Vital Signs with Jacob Effron and Nikhil Krishnan

Jacob sits down with Dr. Angela Fitch, the Founder and CMO of knownwell. knownwell has raised $25 million from investors like a16z and Flare Capital Partners to provide weight-inclusive primary care and metabolic health care. They discuss the future of obesity care, where we are with GLP-1s, the need to expand coverage, and more.

[0:00] Intro

[1:06] Current State of Obesity Medicine

[2:47] The knownwell Approach

[6:06] Challenges in Obesity Treatment

[7:23] The Future of Obesity Medication

[12:40] Insurance and Access Issues

[32:19] Supply Chain and Distribution

[35:38] Final Thoughts and Resources

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

Jacob and Nikhil sit down with Parth Mehrotra, CEO of Privia Health. Privia is a physician enablement platform partnering with 4500+ providers towards practice improvement and value-based care. They discuss the most important ways to manage risk, building effective physician enablement solutions, the future of value-based care programs & contracts, and more.

[0:00] Intro

[0:55] Privia's Business Model and Footprint

[3:26] Physician Choices and Privia's Role

[6:06] Evolution of Value-Based Care

[8:42] Future Role of Payers in Healthcare

[10:48] Choosing Geographic Markets for Expansion

[11:53] Physician Enablement Market Dynamics

[15:02] Influencing Practice Processes Without Ownership

[18:52] Evaluating Value-Based Programs

[21:47] Capabilities Needed for Risk-Based Contracts

[24:28] Risk Pooling and Healthcare Economics

[28:31] Future of Value-Based Care

[31:40] Primary Care and Specialist Roles

[36:18] Commercial vs. Medicare Value-Based Care

[39:30] AI in Healthcare: Current and Future Applications

[43:02] Quickfire

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

Jacob and Nikhil sit down with Bryony Winn, President at Carelon Health. Carelon is the diversified services business within Elevance Health (formerly Anthem), serving 1 in 3 Americans through advanced primary care, behavioral health, specialty enablement, and whole health solutions. They discuss what payers are thinking about, making value-based care work, creating effective provider partnerships, and more.

[0:00] Introduction to Vital Signs Podcast
[0:41] Understanding Elevance Health and Carelon
[1:49] The Future of Healthcare Integration
[2:57] Carelon's Strategy and Partnerships
[3:47] Navigating Healthcare Transitions
[5:22] Lessons from Healthcare Partnerships
[8:10] The Role of Value-Based Care
[9:55] Innovations and Challenges in Healthcare
[21:59] The Commercial Healthcare Landscape
[25:00] Cross-Business Initiatives and Medicaid Innovations
[28:15] The Impact of Generative AI in Healthcare
[32:32] Quickfire

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

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 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 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 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. 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/