Nate Maslak, CEO of Ribbon Health talked with me late last year (2021) after his $40m round from General Catalyst and Andreesen Horowitz. We dug into the really thorny problem of information about physicians. This has so many facets and ramifications but most people only see it when their doctor somehow isn’t in their health plan’s network. But it’s much, much more than that. Nate joined me in nerding out on this topic and explaining how Ribbon is working to fix it — Matthew Holt
Above the Fold
#Healthin2Point00, Episode 246| Healthcare.com, Found, Well, Gamer Health, Belong Health
HAPPY NEW YEAR!!! Let’s break Jess’s New Year’s Resolutions a tiny bit and look at some 2021 healthcare deal holdovers. Healthcare.com raises $180 million, bringing their total to $212 million; Found raises $100 million, bringing their total to 132 million; Well raises $70 million, bringing their total to 135 million, and Garner Health raises $45 million, bringing their total to $70 million.
-Matthew Holt
Simple Bills are Not So Simple
By MATTHEW HOLT
I went for an annual physical with my doctor at One Medical in December. OK it wasn’t actually annual as the last time I went was 2 & 1/2 years ago, but it was covered under the ACA, and my doc Andrew Diamond was bugging me because I’m old & fat. So in I went.
I had a general exam and great chat for about 45 minutes. Then I had blood work & labs (cholesterol, A1C, etc) and a TDAP vaccination as it had been more than 10 years since I’d had one.
Today, about one month later, I got an email asking me to pay One Medical. So being a difficult human, I thought I would go through the process and see how much a consumer can be expected to understand about what they should pay.
Here’s the email from One Medical saying, “you owe us money.”
Continue reading…The Simpson’s Explain Healthcare
By KIM BELLARD
Happy New Year! We’re starting 2022 full of hope and renewed optimism. Oh, wait; not so much. We’re not only still in a pandemic, the Omicron variant is the most infectious one yet. Daily cases are setting new records. Our hospitals are full again. Our beleaguered healthcare workers – the ones who haven’t already thrown in the towel – are at their breaking points. Two years in, and we still don’t have enough tests. We’re in the greatest public health crisis in a century, yet our legislators are taking power away from public health officials, and their angry constituents are forcing many of those officials to quit. We have effective vaccines, but millions still refuse to take them.
The Simpsons – especially, Homer — has the right word for this: D’oh!
Continue reading…Fall Risk: It’s All in Your Head
By HENRY MAHNCKE
More than one in four senior citizens fall each year, making it the leading cause of both fatal and non-fatal injuries in older adults. Anyone with a loved one at high risk of falls can tell you it creates constant worry and curtails many of life’s pleasures. And, if that loved one has fallen and broken a hip, too many of those caregivers can share the oft-told tale of how that break was the beginning of the end.
As our population grows and ages, the costs of this widespread risk multiply. However, recent breakthroughs in the science of brain health demonstrate that we could be taking relatively low-cost, highly scalable, steps to reduce these risks.
Continue reading…Rooting For Schumpter’s Gale
By KIM BELLARD
Not familiar with Schumpeter’s gale? You may be more familiar with the term “creative destruction.” Schumpeter’s “gale of creative destruction” is the inevitable “process of industrial mutation that continuously revolutionizes the economic structure from within, incessantly destroying the old one, incessantly creating a new one.”
We need a Schumpeter’s gale in healthcare.
Continue reading…THCB Gang Episode 76, Dec 23 1pm PT – 4pm ET
This is the last THCB Gang of what has been a long, grueling, but enthralling year. And every week (well almost every week) we have had a group from across the health care luminescence to discuss it.
Joining Matthew Holt (@boltyboy) on #THCBGang at 1pm PT 4pm ET Thursday for an hour of topical and sometime combative conversation on what’s happening in health care and beyond will be THCB regular writer Kim Bellard (@kimbbellard); delivery & tech expert Vince Kuraitis (@VinceKuraitis); privacy expert and entrepreneur Deven McGraw (@HealthPrivacy); WTF Health host & Health IT girl Jessica DaMassa (@jessdamassa); and three occasional gang members making very welcome appearances–venture investor & soccer mogul Marcus Whitney (@marcuswhitney); surgeon & startup guy Raj Aggarwal (@docaggarwal); and health economist Jane Sarasohn-Kahn (@healthythinker).
And towards the end of the show we should have our now traditional (or 2nd time) visit from as many other gang members who can make it!
The video will be below but if you’d rather listen to the episode, the audio is preserved as a weekly podcast available on our iTunes & Spotify channels.
My 22 Oldest Jokes and Why They Still Matter in 2022
By IAN MORRISON
I have been studying American healthcare for more than 40 years and I have assembled a large number of one-liners over the years. As we enter 2022, I thought I’d share my 22 oldest jokes and why they still matter.
Coming to America
- I grew up in Glasgow, Scotland. In Glasgow, healthcare is a right, carrying a machine gun is a privilege. America got it the wrong way round.
Gun violence continues to ravage the United States. We have more guns than people. Kids get gunned down in school playgrounds and classrooms routinely. It happened once in Dunblane, Scotland in 1996 when a local shopkeeper walked into Dunblane Primary School and opened fire, killing 16 5- and 6-year-olds and their 45-year-old teacher. It so galvanized public opinion, according to Smithsonian Magazine: “By the end of 1997, Parliament had banned private ownership of most handguns, including a semi-automatic weapons ban and required mandatory registration for shotgun owners”.
Last time I looked, gun violence was the second leading cause of death in children in the US. In America when we have mass shootings all we get are thoughts and prayers.
And when it comes to healthcare as a right, even if we Build Back Better, it won’t be a right for millions of American residents, especially those who are undocumented.
- I am a Scottish Canadian Californian which gives me a unique perspective on healthcare (and all things to do with healthcare, including death and dying) because the Scots see death as imminent, Canadians see death as inevitable, and Californians see death as optional.
This is one of my oldest jokes and it remains true. In Silicon Valley, where I live, my affluent VC friends want to live forever and are working out and taking supplements to achieve that. In contrast, my British friend Dr. Richard Smith (former Editor of the BMJ) is sitting on the Lancet Commission on the Value of Death. Enough said.
Continue reading…Not Just Token Tokens
By KIM BELLARD
I recently watched some of the recent Congressional hearings on cryptocurrency, and, boy, if there’s anything funnier than watching experts try to educate most members of Congress on anything crypto-related, it’s probably me trying to explain it. I don’t own any digital assets, still don’t see the point of NFTs, and am not going to buy any real estate in the metaverse.
All that being said, there’s something about Web3 that fascinates me. Knowledgeable people are talking about Web3 “reinventing the internet,” “democratizing” it, giving people more ownership of/control over what they do on it. It’s a counterbalance to how the internet – both the traffic and the infrastructure — has grown increasingly dominated by a few very large firms, such as Google, Facebook, or Amazon.
As the Web3 Foundation declares, Web3 is an internet where:
- Users own their own data, not corporations
- Global digital transactions are secure
- Online exchanges of information and value are decentralized
All that sounds very intriguing to me, especially as someone who has dim views of how healthcare likes to silo information, has placed too little value on patient ownership of their own data, and is rushing to centralize.
Continue reading…Matthew’s health care tidbits: #DigitalHealth valuations
Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt
For my health care tidbits this week, it’s time to bring up the disconnect between the continual collapse of #DigitalHealth stock prices and the continued increase in private sector investment and valuation in the same sector.
All of nine months ago, way way back in March 2021 market leader Teladoc hit a stock price of $308. Last week it hit a low of just under $90. Meanwhile several companies have IPOed or SPACed this year and almost all of them have seen their stock fall dramatically. For example, pioneer online mental health company Talkspace is now at a market cap of under $300m. This week a different mental health company Cerebral which was only founded in January 2020 raised $300m at a private valuation of over $4 billion. Yes they could have bought out Talkspace for that amount! In October Medicare Advantage plan Devoted Health raised money at a $12 billion valuation which exceeded the market cap of rivals Clover, Bright Health and Oscar–each of which has more members.
So what’s going on? Part of this is the wash of money still going into venture funds. Interest rates are historically low, while inflation is picking up, so that money has to go somewhere. Additionally some of the companies that SPACed out were probably unable to get such a good valuation in a private round. But it can’t be that all the 50 or so public companies are lower quality than the private ones. That indicates that either the private valuations aren’t real (because there are so many protections built into the deal for investors), or that the private and public valuations are going to get closer together. There is of course one more possibility–some of the private companies may pursue M&A and buy out some of the public ones. But in any event, this current arbitrage cannot last forever.
It’s not unlikely the public stocks may pick up. But we’ve seen private and public market bubbles before and the aftermath isn’t usually pretty.
