THCB

Categories

Above the Fold

UPMC’s Rasu Shrestha on Consumer Health in ‘Big’ Healthcare

• 2

By JESSICA DA MASSA, WTF Health

The phrase ‘consumer health’ doesn’t mean what it used to. And, when you really think about it, neither does the word ‘consumer.’ We’ve changed. Wielding the power of our smart phones, wearable devices, and proximity to CVS Minute Clinics – and armed with expectations of near-instant gratification thanks to the Amazons and Ubers of the world – we’re more demanding, exacting and impatient of the health system than ever before.

As all of this starts to change demand, supply, and (fingers crossed) our entire industry, it’s tempting to focus on what the new guys are doing. I’m as guilty as any for being fixated on the doings of the big tech companies and sexy little startups that are coming into our space. But, the reality is that the greatest amount of change will have to come from those stalwarts of the ‘healthcare establishment’ – the health systems and the payers that ARE the system in and of itself.

So, how are they thinking about the consumerization of healthcare? What does it mean to ‘empower consumers’ when your organization is bearing the risk associated with caring for their lives? Lucky for us, Dr. Rasu Shrestha, Chief Innovation Officer of health-system/payer-system giant UPMC can break it down.

Warning: This interview is long and heady, but, man, is it ever worth it. Rasu talks about the macroeconomics of shifting risk from insurers to providers and consumers, business model implications for all players involved, and how the ‘free the data’ movement feeds into all this. Last but not least, he talks about the kinds of startups he’s hoping will help payers and providers usher in this new consumer-driven era.

If you’re doing any kind of business in healthcare today, you’ll want to give this a listen. And, if Rasu wants to add another doctorate to his name, this interview analyzing ‘the macroeconomics and shifting risk environment of the consumerization of healthcare’ might be the start of his dissertation. We’ll look for our @wtf_health footnote.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health. Filmed at the Bayer G4A Accelerator Launch in NYC, May 2018.

Health in 2 Point 00, Episode 49

• 1

Jessica DaMassa asks me about what I saw at Techcrunch Distrupt, Clarify Health Solutions’s $57m round, what Wellth will do with its $5m & a whole lot about next weeks Health 2.0 Conference–Matthew Holt

Livongo CEO Glen Tullman’s Advice for Startups

By JESSICA DA MASSA, WTF Health

If you’re a health tech startup, should you be building for your exit? Does that really lead to the greatest possible success for your business…if you know how to get out?

Here’s some advice from someone who should know. Glen Tullman is ‘the guy’ who took Allscripts public via a wildly successful IPO in the late-90s. He’s now the CEO of Livongo, a chronic condition management startup that rang in 2018 with a $105M mega-round raised internally among its current pool of investors – at more than two times the company’s previous valuation.

When I caught up with Glen earlier this year, it was just after his round closed, the company acquired Retrofit, and rumors had started swirling about Livongo going public. Needless to say, our conversation turned toward ‘the exit’ and I had the chance to ask what he would tell other startup founders about going IPO. What comes next is a passionate discourse about what it takes to not only exit – but raise and scale – a startup in healthcare. For being a money guy, Glen is no sell-out; young startups would be wise to take his two cents and invest them.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health. Filmed at HLTH in Las Vegas, May 2018.

Does Free Medical School Decrease Social Justice?

• 5

BY ANISH KOKA, MD

The hottest medical school in the country right now is the New York University School of Medicine thanks to the gift of a generous benefactor that promises to make medical school free for all current and future medical students.  The news was met with elation from the medical community of physicians that groans frequently about student debt loads routinely north of $200,000 upon matriculation.  Not surprisingly, the technocrat class of public health experts and economists did not share in the jubilation.  The smarter-than-the-rest-of-us empiricists are, after all, trained to think in terms of social justice and net benefits to society.   The needs of medical students are far down the list of priorities when forming this social justice utopia.

Contemporary arguments for social justice in some form or the other trace their roots to the philosopher John Rawls and his 1971 magnum opus – “A Theory of Justice”.  In words that would infuse liberal thought for a generation, Rawls laid out a blueprint for a just society by proposing a thought experiment called “the original position”.  This was a hypothetical scenario where a group of people are asked to form the rules of a society which they will then occupy. The catch is that the people making the decision do so behind a ‘veil of ignorance’ not knowing the disadvantages conferred by any number of attributes (age, sex, gender, intelligence, beauty, etc. ) they may be reincarnated with. Rawls posited that under conditions in which there was a possibility of being born as a disadvantaged member of society, social and economic inequalities would be arranged to be of greatest benefit to the least advantaged members of society.

At first glance, it would seem that the objections to tuition-free medical school rest on a social justice framework that does not seem to comport with gifts to the soon-to-be-wealthy.  After all, the $200,000 investment for medical school pales in comparison to the lifetime earnings of the average physician who is assured at least a six-figure income in seeming perpetuity. But it is not entirely clear that one has to even combat Rawlsian ideals to rebut the social justice do-gooders with strong opinions on how other people should spend their money.  A Rawlsian framework never intended that everyone in society would be able to achieve the same outcome regardless of starting position.  Rawls actually went out of his way to argue that inequalities were justified in society as long as the operating rules served to raise the position of those worst off in society.  A rising tide should lift all boats – the rich may become richer, as long as the poor become richer as well.

Continue reading…

A conversation with Dr. Nicole Saphier

By, SAURABH JHA

I have a wide ranging conversation with Dr. Nicole Saphier for JACR’s Firing Line Podcast. Dr. Saphier is a radiologist specializing in women’s imaging. We discuss screening mammograms and the breast density law. Dr. Saphier, a frequent contributor to multiple major media outlets, tells us what it means for a radiologist to opine on health policy in the national media.

About the author:

Saurabh Jha is a contributing editor to THCB. He’s the host of JACR’s Firing Line Podcast. He can be reached on Twitter @RogueRad

Physician Well-Being: Lessons From Positive Psychology

• 2

By SANJ KATYAL

The absence of burnout does not equal wellness. While the focus on physician burnout as an epidemic is finally gaining more attention, we may be missing a larger issue. Most physicians are not burned out. We are able to function. We get through our days, make it to some of our kids’ activities and even manage to go out to dinner on the weekends. We survive the work week as we look forward to our next vacation. We do this because that is what we have always done. We put our heads down and do our work. We often project ourselves past the next exam or to the next stage of our lives to help us get through the stress. We become masters of delayed gratification. We develop the mindset of “I’ll be happy when…” I get into medical school or match into a good residency spot or make partner or have enough money to retire etc…Along the way, we may have some bright spots – falling in love, having kids, taking great vacations. We may even reward ourselves for our hard work with a new car or nicer house. We deserve it. But deep inside, “something is missing”. We have achieved most, if not all of the goals we have set for ourselves. Yet despite our hard work, many of us remain unfulfilled with our careers and often with our lives. What is it that we need? A better job with more money? A different car? A different title? Better vacations?

I have struggled with these questions and many more. How do I stop wanting what I don’t have and start wanting what I do have? How can I fully enjoy the present while also preparing for a better future? How can I spend quality time with my kids while they are still around? How can I have a career that uses all of my potentials? Of all the questions that I’ve asked myself, the most important one was this – How can I learn to flourish and not just function?

Fortunately, I found answers in the relatively new field of Positive Psychology which is the scientific study of human flourishing. Unlike traditional psychology which alleviates distress and moves a patient from a -8 to a 0 or +1 (if they are lucky), positive psychology focuses on a patient that is functioning at a +1 and tries to move them to a +8 on the flourishing scale. We need both areas of focus. There are many people that are functioning well by most standards but are nowhere near their potential level of fulfillment.

Continue reading…

Disrupting the Cholesterol Test: Finnish Startup Nightingale Health

• 1

By JESSICA DA MASSA, WTF Health

Today’s cholesterol test is about to be disrupted. Nightingale Health, a five-year-old startup based out of Finland, has built a better blood test that – among other things – is about to disrupt the cholesterol test of today.

Their blood test collects 50 times more biomarker data than the standard test – boasting a 20% better prediction rate for diabetes and cardiovascular disease – and they’re offering it at the same price point as the existing industry standard. Why does this matter? Well, for clinicians, researchers, or those working on new drug development, the Nightingale test is not only offering an unprecedented amount of metabolic data, but it’s an unprecedented amount of AFFORDABLE metabolic data that can impact the health care cost curve as far as the eye can see.

What’s more – and this has gotten investors’ blood pumping – they haven’t even fully realized the full potential of their panel. Listen in as Kristiina Tolvanen talks with me about the company’s priorities to build their evidence base and find out what else their biomarker analysis platform can potentially displace. Freshly funded with a $30M round – and a very prestigious partnership with the UK Biobank to analyze 500,000 blood samples – this is one to watch.

Filmed at Upgraded Life Festival in Helsinki, Finland, June 2018. Find more interviews on health and technology here or check out www.wtf.health. 

Health in 2 Point 00, Episode 48

Jessica DaMassa asks me about Cricket Health’s $24m raise for kidney disease services, Rx.Health from Mount Sinai and a whole bunch of big money in little China. All in 2 minutes–Matthew Holt

Is Universal Health Care Socialism?

• 7

By ETIENNE DEFFARGES

The November midterms elections are approaching, and one of the major topics is health care. Democrats are campaigning on retaining Obamacare, in many cases advocating that we move towards universal health care.

That would be pure socialism, retort Republicans, who would rather repeal the Affordable Care Act as they attempted in 2017, even if this leads to 20 million Americans losing coverage.

Is Universal Health Care Socialism?

Only if we believe that every other developed market-based economy in the world is socialist since the U.S. is the only one without universal coverage. We spend almost $10,000 per year per capita on health care, about twice as much as most developed countries. However, in terms of major health outcomes, such as infant mortality or life expectancy, we are laggards. In a recent OECD survey, we ranked 27th out of 35 countries in life expectancy. Japan spends about $4,000 per year per capita in health care, yet the average Japanese has a life expectancy of 84 years, versus 79 for the average American. Why?

Every developed country other than the U.S. has had universal care for decades. While Prussia’s “Iron Chancellor” Otto Von Bismarck implemented the first universal care system…in 1883, our health care history is a patchwork of partial reforms, an inefficient collage of private and public institutions. We first tied health insurance to employment in 1946, because business and conservative opposition would not allow universal coverage; then added Medicare in 1965 so that our seniors would have coverage after they retired; then Medicaid, a different one for each one of our fifty states; Continue reading…

Health in 2 Point 00, Episode 47

Jessica DaMassa asks me about Patrick Soon-Shiong and his Verity hospital chain going bankrupt, whether Peerfit can justify its $8m raise, and who I’m going to see at TechCrunch Disrupt this week–Matthew Holt

assetto corsa mods