After building and selling Meebo, Seth Sternberg wanted his next venture to transform lives at scale. A decade later, Honor has become the world's largest in-home senior care network, delivering care to 35,000 US homes daily. In this candid conversation, Sternberg reveals how AI saved the company from near collapse in 2015 and why treating caregivers like true professionals creates better outcomes for everyone.

We cover:

🏠 How Honor grew from a "shed startup" to a $2B global care network

🤖 Why AI was the key to solving home care's scaling problem - and how they use 22 different AI models today

👥 The surprising truth about what really drives caregiver retention (hint: it's not hourly wages)

💼 Why they switched from contractors to W2 employees in the first 6 months

🔍 How "revealed preferences" help match caregivers with the right clients

🌐 The dramatic differences in home care models across countries

🚀 Their vision for expanding beyond basic care to solve food, medication and other challenges for aging adults

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About our guest:

Seth Sternberg is the Co-Founder and CEO of Honor, a non-medical home care company with a mission to enable our parents to remain in their homes as they age. Prior to Honor, Seth was the Co-Founder and CEO of Meebo, which brought instant messaging to the web and reached close to half the internet population in the United States. Meebo was acquiredby Google, where Seth became a Product Director working on the Google Identity Platform, and then within GoogleX. Seth started his career with IBM’s Corporate Development group after graduating from Yale.

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"There's been a degree of toxic positivity in US healthcare," says Dr. Sachin Jain, CEO of SCAN Health Plan. In this episode about healthcare's need for radical change, Dr. Jain challenges industry orthodoxy and calls for a leadership revolution. From Medicare Advantage turbulence to the failures of healthcare consolidation, he offers an insider's view of what needs to change.

We cover:

🔄 Why healthcare needs to move beyond "toxic positivity" and incremental improvements toward real transformation

⏰ The fundamental flaw in value-based care: measuring outcomes in one-year increments when real health improvements take decades

💰 Medicare Advantage's current challenges, including benefit cuts, market exits, and controversial star ratings

🏥 Why healthcare consolidation has failed to deliver better outcomes and may be driving clinician burnout

🏠 How SCAN's "12 angry seniors" sparked a movement to help people age at home, and why that mission remains relevant today

⚡ The need for a new generation of healthcare leaders willing to think big instead of being trained to be incrementalists

🔑 His advice for the new administration

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About our guest:

Sachin H. Jain, MD, MBA is President and CEO of SCAN, where he is charged with leading the organization’s growth, diversification, and emerging efforts to reduce healthcare disparities. SCAN’s revenues top $4.3 and the organization serves 300,000 patients. Under his leadership, SCAN has grown its revenues by more than $1B.

Previously, Dr. Jain was President and CEO of CareMore and Aspire Health, innovative care delivery systems with > $1.6B in revenues serving 200,000 Medicare and Medicaid patients and 2500 associates in 32 states. He pioneered the first clinical program in the world focused on social isolation. Dr. Jain is also an adjunct professor of medicine at the Stanford University School of Medicine and a contributor at Forbes.

Prior to joining CareMore, Dr. Jain was global Chief Medical Information & Innovation Officer at Merck & Co. He contemporaneously served as an attending physician at the Boston VA-Boston Medical Center and a member of faculties at Harvard Medical School and Harvard Business School. From 2009-2011, Dr. Jain worked in leadership roles at the US Department of Health and Human Services, where he was senior advisor to the administrator of the Centers for Medicare & Medicaid Services (CMS). Dr. Jain was the first acting deputy director for policy and programs at the Center for Medicare and Medicaid Innovation (CMMI). He also served as special assistant to the National Coordinator for Health Information Technology.

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Thank you to medical school student Eric Shan for help preparing this episode!

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Twenty years before value-based care became a healthcare buzzword, Rushika Fernandopulle was told he had to choose: be a doctor or join "the dark side" of business. Instead, he chose both – building Iora Health from a bootstrapped startup into a billion-dollar healthcare company. In this candid conversation, Fernandopulle reveals the unconventional journey that helped transform American healthcare, from midnight meetings in Las Vegas speakeasies to breaking every rule in the traditional medical playbook.

We cover:

💡 How bootstrapping for 7 years shaped Iora Health's success

🛫 The "Southwest Airlines Theory" of healthcare transformation

💰 The midnight meeting that led to a $4M investment from Zappos' Tony Hsieh

🔄 Why the employment-insurance link needs to break for real healthcare reform

🏢 The challenges tech giants face in transforming healthcare

💪 Why refusing to take "no" for an answer is Rushika's entrepreneurial superpower

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About our guest:

Rushika Fernandopulle is a practicing physician and former Chief Innovation Officer of One Medical, a leading Advanced Primary Care company based in San Francisco, CA. Before this, he was co-founder and CEO of Iora Health, was the first Executive Director of the Harvard Interfaculty Program for Health Systems Improvement, and Managing Director of the Clinical Initiatives Center at the Advisory Board Company. He is a member of the Albert Schweitzer, Ashoka, Aspen, and Salzburg Global Fellowships, and is co-author or editor of several publications. He serves on the staff at the Massachusetts General Hospital and on the faculty of Harvard Medical School. He earned his A.B., M.D., and M.P.P. from Harvard University, and completed his clinical training at the University of Pennsylvania and the Massachusetts General Hospital.

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It’s in our water, our food, and so many other products we use on a daily basis, from non-stick pans to popcorn bags. And it’s making us really sick.

More and more scientists are becoming concerned that PFAS chemicals, also known as “forever chemicals,” are impacting human health. Evidence is growing that links these everyday exposures, particularly to endocrine-disrupting chemicals (or EDCs), are linked to cancer, infertility, birth defects, asthma, allergies, cardiovascular disease, diabetes, obesity, and more.

In this episode, we talk to one of the world’s leading environmental health scientists and advocates about the impact of forever chemicals and what we can do about it. Arlene Blum is the founder and executive director of the Green Science Policy Institute. This is a replay from 2022.

We cover:

🧪 What are PFAS and why do they exist?

🔄 How do forever chemicals get into our bodies, and why does it matter?

👕 Her work in the 70's getting the gene-altering agent Tris, known to cause cancer, banned from the use in children's pajamas

⚖️ Why policymakers are so slow to take action

🛡️ How to keep yourself safe from forever chemicals

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About our guest:

Arlene Blum, PhD, biophysical chemist, author, and mountaineer, is a Research Associate in Chemistry at UC Berkeley and executive director of the Green Science Policy Institute. The Institute’s scientific research and policy work with government and business has contributed to preventing the use of “Six Classes” of harmful chemicals, including flame retardants and fluorinated chemicals, in children’s sleepwear, furniture, electronics, and other products worldwide.

Arlene Blum led the first American—and all-women’s—ascent of Annapurna I, considered one of the world’s most dangerous and difficult mountains, co-led the first women’s team to climb Denali; completed the Great Himalayan Traverse across the mountain regions of Bhutan, Nepal, and India; and hiked the length of the European Alps with her baby daughter on her back. She is the author of Annapurna: A Woman’s Place and Breaking Trail: A Climbing Life.

Blum’s awards include her 2018 induction into the California Hall of Fame, 2017 UC Berkeley International House Alumna of the Year, 2015 award for lifetime achievement of a Reed College graduate, selection by the UK Guardian as one of the “World’s 100 Most Inspiring Women”, National Women’s History Project selection as one of 100 “Women Taking the Lead to Save Our Planet,” selection as an American Association for the Advancement of Science Fellow, and election to the Hall of Mountaineering Excellence.

Arlene Blum received her PhD in Biophysical Chemistry from UC Berkeley and has taught at UC Berkeley, Stanford University, and Wellesley College. More information at www.greensciencepolicy.org and www.arleneblum.com

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What's the boldest company in healthcare? In our last Digital Health Download of the year, Halle and Steve stumble over the answer to this question and break down the latest healthcare headlines and what they mean for our sector.

We cover:

🤖 Why AI chatbots outperformed doctors in diagnosis - and what it really means for the future of medical practice

🚀 Amazon's entry into primary care and what it means for Hims & Hers

💊 The latest on GLP-1s: From Walmart's earnings impact to Medicare coverage proposals

📱 The extension of telehealth prescribing rules and what it means for digital health companies

📊 New evidence showing the ROI of addressing social determinants of health and why politics shouldn't override data

🏥 Forward Health's sudden shutdown and what it teaches us about healthcare disruption versus incrementalism (listen to Adrian on the show last year here)

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Technology is transforming genetic testing and bringing hope to families facing rare diseases. In this episode, GeneDx (Nasdaq: WGS) CEO Katherine Stueland sits down with Steve Kraus to share how AI is being used to crack life's most complex code and speed up diagnosis from years to days.

We cover:

🧬 The evolution from single-gene testing (remember BRCA?) to whole genome sequencing, and why the Supreme Court's decision to ban gene patents changed everything

🔬 How 1 in 10 Americans has a rare disease, yet the path to diagnosis traditionally takes 6-8 years

💪 How parents become "honorary PhDs" in their children's rare conditions and how this drives research forward

🤖 With only 1,500 medical geneticists nationwide, AI can help bridge the expertise gap

💰 The shifting landscape of insurance coverage and why states are starting to see the value of early genetic diagnosis

📊 How GeneDx built the world's largest rare disease database (700,000 clinical exomes and counting) and what that means for future drug development

👩‍💼 Katherine's journey from communications major to CEO, and why having more women leaders matters in healthcare

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Shortcuts:

00:00 Introduction and Overview

01:29 Advancing Diagnoses for Rare Diseases

06:33 The Evolution of Genetic Testing

10:44 The Cost and Coverage of Genetic Testing

21:55 The Role of AI in Genomics and Genetic Testing

29:43 From Communications to CEO: Katherine's Journey

35:23 Promoting Gender Equality in the C-Suite

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About our guest:

Katherine Stueland has dedicated her career to revolutionizing healthcare with patient-centered business approaches. Instrumental in obtaining FDA approval for breakthroughs like the first protease inhibitor for HIV/AIDS and pioneering cancer immunotherapy, she champions the integration of genomic data for precision diagnostics in rare diseases and cancer. As President and CEO of GeneDx (Nasdaq: WGS) since June 2021, she is at the forefront of transforming healthcare through the Company’s industry-leading exome and genome testing. Previously, as Chief Commercial Officer of Invitae (NYSE: NVTA), she elevated the brand to a market cap of over $6 billion.

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🤗 In this bonus episode, pharmacoeconomist Yoona Kim, co-founder and CEO of Arine, talks about tackling the $530 billion problem of medication mismanagement. She shares her approach to optimizing medication therapy using data science and clinical expertise.

We cover:

💊 The shocking scale of medication-related problems and their impact on patient health and healthcare costs

🛢️ How data silos and time constraints in healthcare contribute to dangerous medication errors

🌐 The use of AI and machine learning in predicting and preventing medication-related issues

⚖️ Balancing cost optimization with clinical appropriateness in medication recommendations

🚧 The challenges of integrating with existing healthcare systems and winning provider trust-

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About our guest:

Yoona Kim is the Founder & CEO of Arine, an AI-driven SaaS platform company focused on medication intelligence that grew 100% last year, and has produced more than 33 million life-improving recommendations for over 15 million patients. Prior to Arine, she was the Head of Clinical Modeling and Analytics at Proteus Digital Health. She was responsible for health economic and clinical implementation activities for Proteus Digital Health. Her team developed health economic value propositions from strategic conceptualization to business case development to actualization in the real-world.

Yoona holds a Bachelor's Degree from Stanford University, a PharmD with an emphasis in health policy and management from the University of California, San Francisco and a PhD in health economics and outcomes from the University of Texas at Austin.

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Despite heart disease being the leading cause of death in the United States, cardiovascular care has been an overlooked opportunity in digital health. With 1 in 3 Americans facing cardiovascular disease in their lifetime, how can innovation help turn the tide?

In this episode, we explore heart health in the digital age with Dr. Jeff Wessler, cardiologist and founder/CEO of Heartbeat Health, the nation's largest virtual-first cardiovascular company.

We cover:

⌚If we can trust cardiovascular data from wearable devices (and what doctors call “Apple Heart Syndrome”)

🔢 The difference between “heart age” and “chronological age”

🤨 Why he’s skeptical of the remote monitoring market

❣️ The impact of stress on heart health and the role of inflammation

⚖️ Why he believes GLP-1s are the best heart drugs that have ever existed

🩺 Practical tips for listeners to improve their cardiovascular health (including the important but often-overlooked LPA test)

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About our guest:

Dr. Jeff Wessler is a Cardiologist and the Founder and CEO of Heartbeat Health, the nation's largest virtual-first cardiovascular company. Dr. Wessler graduated from Williams College, received an MPhil in public health and epidemiology from Cambridge University, and his MD from Harvard Medical School.

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Make America Healthy Again?

It's official— Trump was elected as our 47th president and plans to use his second term to "go wild on health." For this special episode, Aneesh Chopra, former U.S. Chief Technology Officer and author of Innovative State: How New Technologies can Transform Government, joins Steve to talk about what we can expect in Trump's second term.

We cover:

🔮 The future of the Affordable Care Act

💻 What a privatized version of Healthcare.gov could look like

🤝 The potential for value-based care to thrive in a bipartisan environment

♀️ The challenges facing women's health and reproductive rights

👵 How Medicare Advantage is facing significant financial and outcome challenges

🏆 Who will be the winners and losers of the next four years

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About our guest:

Aneesh Chopra advocates for interoperability and data-driven approaches that help providers, payers, and employers make smarter decisions to succeed in the shift to value-based care.

Chopra’s influence and leadership in technology includes extensive experience in the public sector. He served as the first U.S. Chief Technology Officer under the Obama Administration, where he spearheaded initiatives to modernize the nation’s healthcare system using electronic health records and health information exchanges. These efforts strengthened the data infrastructure used in healthcare delivery reform, ultimately helping the industry progress toward a more connected and efficient healthcare ecosystem.

Chopra also served as Virginia’s Secretary of Technology under Governor Tim Kaine, where he championed the growth of the state’s technology sector, enhanced educational opportunities through technology, and drove innovation in government operations. As a public servant, Aneesh fostered better public-private collaboration, a theme central to his 2014 book, “Innovative State: How New Technologies Can Transform Government.”

Chopra’s significant contributions to the fields of technology and healthcare have cemented his reputation as a forward-thinking leader committed to leveraging technology for the public good. He’s been recognized by Modern Healthcare as one of the 100 Most Influential People in Healthcare and one of the top 25 "Doers, Dreamers, and Drivers” by Government Technology magazine.

Chopra serves on the boards of IntegraConnect, Virginia Center for Health Innovation, and the George Mason Innovation Advisory Council. He earned his master’s degree in public policy from Harvard Kennedy School and holds a bachelor’s degree in health policy from Johns Hopkins University.

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Keep up with healthcare news in under an hour with our monthly Digital Health Download! We can't believe it's already November. In this episode, we cover the biggest headlines of October:

📝 Findings from Bessemer's State of Health Tech 2024 Report

🤝 Take-aways from the 2024 HLTH Conference

📊 New “AI services as software” benchmarks

😵‍💫 How election season is causing stress and anxiety

⚖️ New data on cost savings for ACOs

💊 Walmart plans to deliver prescriptions in as little as 30

💻 Oracle replacing Cerner with a new AI health record

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