not only was the number for 2015 at $5.7 billion (remember Rock Health, Mercom & Health 2.0 all put it in the mid-high $4s) but the 2014 number had somehow climbed from about $3.5 billion to $5.1 billion. CB Insights chart with 2014 $$ in jan 16 Again check the January post and check the chart I’ve lifted from it below. You’d think this was a curious jump and you’d be right. But nowhere in the post does it say why the total for 2014 in August 2015 was so different from the total for 2014 in January 2016.

Of course being the troublemaker I am, I asked about this on Twitter and got a classic no reply from Anand at CB insights. sanwal
So then I sent all this info off to Stephanie Baum at Medcity News thinking that she might like to write more about it.

And a funny thing happened. Instead of writing the article I wanted her to write (i.e. this one!) She found yet another number for 2015 from CB Insights, and wrote about how they were now back in the pack with everyone else.

Matthew’s Issues & Charities at end 2015, start 2016

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Every year (well almost) I write a letter to friends and contacts about which charities I give to and which issues I support, and recently I’ve been posting it on THCB–hey I own the joint so who’s going to stop me!. Here’s this end/start year edition–Matthew Holt

Yes another year with a Matthew issues letter nearly missed but not quite. I’m poolside in Maui winding down as much as possible when on a vacation with little kids and I’ve missed getting this out for end 2015 but because of the weekend 2016 isn’t really here yet, and I’m finally hammering out my end of year news, gossip, charities and issues letter. A couple of weeks ago someone asked me how the new year was shaping up, and I told them I was about ready for 2012….and I still feel the same way. I seem to spend more time reading articles on the habits of productive people than actually being one …thanks Buzzfeed!

If you don’t know, this is a letter I write mostly to myself about what happened in what’s now last year and what I should do about it–in terms of making charitable donations while it’s still 2015, although I must confess that I sometimes give money on Jan 1-2 and claim it on my taxes for the year before, so I hope the NSA isn’t sharing this email with the IRS. People do ask me about it every year, sometimes in advance, so hopefully it’s not a waste, and if you don’t care then hit delete, or go onto the next fascinating Facebook article on 15 celebs that look gross after plastic surgery, or whatever….and I love comments on the blogs/Facebook/Twitter or by email, so please let me know what you think.
 
The main stuff is the issues below, but quick update on me and mine. Aero (1), Coco (4) and Amanda (unspecified) still continue to interrupt my attempts to waste my life away. Amanda says that my appeals for a diaper changing robot are unnecessary as Aero only has about 2,000 changes to go. She does say though that I might soon need one, Health 2.0 had a great year with our biggest ever crowd in Santa Clara plus 2 other successful conferences in the US plus others in Europe (Barcelona) Korea, Latin America  (São Paolo) and Japan, where I had great fun this November. I also snuck in a trip to Finland to talk about Health 2.0 (12 mins of fun here) at the wonderful SLUSH conference and had a cold plunge after a sauna, leading to my most viewed and commented Facebook video post ever! (Thanks to my host Pekka Sivonen). Thanks to everyone who worked for, volunteered at, spoke at or came to a Health 2.0 conference. 
 
In addition due to the work of  my long suffering partner Indu Subaiya, and our New York team led by Graeme Ossey & Jen David we now have a really vibrant business running challenges and pilots, including a huge new project for the World Bank exposing hospitals in India to new technology. You can also very occasionally see me write on The Health Care Blog which I own while John Irvine manages it (well sort of!!)
 
But this email isn’t about that, it’s about about issues, charity and politics—I missed end of 2013 but 2014’s was pretty good, so much of this is a minor update. If you want to see the past editions here’s 20122011 2010 20092008 and you can search back to 2002 (first one was either 2000 or 2001 but either way it was pre-Blogger so I dont have a copy!), As ever, this letter is about my views and suggestions for donations about health care, poverty in developing world, poverty at home, torture, drug prohibition, and other stuff…. And as I said earlier comments/insults are welcome
 
Health care & (poor) women’s & kids care
 
The affordable Care Act is finally established, having survived yet another crazy attack in the Supreme Court. And in the most expensive and inane way basically 10 more million Americans have health insurance than did before. But before you criticize, realize that this was the best that could be done given the insane politics of America and that, other than the disgraceful refusal by many southern Republican governors to expand Medicaid in southern states leaving many of the very poor uncovered, almost everyone now has the chance to be in the system–including those  people who had health conditions who were previously left to go broke or die. America hasn’t done entirely the right thing yet, but we are getting there.
 
What sadly has come into focus this year is the desperate attempts to attack women’s access to health care. If you’re a woman– especially a young or poor one who needs access to contraceptives, mammograms, cervical cancer screening, sexually transmitted disease testing, and all kinds of health procedures including safe abortions, it’s become the mission of mainstream Republicans to stop you getting them–using disgusting, deceitful, and downright illegal methods. And that’s as polite as I can say it. So my biggest bump in funding this year went to the one organization that consistently not only campaigns for but actually provides reproductive health services (including contraception, STD testing, counseling, pregnancy support and, yes, safe abortions), Planned Parenthood. I cannot believe that men want to live in a world where women cannot get these services, although I guess the evidence shows enough do….especially in Texas, Louisiana, Indiana and many more.

Finally Coco’s first pediatrician, the amazing Nadine Burke Harris just got a big grant to study the impact of Adverse Childhood Events.. Worth checking out some information about that here (no donation required!) 

The End Game–Live in Finland!

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some_1Today I am in Finland at the Vertical digital health accelerator, part of a really impressive network of accelerators and incubators in Helsinki. Tomorrow is the huge SLUSH festival at which I (plus Steven Krein of Startup Health) will be talking on Thursday. Today, I’m speaking and moderating a great seminar with excellent speakers at Vertical for the End Game.

The End Game
 is a thought leader seminar that finds answers to questions. The most insightful speakers from around the world will talk about digital health. Speakers include the Head of Health & Medical equipment division of Samsung France, the Head of Healthcare of Telia, and many others including Luis Barros VC expert from Boston.

 

The seminar is streaming live on www.endgame.fi on November 10th at 3pm Finnish time (8 am ET, 5 am PT) The video will also be available for later viewing.

Five takeaways about the Theranos broo-ha-ha

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You’ve probably seen by now both that the WSJ’s John Carreyrou has run a well researched hit piece on Theranos and that the company, led by wunderkind Elizabeth Holmes, has somewhat muffed its reply. If you haven’t, best thing is to read the Roger Parloff Fortune piece which summarizes the pay-walled piece so you don’t have to do the painful task of sending Rupert Murdoch money. Now in the spirit of FD I need to let you know that we’ve invited Holmes to speak at Health 2.0 twice and her PR handlers have been unbelievably hard to communicate with. They’ve either flat out ignored us or taken forever to turn us down, even though she’s appeared often at (what I at least consider) much less important or relevant venues. I have no idea if she’s badly advised, wanting to stay away from sophisticated health tech audiences, or if her handlers decided that we and our 2,000 strong crowd are just not cool enough for her. Or maybe simply her calendar hasn’t allowed it. Either way I have no first hand knowledge of her or the product–although Elizabeth our invite is still out there! But I do know five things.

1) Lab business decentralizes & democratizes. Whether or not Theranos is lying, cheating, not using its own tech, or its cool stuff just doesn’t work, the trend towards comprehensive, cheap and soon at home lab testing is clear. More than 5 years ago a company called BioIQ was selling at home fingerstick based cholesterol & glucose tests. In the past year the two stage Nokia Sensing XCHALLENGE (of which we hosted stage 1 at Health 2.0 in 2013) has revealed a plethora of companies taking minute quantities of blood, pee or spit and doing complex diagnosis from them. And it’s not stopping there. The next phase is using light and other sensors to diagnose direct from the skin. Whether or not the locus of activity ends up using Theranos at Walgreens or the kitchen table using something else, the dam holding back continuous, cheap multi-faceted testing is going to burst soon.

2) Theranos and Holmes are not the most important thing in health care. There, I’ve said it. While Holmes has talked a lot about revolutionizing health care access and has given lots of transparency into Theranos’ pricing if not its testing technology, what they’re up to is getting easier access to lab tests. I think this is very important and a very good thing, but no one can seriously believe that this is the biggest change in health care. It’s part of a trend towards consumerism. But I’d argue the most important trend in health care is the redesign of chronic care management, on which we spend a shed-load more than lab testing. I may be wrong but if you insert your pet issue here, I’d bet it’s not cheaper lab testing. The media has been a tad snowed by the “youngest female billionaire” and “blonde Steve Jobs” analogies, but even if she runs the field and takes over most lab testing, it’s an incremental change not a huge revolution in health care.

Indu & Matthew talk Health 2.0 with Lisa & Dave

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One of the most insightful and funniest writers in health care is recovering VC Lisa Suennen. With trusty sidekick Dave Shaywitz, she’s been doing Tech Tonics, one of these newly trendy (again) podcasts. And Sunday at Health 2.0 they interviewed my partner Indu Subaiya, and me. Want to know a little more aobut the backstory of Health 2.0? Listen in!

Can We Tame The Wild West of Health Care Pricing?

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Screen Shot 2015-08-27 at 12.22.43 PMHealth care pricing is like the Wild West and it is only a matter of time before it catches up with us. In July, the Centers for Medicare & Medicaid Services (CMS) confirmed what many consumers, employers and health plans already knew: there is no cost and quality standard in the American health care system.
Improving our system starts with driving payers and consumers to high value providers. But first, we must know who is charging what. Price transparency tools offer that important information, enabling people to actually comparison shop for their health care services.

In early July, CMS released a proposed rule aiming to address price variation by starting with joint replacements. According to CMS, there were more than 400,000 Medicare inpatient joint procedures, resulting in more than $7 billion in hospitalization costs in 2013. The average Medicare expenditure for surgery, hospitalization and recovery ranged from $16,500-$33,000 depending on geography, with widely varying rates of infection and implant failure post-surgery.

To address this variation, CMS outlined a new payment model that would make some hospitals accountable for the costs and quality of care from the time of surgery through 90 days after.

The New Laws for Hope(Lab)

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HopeLab, which is funded by the Omidyar eBay fortune, has for near a decade produced games to promote kids’ health, like Re-Mission for kids with cancer, and Zamzee, promoting activity for all children. But the real impact on the population of poor health environments for kids is only really just starting to be acknowledged more generally in society.

So it’s fabulous that HopeLab has appointed a new CEO, Margaret Laws. She was previously responsible for CHCF’s Innovation Fund, aimed at getting technology to move the needle for the underserved. She took the time to explain to me why she took her new role (think impact on children and their communities). And on a personal note, having known Margaret for several years, I think HopeLab made an excellent choice. This is a fascinating interview, even if the headline may be the worst pun in THCB history. Margaret also suggests where partners both in the health world and the tech world might work with HopeLab.

Intersystems emerging from behind the scenes

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I’m steadily getting all those interviews I did 3+ months ago at HIMSS up onto THCB. (For those of you not paying attention we had a bunch of tech issues at THCB needing a big change and had to forswear videos for a while. But we’re baaack…)

Intersystems has grown dramatically in recent years as its Cache database tends to get sold in conjunction with Epic’s EMR. But Intersytems not only has its own EMR (sold outside of the US) but is a big player in the HIE business. At HIMSS 2015 they unveiled a new solution called the “Healthshare Personal Community” which allows providers and others to build patient accessible records on top of their HIE solution Healthshare. I interviewed Paul Grabscheid, VP of Strategic Planning about the company, the technology and what he’s seeing. (Ignore the last question as I ran out of disk space before he could answer!)

Dan Burton explains what Health Catalyst does!

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I’m steadily getting all those interviews I did 3+ months ago at HIMSS up onto THCB. (For those of you not paying attention we had a bunch of tech issues at THCB needing a big change and had to forswear videos for a while. But we’re baaack…)

Dan Burton is CEO of Health Catalyst which is a data warehousing and analytics company that’s seen remarkable growth by selling to big names like Kaiser, Partners & Allina. It’s raised over $150m and has even gone at risk with Allina over outcomes–to show how confident they are in their data and analytics. This is a very interesting interview about a company that’s at the crux of the world of clinical data management, with over $100m booked revenue in 2014.

Dan will also be interviewed at Health 2.0 this fall as one of our “3 CEOs”. (And FD Health Catalyst is a THCB sponsor, but as I tease Dan they’re also in the conference business themselves, running the Health Analytics Summit!)

Xerox is extending to consumers & communities

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I’m steadily getting all those interviews I did 3+ months ago at HIMSS up onto THCB. (For those of you not paying attention we had a bunch of tech issues at THCB needing a big change and had to forswear videos for a while. But we’re baaack…)

This interview is with Xerox’s Tamara StClaire (Chief Innovation Officer, Commercial Healthcare) and Gail Croall, Chief Medical Officer, Healthspot.

Xerox has a big business in inpatient analytics–I interviewed Justin Lanning who runs their Midas+ Division back in 2012, and does lots of government based claims-processing (especially for Medicaid) and customer service centers. It even was one of the many companies building health exchanges (and struggled like many others!). In May this year (after this interview was shot) Xerox bought a community based visualization company called the Healthy Communities Institute which sells dashboards about public health issues to towns and counties–and has been a big player both at Health 2.0’s Healthy Communities Data Summit but also winning a couple of our challenges.

In late 2014 Xerox invested in Healthspot a telehealth company that builds kiosks. That partnership is the main focus of this interview. Below the fold there’s another video which is a tour of the Healthspot hub that you can expect to see cropping up in RiteAid pharmacies across Ohio and later the nation.