Vital Signs with Jacob Effron and Nikhil Krishnan – Details, episodes & analysis

Jacob sits down with Kristina Saffran, the Co-Founder and CEO of Equip. Equip delivers at-home, virtual eating disorder treatment for both adolescents and adults. They discuss Kristina’s journey to founding Equip, getting payors on board, evidence-based treatments for eating disorders, and more.

[0:00] Intro

[1:06] Kristina's Personal Journey

[3:27] Founding Project Heal 

[4:07] Challenges in Eating Disorder Treatments 

[5:15] The Role of Evidence-Based Treatments 

[6:40] Transition to Venture-Backed Startup 

[13:33] Virtual Care Model for Eating Disorders 

[17:23] Adapting Treatment for Different Populations 

[22:42] Working with Insurance Companies 

[24:37] Equip's Year-Long Care Program 

[25:15] Challenges in Operationalizing Innovative Payment Models 

[28:21] Patient Archetypes and Outreach Strategies 

[32:41] Provider Education and Partnerships 

[34:16] Growth and Future Plans for Equip 

[39:07] The Role of Peer Support in Treatment 

[43:05] Quickfire

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Savvy CEO Suril Kantaria to discuss the future of the ICHRA market and what he would do differently if he was starting Savvy today.

[00:00] intro

[00:35] ICHRA

[06:20] is this better for employees?

[15:20] is ICHRA policy doomed to fail?

[19:10] venture’s role in healthcare

[24:00] early founders building in “stealth”

[29:00] making the decision to “stop” as a founder

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Dr. Amy Abernethy, whose health tech career spans from clinician and researcher to CMO at Flatiron Health to Principal Deputy Commissioner and Chief Innovation Officer at the FDA to CMO and President of Product Development at Verily to co-founder of her own non-profit to accelerate evidence generation. They discuss the current and future states of real-world evidence, how clinical research can improve, the adoption of GenAI in healthcare, Verily’s growth story, her new venture, and more.

(0:00) intro

(0:40) real-world evidence

(13:48) the future of control arms in clinical trials

(22:16) startup ideas

(25:04) generative AI in healthcare

(27:18) regulating AI

(35:09) the evolution of Verily

(38:26) what is next for Amy?

(42:59) over-hyped/under-hyped

(43:37) one policy change to improve healthcare in the U.S.

Out-Of-Pocket: https://www.outofpocket.health/

Oscar Health is a $4B public healthcare company, providing healthcare insurance to nearly 1 million members. Oscar is at the forefront of AI adoption, continuously developing new AI use cases in healthcare. On this week’s episode, we sat down with Oscar Health Co-Founder, former CEO, and now President of Technology Mario Schlosser to talk about where AI will have the biggest impact in healthcare, limitations of GPT-4 in healthcare, and why can't we have robot doctors today.

(0:00) intro

(1:06) how will AI change healthcare in the next decade

(9:09) how Oscar uses AI

(18:40) how to build around healthcare requirements

(25:46) when would GPT-4 fail "miserably" and fundamental limitations of LLMs

(36:28) we shouldn’t piss off our smartest robots

(38:15) sharing AI knowledge between companies

(41:50) developing healthcare-specific models

(44:35) hackathons and karaoke nights at Oscar

(49:07) the need for a safety layer in LLMs

(51:33) best commercial opportunities in healthcare

(55:19) will their be AI doctors this decade?

(59:18) over-hyped/under-hyped

(1:00:49) most exciting AI company?

(1:08:46) over-hyped/under-hyped

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Sarah London, CEO of Centene Corporation, the largest managed Medicaid organization in the country, serving 15 million Medicaid members. They discuss Medicaid partnerships and redeterminations, SDoH innovation and outcomes, and payers vertically expanding their ownership.

(0:00) intro

(0:39) Centene’s footprint today

(1:37) working with startups

(6:24) Centene’s priorities

(12:23) how state RFPs have changed over time

(15:04) differences between states

(18:40) Medicaid redeterminations

(22:35) will every payer end up looking like United Optum?

(29:09) what kind of data is most helpful?

(31:46) where Gen AI can be implemented in healthcare

(35:20) ICHRA markets

Out-Of-Pocket: https://www.outofpocket.health/

Jacob sits down with Dr. Ezekiel Emanuel again to discuss the future of health policy and care delivery, hyped innovations in healthcare, market trends among payers and providers, and more. 

(0:00) intro

(0:57) generative AI

(4:08) the ethics of NOT using AI

(7:04) ML-based risk adjustment

(11:46) why didn’t hospitals become payers?

(19:37) what does the future of hospitals look like?

(26:15) can insurance cover mental health treatment for everybody?

(29:45) GLP-1s

(35:02) the future of healthcare policy

(41:07) what should we be learning from the way other countries do healthcare?

(45:57) Ben Franklin

(49:37) Zeke Bar update

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Toyin Ajayi, Co-Founder and CEO of Cityblock Health, an SDoH-focused provider of primary care, behavioral health, and chronic disease management for Medicaid and dual eligible patients. They discuss innovating in Medicaid, engaging patients with digital solutions, building sustainable companies, and more.

(0:00) intro

(0:50) the state of Medicaid innovation today

(2:33) Toyin’s time at Commonwealth

(7:33) incubators in the current climate

(11:02) biggest risks starting Cityblock

(14:46) surprises in building Cityblock

(23:06) how Cityblock chooses which services to offer and which to outsource

(29:22) lower acuity patients

(33:23) state-by-state differences

(37:59) policy changes to improve Medicaid

(42:15) a shift towards profitability

(45:01) generative AI

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil sit down with Marta Bralic Kerns, Founder and CEO of Pomelo Care, a multispecialty virtual medical practice that cares for mothers and babies from preconception to one year postpartum. They discuss payer contracting and Medicaid, career advice for those joining startups, why maternity care is such a pressing issue in the US, and more.

(0:00) intro

(0:47) maternity outcomes in the U.S.

(5:39) clinician supply issue

(6:56) how Pomelo Care works

(12:20) how patients find Pomelo

(15:21) how Pomelo fits into the healthcare journey after pregnancy

(17:06) pitching Pomelo to payers

(24:16) Pomelo’s Medicaid focus

(26:59) state-by-state differences in maternity care

(30:30) constraints to growing Pomelo

(31:34) team-based maternity care

(34:19) how to sell to payers

(40:43) advice for people early in their health-tech careers

(45:32) Flatiron and EHRs

(51:17) over-hyped/under-hyped

(53:06) NOT hiring Nikhil

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil speak with Farzad Mostashari, Founder and CEO of Aledade, which supports independent primary care practices to succeed in value-based care. Farzad talks about the current evidence of success in VBC, why VBC is still underhyped, barriers for Medicaid models, and more.

(0:00) intro

(0:40) why we don’t see more doctors starting their own practices

(8:32) what actually works in value-based care?

(11:48) what does Aledade do?

(23:18) how competitive has it become to acquire new practices?

(28:29) Aledade First

(37:27) one policy change Farzad would make in healthcare

(42:18) best way to learn more about Aledade

Out-Of-Pocket: https://www.outofpocket.health/

Jacob and Nikhil speak with Heather Fernandez, CEO and Co-Founder of Solv, a company that focuses on getting people access to high-quality, last-minute care. Heather discusses the future of urgent care, operating a digital health company during Covid, crafting a strong go-to-market strategy, the role of private equity in urgent care, and more.

(0:00) intro

(3:07) what is Solv?

(10:50) why is scheduling so bad in healthcare?

(16:03) is urgent care a net good?

(20:35) areas where urgent care can improve

(24:07) will urgent and longitudinal care combine somehow?

(25:31) Solv during Covid

(32:54) state by state healthcare nuances

(39:16) private equity and urgent care

Out-Of-Pocket: https://www.outofpocket.health/