Vital Signs with Jacob Effron and Nikhil Krishnan

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/

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/