Can Startups Save Primary Care?

Today, primary care is considered the bees’ knees of value-based care delivery. Instead of being viewed as the punter of the football team, the primary care physician (PCP) has become the quarterback of the patient’s care team, calling plays for both clinical and social services. The entire concept of the accountable care organization (ACO) or patient-centered medical home (PCMH) crumbles without financially- and clinically-aligned PCPs. This sea change has resulted in rapid employment or alignment to health systems, as well as a surge in venture capital being invested into the primary care space.

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3 Reasons Why Healthcare Startups Fail

I’ve read countless articles pontificating about why digital health and healthcare startups often fail. Or at the very least, why we rarely see the break-out successes in healthcare enjoyed in the consumer tech or social media space. The realest article was written by Neal Khosla, who likely gave some founders and investors PTSD over his description of the challenges faced. Now I’ve worked in strategy for a hospital, health plan, and healthcare technology company, and still feel somewhat unprepared to offer a bulletproof opinion. However, I’ve received multiple requests to address this topic and therefore will try to give the people what they want. In reality, there are literally a million reasons why healthcare startups fail. Bad founders. Unable to pass FDA approval. Inability to receive patient or physician adoption. No legitimate reimbursement. HIPAA and regulatory barriers. And a ton of other reasons. Rather than boil the ocean, I will now dive into 3 factors that I believe disproportionately take the cake.

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Recap from the 17th Annual HBS Health Care Conference

So… I just returned from the 17th Annual Harvard Business School (HBS) Health Care Conference. The running theme of the conference was moving from healthcare to whole person care. Despite the frigid temperatures, the event warmed my heart with attendees full of promise for the healthcare industry. I will admit, it was a bit of a lovefest for Harvard alumni and students, but who can really blame them? They all got into the Michigan of the East… joking. Shout out to the conference organizers, Olivia vonNieda, Bhumika Agarwalla, Jay Thaker, Soltan Bryce, and many others for planning the event! But since many of you could not attend, here’s my breakdown of the conference takeaways.

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What Healthcare Tech Startups Should Know About ACOs

Every week I speak to a healthcare entrepreneur who is building a technology company that will “enhance value-based care” and “improve care coordination”. Shortly after this initial description, the founder typically mentions Accountable Care Organizations (ACOs) as a primary target for their sales strategy. Having worked around ACOs for the past 6 years I’ve always found this particular stakeholder to be an interesting first choice for startups looking for product-market fit. However, these startups are not alone. When I type the phrase, “Care Management” into the business information site Crunchbase, I see 711 results of companies who use that exact terminology in their summary description. “Population Health” has 449 companies and “ACO” has 87 companies. So… instead of having many more calls with founders looking for general advice on how to penetrate the ACO market, I figured I’d just write out some of my thoughts here.

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Why the Centene and WellCare Merger is the Biggest Deal in 2020

I feel like the healthcare world just skipped over the $17.3 billion mega-merger between Centene and Wellcare, which just received final regulatory approval last Wednesday. With their powers combined, this new company will create the Thanos of government-focused health plans, hopefully without any of the deranged plans to take over the world. I do get it, 181 million lives are covered by employer-sponsored insurance, between full-risk and self-insured plans. These employer populations have the most disposable income and their HR departments are willing to provide supplemental benefits. However, in my opinion, the future growth of health insurance will be governmental programs like Medicare Advantage (MA), Medicaid managed care, and ACA exchanges. But instead of me telling you this, here is exactly what Centene and WellCare said in a press release to defend the merger:

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Never Miss Another Slice Again.