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/

Jacob and Nikhil sit down with Mark Cuban to discuss his pharmaceutical startup, The Mark Cuban Cost Plus Drug Company. They discuss why Mark entered the healthcare industry, competing on price, staying curious, and the future of AI.

 

(0:00) intro 

(1:05) Mark’s journey into healthcare 

(3:57) how the Mark Cuban Cost Plus Drug Company works 

(7:51) B2B angle and disrupting PBMs

(12:51) getting into biologics and biosimilars 

(24:46) manufacturing drugs 

(27:11) how much of a role can technology play in healthcare? 

(33:06) why Mark doesn’t put his name on buildings 

(35:35) over-hyped/under-hyped 

(40:08) policy changes that could improve healthcare 

(41:17) Mark’s best cameo

Jacob sits down with Marley Medical CEO Chris Hogg to discuss how he and his team select markets, think about go-to-market and utilize AI. Chris also reflects on his learnings from Propeller and more.

 

0:00 intro

1:08 digital health over the last decade

3:01 100Plus

5:45 Propeller and fitting into patients’ daily lives

12:37 is the B2B2C model flawed?

17:01 Marley Medical

19:32 selecting markets

28:23 standing out from the competition

30:23 how is Marley using AI?

36:57 over-hyped/under-hyped

Jacob sits down with Amir Dan Rubin, the CEO and Founding Managing Partner at Healthier Capital. Amir previously served as the CEO of One Medical and Stanford Health Care, as well as an EVP at United/Optum. They discuss payer-provider integrations, lessons learned from leading One Medical, applications of generative AI, and more.

 

(0:00) intro

(0:44) when does venture capital make sense in the healthcare world?

(3:04) the future of health systems as we move towards value-based care

(5:14) dealing with staffing shortages and leveraging new technologies

(11:49) hospitals investing in companies

(16:13) the gold standard of United Optum

(18:57) is the payer-provider combo inevitable?

(27:21) the key to successful acquisitions

(33:36) Amazon’s acquisition of One Medical

(38:25) over-hyped/under-hyped

(40:23) surprises and decisions at One Medical

 

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

Jacob and Nikhil sit down with Sean Duffy, the CEO of health tech unicorn Omada Health, to discuss how Omada is using Large Language Models and incorporating GLP-1s into its care. They also hit on how Omada has thought and evolved its employer pricing.
 

0:00 intro

0:43 starting Omada Health

5:14 how Omada differs from Sean’s original vision

8:58 evolving employer pricing

16:31 how the care model has changed over time 

19:25 GLP-1s

27:14 how Omada has incorporated AI

36:12 Livongo-Teladoc merger

40:20 coining the term “digital therapeutics”

43:14 over-hyped/under-hyped

44:47 policy changes that could improve healthcare

Jacob sits down with PathAI Ceo Dr. Andy Beck to discuss the state of AI adoption in diagnosis, why Path acquired their own lab, pathologists' jobs in the future and nailing GTM to reach a ~$1B valuation. 

 

00:00 intro 

01:01 pathology and AI 

13:30 nailing go-to-market strategy 

19:47 how pathology labs can go digital 

25:36 regulatory frameworks and roadblocks 

33:05 do improvements in foundation models impact PathAI? 

36:26 standardizing diagnoses 

40:05 how will the job of a pathologist change going forward? 

42:35 NASH 

47:30 working in Daphne Koller’s lab

Jacob and Nikhil sit down with Dr. Austin Chiang, an interventional GI doc and Chief Medical Officer of Medtronic’s GI business who also has >500K TikTok Followers. We discuss how social media companies deal with public health issues, how doctors can use social media, lessons from being a “physician influencer,” the consumerization of GLP-1s and more.

 

0:00 intro

1:02 how Austin got into medicine and social media

4:59 highlights and lowlights of being a recognizable figure in the medical world

8:47 balancing engagement with education

25:22 how to steer away from misinformation

30:51 the consumerization of GLP-1s

39:24 tips for doctors on social media

45:45 how to market to physicians

47:31 public health campaigns on social media 

52:10 Austin’s favorite post

Jacob and Nikhil sit down with Dotmatics CEO Thomas Swalla to discuss R&D software, differences in software requirements across biotechs, growing through 11 acquisitions and expanding beyond life sciences. 

 

0:00 intro

0:36 getting into healthcare

5:20 what R&D looks like today

8:03 what does Dotmatics do?

13:06 differences in software requirements across biotechs

20:15 bundling vs. “best-of-breed”

23:46 do life sciences need their own data tools?

26:44 incorporating AI into Dotmatics tools

34:38 AI replacing scientists

37:39 how Dotmatics tools can serve companies outside of life sciences

39:50 acquisition strategy

44:43 spaces for innovation in R&D

Jacob sits down with Insitro CEO Daphne Koller to discuss founding Coursera, where and how ML can drive the most impact in drug development, and if foundation models can transform core drug discovery work and edtech.

 

00:00 intro

00:59 Daphne’s journey

09:02 AI and biology discovery

10:42 insitro vs. traditional pharma

19:47 phenotyping patients

25:44 early mistakes

29:34 the future of data

35:16 partnering with larger pharma companies

38:00 impact of LLMs on biopharma

43:47 over-hyped/under-hyped

00:00 intro

01:08 James’ background

04:39 regulation of AI medical devices

14:43 impact of foundation models on healthcare

19:41 the future of cancer detection

23:47 real-world control arms

35:18 AI drift

37:42 over-hyped/under-hyped

40:03 most surprising AI interaction 

Jacob and Nikhil sit down with Dr. Ezekiel Emanuel and discuss his reflections on his “Why I want to Die at 75” piece, how publishing/financial incentives harm research, doctors' increasing social isolation and his love of chocolate-making.

Jacob sits down with HumanFirst CEO Andy Coravos and Orchestra CEO Ashoka Rajendra to discuss at home data collection in trials, Andy being an EIR at the FDA, why Benchling has been so successful and more.

Andy Slavitt, former Optum EVP, head of CMS, COVID advisor and healthcare.gov saver joins Nikhil and Jacob to discuss public/private sector collaboration, Optum’s evolution, and his lessons on communication from COVID. Andy also shared his career journey, what he would do if he was running United today and how the private sector can work better with the public sector.

Jacob and Nikhil sit down with Mike Kopko, CEO and co-founder of Pearl Health to discuss Pearl’s care model and what it’s been like building the company as ACO Reach evolved. Mike also shares some great stories negotiating claims in the early days of Oscar.

Jacob and Nikhil sit down with Dr. Vivek Garg, the Chief Medical Officer & SVP, Primary Care at Humana; Chief Medical Officer at both CenterWell and Conviva; and a former clinical leader at CareMore, Oscar, and One Medical. They discuss Vivek’s insights around primary care, value-based care, and more.

 

(0:00) intro

(0:52) how different care models compare

(7:28) best areas to outsource

(11:15) where are we in the adoption of value-based care?

(14:40) how do we get hospitals on board with value-based care?

(19:38) payer acquisition of provider assets

(22:42) payers vs. providers

(25:18) something Vivek thought would work that didn’t

(26:43) AI in healthcare

(29:29) ambient clinical documentation

(33:59) over-hyped/under-hyped

(35:59) another company Vivek would want to run

 

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

Jacob and Nikhil sit down with Dr. Jeffrey Kang, CEO of WellBe Senior Medical, and former President of ChenMed, SVP Health and Wellness Solutions at Walgreens, CMO at Cigna, CMO at CMS and CEO of Urban Medical Group. They discuss risk adjustment, retailers in healthcare and how healthcare has/hasn't changed since his work doing risk-based care for complex patients and at CMS in the 80s and 90s.

Jacob and Nikhil sit down with Naomi Allen, CEO and founder of Brightline (child and teen focused mental health company that’s raised >$100M) and Castlight/Livongo exec. They discuss the difficulties of balancing employer customers and employee satisfaction at Castlight, how Livongo captured member delight and Brightline's care model.

Jacob sits down with Geisinger CEO Dr. Jaewon Ryu to discuss how he and Geisinger think about their Fresh Food Farmacy, population-wide DNA sequencing efforts, and transforming medical education.

Jacob sits down with Homeward Health CEO and former Castlight and Livongo CMO Dr. Jenny Schneider to discuss solving provider shortages in rural markets, how tech can/can’t help care and what Livongo did to make coaching more effective.

Jacob and Nikhil sit down with Tomorrow Health CEO and former Oscar Texas GM Vijay Kedar to discuss lessons he learned at Oscar, reflections on the ACA market, the nuances of operationalizing at home care and what Tomorrow is building.

Jacob and Nikhil discuss annual health-tech predictions and are then joined by Thyme Care co-founders Robin Shah and Dr. Bobby Green to discuss the nuances of taking risk in oncology, lessons on selling to providers, and what they're building at Thyme Care. 0:00-9:10 Jacob & Nikhil discussion 9:13-end Thyme Care founders interview with Robin Shah and Dr. Bobby Green

Jacob sits down with Chris Gibson, the co-founder and CEO of Recursion, to discuss how Recursion predicted drugs that would be effective for COVID, his take on different techbio business models, what pharma R&D will look like in 25 years and more.

Jacob sits down with Dr. Arif Nathoo, the CEO of Komodo Health (most recently valued at $3.3B) to discuss Komodo’s journey from a single app to a platform, why EHR data is overhyped and where healthcare data is headed.

Jacob and Nikhil sat down with Dr. Bob Kocher, the Venrock partner who helped write the Affordable Care Act while in the Obama administration to discuss how health systems will increase productivity, what drives healthcare costs, and his reflections on the ACA.

Jacob and Nikhil sit down with Carbon Health CEO and founder Eren Bali to discuss Carbon Health's evolution, how he thinks about Carbon Health's tech, partnerships and expansion and what policy changes he thinks would improve healthcare.

Jacob and Nikhil sit down with Virgílio (“V”) Bento, Founder and CEO of Sword Health, the $3 billion company focused on improving pain management. They discuss Sword’s new AI care model, the evolution and key decisions behind Sword’s success, customer acquisition, and more.

 

(0:00) intro

(1:15) Sword’s journey

(9:13) advice on selling to employers

(16:45) getting employees to use the product

(18:41) building Phoenix, an AI care model

(22:50) limitations of Phoenix

(31:17) Sword’s org structure

(33:56) less successful ventures for Sword

(36:23) working with brokers

(39:01) international opportunities

(42:12) over-hyped/under-hyped

(42:37) parts of the U.S. healthcare system that don’t make sense

(44:23) flying across the world for dinner with Vinod Khosla

(46:57) decisions that were instrumental to Sword’s success

 

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

Jacob and Nikhil sit down with Dr. Sachin Jain to discuss operating as a non-profit, competing in Medicare Advantage and when PE/VC backing doesn’t make sense. He also shared some hot takes on new people entering healthcare and the importance of health systems in driving the move to value-based care.

Jacob sits down with Seema Verma to talk about rapid policymaking during COVID, recent drug pricing legislation, her reflections on her time at CMS and what areas of tech she's most excited about.

Jacob sits down with Nikhil Krishnan, founder of Out of Pocket, to discuss his path to becoming a healthcare meme king and the community he's building to get more people into healthcare and make it easier to start health tech businesses. They also hit on Nikhil’s thoughts on physician payment, big tech in healthcare and more.  

Jacob sits down with Lucia Huang, co-founder and CEO of Osmind, to discuss new psychedelic and neuromodulation mental health treatments, how Osmind is furthering research around them, and what’s next for the space.

Jacob sits down with Brad Smith, founder of CareBridge, Main Street Health and Aspire and former head of CMMI, to discuss the novel ways he’s bringing risk-based models to rural healthcare and Medicaid and hear why he thinks CMMI programs haven’t worked to date.

Jacob sits down with Dr. Tom Lee founder of One Medical, Galileo and Epocrates. They discuss Amazon’s $3.9B acquisition of One Medical, what Tom’s building at Galileo and the future of medical education.

Jacob sits down with Dr. Mandy Cohen - former Secretary of North Carolina’s Department of Health and Human Services, COO of the Center for Medicare & Medicaid Services and current CEO of Aledade’s newest business line Aledade Care Solutions. They discuss her work in North Carolina around Social Determinants of Health, how Medicaid policy and innovation works, the new business line she’s building at Aledade and what’s required for primary care practices to succeed under risk.

Jacob sits down with Adam Boehler - former CEO of Landmark Health, Head of the Center for Medicare and Medicaid Innovation and current CEO of Rubicon Founders. They discuss how building a value-based care business has changed, how Adam came up with the idea for Landmark and his other businesses, what makes different patient segments a fit for value-based models and where the space is headed. They also touch on Adam's hopes for future policy and the changes he’s seen in healthcare talent.

Jacob and Nikhil sit down with Dr. Atul Butte, a professor at UCSF, Chief Data Scientist of the UC Health System, and a co-founder of numerous healthcare startups. They discuss Dr. Butte’s takes on healthcare AI opportunities, challenges, hype, and more.

 

(0:00) intro

(0:31) AI hype through the years

(5:44) when LLMs don’t work

(8:42) when LLMs surpass humans

(11:07) AI adoption timeline

(13:22) converting skeptical doctors

(20:30) commercialization in AI

(24:15) how will AI change med school?

(33:28) regulating consumer-facing AI apps

(44:08) over-hyped/under-hyped

(45:44) coolest AI demos

(47:06) what company would Atul want to run?
 

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

Jacob and Nikhil sit down with Dr. David Shulkin, the former Secretary of Veterans Affairs who has also held roles as CMO of the University of Pennsylvania Health System, CEO of Beth Israel Medical Center, and Vice Dean of the Drexel University College of Medicine. They discuss David’s experiences innovating within the VA, meeting the health needs of a population, and more.

 

(0:00) intro

(0:34) footprint of the VA today

(2:38) privatization debate

(5:36) solving access to healthcare for veterans

(12:29) setting priorities as a leader

(19:34) monolithic single-payer funding

(23:41) what does the rollout of a massive EHR look like?

(32:44) things that the VA does well

(38:35) startups having success in the VA

(41:26) how will the medical education system change going forward?

(44:51) applications of AI in healthcare

(48:23) over-hyped/under-hyped

(49:20) what company would David want to lead?

 

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

Jacob and Nikhil sit down with Jean-Charles Samuelian-Werve, Co-Founder and CEO of Alan. Alan is a multi-billion dollar French health insurance company that has expanded to become an all-in-one health platform for its consumers. They discuss Alan’s product strategy and business model, building AI for healthcare companies, what healthcare looks like in Europe, and more.

 

(0:00) intro

(0:47) French healthcare 101

(6:30) similarities with Oscar 

(9:50) building a healthcare super-app

(15:11) medical loss ratio

(21:58) contracting with providers

(29:29) optimizing Alan for different countries/continents  

(35:08) finding new users

(38:17) AI in healthcare

(48:31) over-hyped/under-hyped

(50:36) healthcare policy changes Jean-Charles would make in France

 

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

Jacob and Nikhil sit down with Malay Gandhi, Head of Strategy & Corporate Development at Benchling. Malay previously served as CEO of Rock Health and SVP of Business Operations at Evidation Health, and his seminal pieces helped shape early digital health thinking. They discuss some of Malay’s early pieces, the future of life sciences & real-world evidence, building & scaling software at Benchling, and more.

 

(0:00) intro

(0:58) how Malay feels about his old essays

(8:00) the Benchling story

(16:29) serving customers in different industries

(22:12) how will AI change Benchling

(29:49) the state of tech in biopharma

(38:41) the real-world experiment

(42:04) have trial designs changed?

(46:24) over-hyped/under-hyped

 

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

Jacob and Nikhil sit down with Will Stokes, Co-Founder and Chief Growth Officer of Strive Health, a pioneer in value-based care that partners with payers and providers to care for patients with chronic kidney disease. They discuss the nuances of risk-based contracting, value-based models for specialists, selling to both payers and providers, and more.

 

(0:00) intro

(0:39) when do risk-based models make sense

(8:50) surprises when building Strive

(13:53) negotiating risk-based contracts

(21:08) primary care for patients with specialized conditions

(30:28) approaching risk-adjustment changes

(34:35) using LLMs at Strive

(38:44) when does it make sense to incubate a company?

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